Inspection on 02/08/05 for Greenfields Lodge Residential Care Home

This inspection was carried out on 2nd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Greenfields Lodge Residential... 27/01/09

Greenfields Lodge Residential... 21/03/07

Greenfields Lodge Residential... 19/12/05

Greenfields Lodge Residential... 08/12/04

Greenfields Lodge Residential... 25/06/04

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

CARE HOME ADULTS 18-65 Greenfields Lodge Residential Care Home 152a Stockton Road Hartlepool TS25 5BQ Lead Inspector Stephen Willcock Unannnounced 2 August 2005 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. Greenfields Lodge Residential Care Home B54 S21749 Greenfields Lodge V228644 030805 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Greenfields Lodge Residential Care Home Address 152a Stockton Road Hartlepool TS25 5BQ 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) 01429 232 892 Milbury Care Services Limited Mrs Angela Robertson Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Greenfields Lodge Residential Care Home B54 S21749 Greenfields Lodge V228644 030805 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th December 2004 Brief Description of the Service: Greenfields Lodge is a modern, purpose built single storey building situated in a residential area of Hartlepool. Accommdation is provided in fully furnished single rooms with en-suite facilities. Most areas of the home and gardens to one side are accessible to wheelchair users. The remaining garden to the side of the home is banked. The home is registered to provide personal care and accommodation for up to 10 adults who have a learning disability. Currently accommodation is offered on a short break basis rather than permanent occupancy. Greenfields Lodge Residential Care Home B54 S21749 Greenfields Lodge V228644 030805 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 2nd August 2005 and lasted around 4 hours. Time was spent talking to staff, manager and service users. We looked around the building and at a number of records and documents. The home was very pleasant and the service users who were at the home on the day appeared happy and well cared for. Comments received after the inspection indicated a general satisfaction with the home and the care provided. These comments from service users and their relatives were “It’s a nice place to come and stay”, “excellent care and very friendly staff” and “staff are great and very hospitable. The home is very clean”. There was some concern in relation to passive smoking when staff have a cigarette break, and the effect this may have on service users. Access to the side garden could be made a lot better for wheelchair users as the banked surface restricts its use. The manager said that there were plans to level the garden area in the future. What the service does well: What has improved since the last inspection? Staff training has continued to improve and the number of staff achieving NVQ level 2 in care has risen to above the National Minimum Standard target of 50 of care staff qualified to that level by 2005. Redecoration of the home has been started and staff have contributed to the decorating programme. Greenfields Lodge Residential Care Home B54 S21749 Greenfields Lodge V228644 030805 stage 4.doc Version 1.30 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. Greenfields Lodge Residential Care Home B54 S21749 Greenfields Lodge V228644 030805 stage 4.doc Version 1.30 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 Greenfields Lodge Residential Care Home B54 S21749 Greenfields Lodge V228644 030805 stage 4.doc Version 1.30 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) 1, 2 and 4 The home provides service users with satisfactory information to base a decision about whether to stay at the home. Appropriate assessment of individual service users needs is undertaken. EVIDENCE: A Statement of Purpose was made available to service users and their representatives, enabling informed choice about living at the home. The manager said the Service User Guide was being reviewed to be more accessible to service users. It was noted the service users guide was available in picture form and easy to read. Assessment documents for individual service users were seen to be in place. The documents contained original assessments from social workers and also the homes own assessments conducted prior to admission. Service users visiting the home for short stays are offered the opportunity to stay for tea before deciding to stay at the home. It was noted that service users had stayed at the home regularly, making many return visits. Greenfields Lodge Residential Care Home B54 S21749 Greenfields Lodge V228644 030805 stage 4.doc Version 1.30 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 The care planning system is satisfactory and being further developed. Service users are supported to enhance their lifestyle within a risk assessment framework and are consulted on their personal care delivery. EVIDENCE: Individual service user care plans were looked at and found to be informative and up to date. The manager said the care planning format was under review and that a new system of Person Centred Planning was to be introduced. The manager had introduced an information leaflet with the service users, giving new staff an insight into the service users likes and dislikes and personal care preferences. Service users are invited to attend a residents meeting to air their views and give comment about their stay at the home. The manager said a guest committee may be set up to give service users a say in the way the home is run and to make suggestions about what they would like to see happening in and out of the home. Greenfields Lodge Residential Care Home B54 S21749 Greenfields Lodge V228644 030805 stage 4.doc Version 1.30 Page 10 Service user case files showed that risk assessments were in place for a variety of activities and included specific assessments relating to personal care and everyday activity. Greenfields Lodge Residential Care Home B54 S21749 Greenfields Lodge V228644 030805 stage 4.doc Version 1.30 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 and 14 Service users are provided with a satisfactory range of opportunities for personal development, activity and leisure . EVIDENCE: The manager gave details of how service users are encouraged to develop new skills while staying at the home and talked of one service user who had been given training in the Control of Substances Hazardous to Health. It was encouraging to note that the service user was now able to carry out domestic work one day per week at the home when not staying there for a short stay. There was a range of activities pursued at the home. The manager said there were visits to the cinema, the local marina, access to sportability schemes and karaoke nights at the local pub. The local drama club was also popular. Greenfields Lodge Residential Care Home B54 S21749 Greenfields Lodge V228644 030805 stage 4.doc Version 1.30 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 standard(s) 18 and 20 Service users are given their preferred personal support and procedures are in place to assist a service user to control their medication if requested. EVIDENCE: Information of how service users prefer their personal support to be given was recorded in their personal files and in the document “All about me” that the manager had introduced with the service users help. It was noted that one service user continued to receive the same nursing support they had in the community from their own supporters, and this arrangement was working very well within the home. Examination of medicine administration records found them to be well kept and accurate. Service users who are self-medicating on admission to the home could continue to do so, but the manager said that this would be under the supervision of the staff. The manager was able to outline the homes procedures of risk assessment and monitoring should a service user wish to develop self-medicating skills. Staff at the home had undergone college training in the administration of medication along with the homes policies and procedures on medication and the manager operated a photographic medication recognition file. Greenfields Lodge Residential Care Home B54 S21749 Greenfields Lodge V228644 030805 stage 4.doc Version 1.30 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 standard(s) 23 Arrangements are in place at the home to enable complaints to be investigated and to protect service users from abuse. EVIDENCE: The home had a complaints book and followed a complaints policy and procedure. It was noted that more information could be recorded when a complaint is received to show if the complainant was satisfied with the outcome of any investigation. The complaints policy also needed to be amended to show the current contact details of the Commission for Social Care Inspection. The home operates an adult abuse policy and staff have undertaken training in abuse awareness and the Adult Protection strategy “No Secrets”. The manager was able to outline the procedures to be followed in the event of an adult protection incident arising. Greenfields Lodge Residential Care Home B54 S21749 Greenfields Lodge V228644 030805 stage 4.doc Version 1.30 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 standard(s) 24, 25, 27 and 30 The home provides a safe environment in comfortable surroundings and offers specialist bathing and toileting facilities. Some areas of the gardens are not fully accessible to wheelchair users. EVIDENCE: The home provides spacious accommodation that is generally well maintained and pleasantly decorated. The gardens to both sides of the home are large and offer a pleasant area to sit in the summer months. However, access to one of the areas does present a problem of access to wheelchair users as it is steeply banked. The manager said the issue of access had been discussed with the estates manager to seek improvement. A room has been made available and provided with sensory equipment, mood lighting and comfortable seating, and is well used by service users, wanting to relax or have a short nap. Bedrooms at the home were pleasantly decorated and had the addition of an en-suite. As the home is used for short stay respite, the manager tries to ensure that bedrooms are homely and service users are encouraged to personalise the rooms during their stay according to their needs. Greenfields Lodge Residential Care Home B54 S21749 Greenfields Lodge V228644 030805 stage 4.doc Version 1.30 Page 15 The home provides sufficient toilet and specialised bathing facilities. The home was clean, tidy and free from odour. After the inspection a letter was received from a visitor to the home raising concerns about staff smoking at the home. The concern was in relation to passive smoking and the possible effects on service users. The manager is asked to consider this issue in relation to where and how often staff smoke so that service users are not compromised. Greenfields Lodge Residential Care Home B54 S21749 Greenfields Lodge V228644 030805 stage 4.doc Version 1.30 Page 16 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) 35 and 36 Staff undertake training to enable them to carry out their roles and receive appropriate supervision from the manager. EVIDENCE: Staff training at the home was continuing and, the Learning Disability Awareness Foundation (LDAF) course was being done by all staff. Staff had recently enrolled to complete a 12 week course in the safe handling of medication and studies leading to the achievement of NVQ2 in care were ongoing and some staff members had continued to NVQ level 3 in care. Staff supervision records were in place and sessions were well established and arranged on a regular basis. Greenfields Lodge Residential Care Home B54 S21749 Greenfields Lodge V228644 030805 stage 4.doc Version 1.30 Page 17 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) 39 and 42 Records in relation to Health and Safety are satisfactory and the manager conducts review of the service provided through Quality Assurance methods. EVIDENCE: Quality Assurance monitoring is carried out at the home in the form a questionnaire to service users families and healthcare professionals involved in the service users care. The manager said that frequent meetings are held with relatives to appraise and review the care provided at the home and a monthly magazine from the organisation gives details of events and service users views and opinions. Records of maintenance and fire safety were held at the home and were found to be satisfactory. The manager demonstrated that as far as reasonably practicable the health, safety and welfare of service users, staff and visitors to the home, were maintained. Greenfields Lodge Residential Care Home B54 S21749 Greenfields Lodge V228644 030805 stage 4.doc Version 1.30 Page 18 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 3 3 x 3 x Standard No 22 23 ENVIRONMENT Score x 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 2 3 x 3 x x 2 Standard No 11 12 13 14 15 16 17 3 3 x 3 x x x Standard No 31 32 33 34 35 36 Score x x x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Greenfields Lodge Residential Care Home Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x B54 S21749 Greenfields Lodge V228644 030805 stage 4.doc Version 1.30 Page 19 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 Regulation Requirement Timescale for action 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. 4. 5. 6. Refer to Standard 23 23 24 24 30 37 Good Practice Recommendations The manager should amend the complaint recording process to provide more information as to how the complaint was investigated and its resoution. The manager should amend the complaint information to include the current contact details of the CSCI. The manager should make arrangements for improved access to the gardens by wheelchair users. The manager should develop an action plan showing how magnetic door closers can be fitted to enable wheelchair users easy access and egress throughout the building. The manager should devevop and action plan to control the effects of passive smoking and its effects on service users. The manager should achieve qualifications in management and care at NVQ4 by the end of 2005. Greenfields Lodge Residential Care Home B54 S21749 Greenfields Lodge V228644 030805 stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Darlington Area Office No.1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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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