Inspection on 27/01/09 for Greenfields Lodge Residential Care Home

This inspection was carried out on 27th January 2009.

CSCI found this care home to be providing an Good service.

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... 21/03/07

Greenfields Lodge Residential... 19/12/05

Greenfields Lodge Residential... 02/08/05

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 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Greenfields Lodge Residential Care Home 152a Stockton Road Hartlepool TS25 5BQ two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jane Bassett Date: 2 7 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Greenfields Lodge Residential Care Home 152a Stockton Road Hartlepool TS25 5BQ 01429232892 01429232252 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Milbury Care Services Ltd care home 10 Number of places (if applicable): Under 65 Over 65 10 0 learning disability Additional conditions: Date of last inspection 2 1 0 3 2 0 0 7 A bit about the care home Greenfields Lodge is a modern, purpose built single storey Residential Care Home set in its own grounds and provides residential care services for up to 10 adults in the Category of Learning Disability (LD). Currently accommodation is offered on a short break basis rather than permanent occupancy. The home is located in a residential part of Hartlepool and in easy reach of the town centre and its amenities. The accommodation at Greenfields Lodge comprises of 10 fully furnished single en-suite bedrooms, communal bathrooms, toilets, a large kitchen, two lounges dining room, snoozelium, staff sleep over room and office space. The homes garden areas were fully enclosed and accessible to wheelchair users. There are car parking spaces for visitors and staff to the side and rear of the home. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was an unannounced key inspection. As a key inspection, all of the key standards were looked at or discussed. This was to check that the home meets the standards that the Commission for Social Care Inspection say are the most important for the people who use service, and that it does what the Care Standards regulations say it must. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This inspection was carried out by one inspector. The inspection lasted a total of three and a half hours. During this time the inspector looked at a range of documentation including, service user and staff files. The inspector spoke to one service user, two family members, three staff members, and the manager. The manager of the service completed an Annual Quality Assurance Assessment (AQAA). Three service users, and four staff returned surveys to CSCI. At the time of the inspection the home was providing services to a total of 48 service users. What the care home does well Greenfields Lodge continues to provide a comfortable, safe and caring environment for its service users. People who use the service provided by Greenfields Lodge expressed satisfaction with the care and support that they receive. People said staff are friendly, kind and courteous. The inspector observed good interaction between service users and staff. Staff were seen to meet peoples needs in a relaxed, friendly and respectful manner. Comments received by the inspector included its brilliant, a second home and its loving and caring, I know I am safe. People who use the service were happy with the choice and quality of food provided and thought there was plenty of choice and different things to do. What has got better from the last inspection What the care home could do better Assessments of service users needs and preferences carried out by the home should be reviewed on a more regular basis. A programme of competency checks should be developed to include all staff who administer medication. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Jane Bassett St Nicholas Building St Nicholas Street Newcastle upon Tyne NE1 1NB 0191 2333300 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home has procedures that should ensure that prospective service users have their needs assessed. Evidence: During the visit the inspector examined the files for three people who use the service provided by Greenfields Lodge. Each was found to contain evidence of information gathered by the home prior to that persons admission. During discussion with the manager she was able to describe the process that is followed to obtain information about a prospective service users needs including, an assessment from the care manager if that person is funded by a local authority. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Individuals are involved in decisions about their lives, and play an active role in planning care and support they receive at Greenfields Lodge. Evidence: During the visit the inspector looked at the files for three people who use the service provided by Greenfields Lodge. Each file was seen to contain assessments carried out by staff at the home including activities of daily living, service user preferences and preferred routines. However these had not been reviewed for over a year. Files also contained assessments and information supplied by the local authority funding the care. Records were maintained of the daily life of the individual service user within the home and included information on the various activities the resident had taken part in. A service user who spent time with the inspector described the support and encouragement she receives from the staff to make choices and remain as independent as possible. Information contained in surveys returned to CSCI indicated people are given the choice on how they spend their time during stays at the home. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who use the service are able to make choices about their lifestyles within the home and are supported to develop their life skills. Social, cultural and recreational activities meet individuals expectations. Evidence: People who use the service are offered a range of activities that meet their needs and preferences. Responses in surveys and discussion with service user and family members confirmed this. Activities were arranged for the individual service users or the group as a whole by the home but people could arrange their own activities, if they wanted to. If service users did not want to take part in any activity they did not need to and staffing levels enabled this to happen. Service users continue to attend at day placements during their stay at Greenfields Lodge to maintain contact and engage in activities with their peer groups. People who spent time with the inspector spoke of trips out, bowling, visiting the cinema, restaurants and public houses. Comments received from service users and families included I choose what I want to do and activities are age appropriate. The inspector was told there is an open door policy and families can visit when they wish. Menus are discussed with service users and information is kept on individuals preferences and diets. The menus at the home took account of the likes and dislikes of the residents but kept to a healthy eating programme, wherever possible. Evidence: People who spent time with the inspector or returned surveys to CSCI all expressed satisfaction with the choice and variety of meals provided. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The health and personal care that people receive is based on their individual needs. The principles of respect dignity and privacy are put into practice. Evidence: During the visit the inspector examined the files for three service users. Each were found to contain plans of care and risk assessments in relation to their health and social needs. These documents were reviewed on a regular basis and included information from the service user and their family where appropriate. Each file seen by the inspector contained a booklet that gave a clear pen picture of the individuals preferences in how they wished their care to be given. The home has reviewed its policies and procedures in relation to the use of bed rails as recommended at the previous inspection. Staff have clear written guidance on safe use, risk assessments are carried out for individual service users who require bed rails. Information contained in files indicated service users were receiving support and advice from the appropriate health professionals when necessary. Service users and families who spent time with the inspector or returned surveys to CSCI all expressed satisfaction with how care is given. People said staff were kind and supportive and described the care as the best. Staff who spoke to the inspector were able to demonstrate a good knowledge of individuals needs and how these are met. Staff spoke of promoting individuals privacy, dignity and independence. Information contained in the AQAA returned to CSCI indicated the home has policies and procedures in relation to the safe handling of medication. The inspector was told staff involved in the administration of medication had undergone an appropriate training. The manager told the inspector she was to commence an annual competency check for all staff who administer medication. A sample audit of medication systems found no major concerns with ordering, storage Evidence: and recording. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who use the service are able to express their concerns and have access to a complaints procedure, are protected from abuse and have their rights protected. Evidence: Information in the AQAA returned to CSCI indicated the home has policies and procedures in relation to handling complaints and safeguarding people from abuse. The complaints policy was seen to be accessible to all. Further information in the AQAA indicated the home has not received any complaints in the previous twelve months. Discussion with a service user and family members confirmed people were aware of how to raise any concerns. All those who spoke to the inspector said staff listened and acted on any concerns raised. One person commented its loving and caring, I know I am safe. Staff confirmed they had received training on how to deal with the Protection of Vulnerable Adults. Staff who spoke to the inspector were able to demonstrate through response to questions the action they would take if they became aware of a concern. All demonstrated a commitment to protecting service users from abuse. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment, which encourages independence. Evidence: During the visit the inspector walked around the building. It was seen that the home provides a clean, odour free & homely environment. The manager told the inspector whilst service users stay within the home was for short periods, people are encouraged to bring in personal items. Staff alter the lay out and provision of furniture in bedrooms to meet individuals needs. The home offers a range of communal areas for people to use. These include lounges, dining room and sensory room. One bathroom contains sensory lights and equipment offering a relaxing atmosphere. Garden areas are well maintained and accessible. Information contained in the AQAA returned to CSCI indicated the home and equipment are maintained as required. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service. The home has a recruitment procedure that promotes the safety and wellbeing of service users. Evidence: Service users, families and staff who spoke to the inspector told her there were sufficient staff on duty to meet current care and social needs. A service user and family members who spoke to the inspector told her they were satisfied with the care given. One person stated staff are brilliant, another stated its the best. Information in the AQAA indicated the home has a policy and procedure in relation to recruitment. The inspector examined the file for a staff member most recently recruited. This was found to contain evidence of application, two written references and CRB (Criminal Record Bureau) check. Staff training records seen by the inspector contained evidence that staff have received training including moving & handling, safe handling of medication, first aid, no secrets, fire safety, infection control and food hygiene. Staff have also completed training in introduction to learning disabilities, challenging behaviour, diabetes, autism, downs syndrome and epilepsy. Staff who spoke to the inspector confirmed this. Staff members participate in training using a computer programme (EL box), which staff said had enhanced the training and made it more accessible. Information given to the inspector indicated 12 of the 14 staff had successfully completed NVQ at level 2 or above and the remaining 2 staff were undertaking the training. Records seen by the inspector indicated staff receive regular formal supervision. Staff who spoke to the inspector and those who returned surveys to CSCI confirmed this, and spoke of the support they receive from the manager. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The management and administration of the home is based on openness and respect, has quality assurance systems that should promote the safety and well being of service users. Evidence: Information in surveys returned to CSCI and people who spoke to the inspector told her communication is good. There is an open door policy and regular meetings are held. Comments received by the inspector included Greenfields is the best, it is brilliant and Greenfields is home from home. Another service user stated I am listened to and treated like a grown up. All who spoke to the inspector or returned surveys expressed satisfaction with the care and support they receive. Staff who spoke to the inspector told her the team work well together and supported each other, one person commented on feeling proud to be part of the team. The inspector saw evidence of monthly Regulation 26 visits and reports. The manager carries out a monthly health and safety audit. Accidents were seen to be recorded appropriately, fire alarms are checked weekly and hot water temperatures are checked and recorded on a regular basis. A sample audit of service users monies held by the home found no discrepancies between the amount held and the amount recorded. Information contained in the AQAA returned to CSCI indicated the home has a range of policies and procedures that should promote the safety and well being of service users, and these were reviewed in 2008. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 Assessments of service users needs and preferences carried out by the home should be reviewed on a more regular basis. A programme of competency checks should be developed to include all staff who administer medication. 2 20 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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