Inspection on 16/12/05 for Greengate Lodge

This inspection was carried out on 16th December 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Greengate Lodge 26/01/08

Greengate Lodge 02/06/06

Greengate Lodge 29/06/05

Greengate Lodge 21/01/05

Greengate Lodge 02/08/04

Greengate Lodge 24/02/04

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

CARE HOMES FOR OLDER PEOPLE Greengate Lodge Greengate Lodge Cave Road Plaistow London E13 9DX Lead Inspector Lea Alexander Unannounced Inspection 16th December 2005 09:45 X10015.doc Version 1.40 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 Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 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 Older People. 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. Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Greengate Lodge Address Greengate Lodge Cave Road Plaistow London E13 9DX 020 8430 2000 020 8548 0193 farouk.ruhomally@newham.co.uk 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) London Borough of Newham Mr Farook Ruhomally Care Home 33 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0), Physical disability (0) of places Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th June 2005 Brief Description of the Service: Greengate Lodge is a thirty-three bedded residential home providing care for older people in Newham. The home is owned and run by the London Borough (LB) of Newham. Twenty-four beds are available for permanent service users and seven for respite care. The home is currently arranged to deliver care to service users in four different units. The Abbey unit provides care for more independent older people. The Dundee unit provides care for older people with mental health support needs. The Emotan and Roshni units provide culturally specific residential care for older people from the African Caribbean and Asian communities respectively. The home is a purpose built dwelling on one level. There are thirty-one single rooms and one double. All rooms have their own en-suite facilities. The home has a central courtyard with protected pond and there are additional patio areas with outdoor seating. The home is located in a residential area in Plaistow, close to shops and amenities. A range of nearby bus routes can be easily accessed. The nearest underground stations are Plaistow and Upton Park on the District Line. The home has a small car park and unrestricted street parking is available. Since the last inspection the Registered Manager has been temporarily seconded to other duties and a temporary manager has been appointed and is in post. Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this inspection over the course of a morning. The main focus of the inspection was review the progress made with the thirteen requirements and four recommendations made at the last inspection. The Inspector met privately with the acting manager, a residential support worker and three service users. In addition service users personal files and other relevant paperwork was sampled and the premises toured. The Inspector would like to thank service users and staff for their assistance whilst conducting this inspection. What the service does well: What has improved since the last inspection? The home has satisfactorily addressed a number of requirements since the last inspection. Staff meetings are held more regularly, as are service users meetings on two of the units. The home offers a range of social and cultural activities to meet the diverse needs and interests of its service user group. Since the last inspection the activities co-ordinator has received training to support them with this role. Staffs have received manual handling and adult protection refresher training since the last inspection. The homes health and safety practises with regard to food labelling have improved, and a current portable appliance-testing certificate was available. The homes visitors’ policy has been revised to include guidance to visitors on supervising their children on site. The majority Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 6 of repairs and maintenance issues identified at the last inspection have been completed. 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. Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Service users express the opinion that they are happy and well looked after within the home. EVIDENCE: The Inspector sampled the personal files of four service users, one from each of the homes units. The Inspector noted that one service user had been occupying a respite bed for 18 months whilst a dispute regarding their longterm care is settled. The Inspector noted that the personal file and individual plan contained very little information relating to this service user. Service users spoken to by the Inspector said that they were “very happy” living at the home and that staff “were very helpful”. Key standard 6 was not inspected on this occasion. It was inspected on the 29th June 2005 and assessed as met. Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 & 9. Service users individual plans do not address all areas of their health and social care and are not reviewed on a monthly basis. Staffs provide assistance with personal care in a respectful and dignified manner and this is reflected in some service users individual plans. EVIDENCE: The Inspector viewed three service users individual plans and found that they were not being reviewed on a monthly basis. One care plan had revised following a review in June 2005. A second service users individual plan had been developed in February 2005 and there was no evidence of subsequent review. A third service users individual plan developed in November 2004 had been annotated to indicate review of some elements of the plan in November 2005, but continued to omit details of this service users self medication as required by the previous inspection. It was not evidenced from the individual plans sampled that service users or their representatives had signed or participated in the development of Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 10 individual plans. Two of the individual plans sampled did not have a risk assessment completed. The Inspector noted that the review of one service users individual plan had resulted in the development of detailed information in the actions to be taken by care staff to support them with bathing. Discussion with the acting manager evidenced that a system to promote the monthly review of individual plans had been developed and was in the process of being piloted in one of the units. The Inspector met with one service user who is currently self-medicating. The Inspector noted that whilst they had been provided with a lockable cabinet in which to keep this, they found it more convenient to store their medication in another cupboard that was not lockable. One service user spoken to by the Inspector said that “staff help me how I want them too”. Another service user described the staff as “helpful with everything”. Key standards 8 and 10 were not inspected on this occasion. They were inspected on the 29th June 2005 and assessed as met. Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12. The home recognises and attempts to address the diverse cultural, religious and social interests and needs of service users. EVIDENCE: The events diary of the previous month indicated that various Christmas events had been organised including several parties and Christmas carol events. In addition there had been a trip to a local shopping centre and regularly scheduled visits by the mobile shop and hairdresser. Discussions with service users evidenced that appropriate events had also been organised for recent Diwali and Eid celebrations. The acting manager advised that regular art, exercise and reminiscence groups are run within the home and that an external facilitator had provided some training to the activities co-ordinator. The acting manager also stated that training with regard to activities could be offered to other staff members over coming months. A previous recommendation to develop individual service users activity assessments and action plans remains outstanding. During discussion with the Inspector the acting manager advised that these tools are in development and should be introduced in the near future. Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 12 At present outside of the respite unit units are organised along loose cultural associations. The Emotan unit accommodates service users from an African Caribbean background and Roshni accommodates service users from an Asian background. The Inspector is of the view that the home will need to develop and review this approach in the future. At present the Roshni unit accommodates service users from three different religions with no shared first language. The most recently admitted service user is of Turkish origin. An increasing diversity amongst loose cultural groupings seems likely in view of the local areas cultural make up and the home will need to address this in its future development plans. The Inspector viewed the homes visitors’ policy that is prominently displayed at various locations within the home. This had been amended as recommended by a previous inspection to include guidance on appropriately supervising children during visits. Key standards 13, 14 and 15 were not inspected on this occasion. They were inspected on the 29th June 2005 and assessed as met. Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 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. Service users well being is promoted through the provision of adult protection refresher training. EVIDENCE: The acting manager advised the Inspector that since the last inspection all staff had received adult protection training. The Inspector was also advised that a training record to reflect this occurrence was being developed by one of the residential support officers. Key standard 16 was not inspected on this occasion. It was inspected on the 29th June 2005 and assessed as met. Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Service users benefit from a pleasant and hygienic environment. EVIDENCE: The home is purpose built, and a homely atmosphere is promoted by using the home as four units. Each unit is individually decorated and the hallways between them display pictures representative of the service user group. The home is generally well maintained, and a number of repairs identified by a previous inspection on the 29th June 2005 had been satisfactorily addressed. However, a requirement for the room of the most recently admitted service user on the Roshni unit to have their bedroom wallpaper cleaned and repaired or replaced remains outstanding. The Inspector noted that some of the décor in the communal areas is tired and deteriorating and a programme of planned redecoration should be developed and implemented. Each service user has a private bedroom and access to a communal lounge and dining area. These communal areas are individually decorated and have a Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 15 homely atmosphere. Several service users showed the Inspector their bedrooms and it was noted that each contained a bed, wardrobe, chest of draws, bedside table, armchair and en-suite shower facilities that were wheelchair accessible. Service users are able to personalise their rooms with mementos and pictures. Externally there is a large rock garden with covered pond. The Inspector noted that the premises were clean, hygienic and free from offensive odours. Staff carry out laundry in a self contained area that contains commercial type equipment. The home has separate sluicing facilities. Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30. Service users benefit from staff that have appropriate training and skills. EVIDENCE: The acting manager and residential support officer advised the Inspector that since the last inspection all staff have undertaken manual handling refresher training and that a training log to reflect this is in development. Key standards 27, 28 and 29 were not inspected on this occasion. They were inspected on the 29th June 2005 and assessed as met. Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 37 & 38. The home is appropriately staffed with regular staff meetings being held. The home is not effectively consulting with service users across all units with regard to the day-to-day running of the home. Whilst health and safety practises have improved, failure to record refrigerator temperatures continues to be a shortfall. EVIDENCE: The Commission for Social Care Inspection had been advised in October 2005 that the registered manager had been temporarily seconded to a different post. The LB Newham has drafted an acting manager into the home, and this had also been notified to the Commission. Minutes viewed by the Inspector evidenced that staff meetings had occurred on three occasions so far in 2005. Separate officers meetings for staff in dayGreengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 18 to-day management positions were evidenced as occurring on two occasions in 2005. The Inspector viewed the minutes of service users meetings. These indicate that meetings to consult the views of service users and promote their choices in the day-to-day running of the home occur on Emotan and Roshni units. Records for the Abbey and Dundee units indicate that a meeting has not recently been held. The manager should consider the best forum in which to obtain service users and their representative’s views on these units and evidence this. The acting manager advised that at present the home does not operate its own quality assurance programme although there is corporate LB Newham information available. The Inspector sampled four personal files for service users and found these to generally be in good order. However, the inspector noted that some papers were still not being filed and were loose in the notes. During the site inspection the Inspector viewed the contents of refrigerators on each unit and found the contents were appropriately labelled with start and end dates. However, there were gaps in the temperature recording charts for refrigerators on several units. A copy of the current electrical testing certificate dated July 2005 was produced and found to be in order. Key standards 35 was inspected on the 29th June 2005 and assessed as met. Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 1 X X X 2 3 Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 14 Requirement Appropriate, up to date assessment and needs information must be recorded for each service user. The home must develop the information it records on it service user plans. (1) These must be drawn up with the involvement of the service user and signed by them or their representative. The home must evidence that service user plans are reviewed at least once per month and updated to reflect changing needs. It should also include appropriate information regarding service users who self medicate. Service user plans must include a risk assessment. Version 5.0 Page 21 Timescale for action 31/03/06 2 OP7 15 31/03/06 (2) (3) (4) Greengate Lodge DS0000034843.V272537.R01.S.doc This is a restated requirement. The previous timescale of the 28/12/05 was not met. 3 OP9 13 Self-medicating service users must be provided with an appropriate lockable space in which to keep their medication. This is a restated requirement. The previous timescale of the 28/09/05 was not met. 4 OP19 23 The room occupied by the most recently admitted service user on the Roshni unit must have its wallpaper cleaned and repaired or be redecorated. This is a restated requirement. The previous target of the 28/09/05 was not met. A programme of redecoration for the premises must be developed and implemented. 6 OP33 12 & 24 The home must develop a quality 31/03/06 assurance system to obtain feedback from service users, their relatives, other professionals and stakeholders. The results of these surveys must be published and copies made available to service users and other interested parties, including the Commission for Social Care Inspection. This is a restated requirement. The previous target of the 28/12/05 was not met. Regular service users meetings and consultation must be held to promote their autonomy and choice in the running of the Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 22 31/03/06 31/03/06 home. This is a restated requirement. The previous target of the 28/12/05 was not met. 7 OP37 13, 17 & 18 Service users personal files must be regularly maintained and all necessary papers properly filed. This is a restated requirement. The previous target of the 28/09/05 was not met. The home must develop records to evidence the date and types of training undertaken by staff. 31/03/06 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 2 Refer to Standard OP12 OP12 Good Practice Recommendations The home should start to review and develop its practise for addressing diverse service users cultural needs. Individual activity assessments and action plans should be developed for service users. This is a restated recommendation. Greengate Lodge DS0000034843.V272537.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ 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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