Inspection on 12/10/05 for Greengates

This inspection was carried out on 12th October 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Greengates 17/03/09

Greengates 03/10/07

Greengates 10/07/06

Greengates 09/06/05

Greengates 01/02/05

Greengates 19/05/04

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Dalewood Respite Care

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Fairways

Treloar College

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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 Greengates 96 Monkton Street Ryde Isle Of Wight PO33 2DD Lead Inspector Liz Normanton Unannounced Inspection 12th October 2005 09:50 Greengates DS0000012494.V251406.R01.S.doc Version 5.0 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 Greengates DS0000012494.V251406.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 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. Greengates DS0000012494.V251406.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Greengates Address 96 Monkton Street Ryde Isle Of Wight PO33 2DD 01983 564418 01983 564418 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) Islecare `97 Limited Mr Matthew John Perkis Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Greengates DS0000012494.V251406.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th June 2005 Brief Description of the Service: Greengates is a residential home providing care and accommodation for up to five younger adults with learning disability. The home is a detached twostorey property. There has been work undertaken to provide a semiindependent living flat, which is situated on the ground floor. The home is situated in a residential area of Ryde, a short walk from local shops, beach and leisure facilities. The home is also close to Ryde town centre, bus station and the railway station. There is a good-sized garden, which is mainly laid to lawn with patio and seating for use by the service users. Off road parking is limited but spaces can usually be found in the neighbouring streets. The home is rented from South Wight Housing and is run by Islecare ‘97 Ltd. The registered manager is Matthew Perkis. Greengates DS0000012494.V251406.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the second in the inspection year. The inspection took place on the 12th October 2005. The inspector focussed on the key-standards, which were not audited at the last inspection. Two residents were at home throughout the day being cared for by two staff. One was out in the morning at day centre services and returned mid-afternoon. One resident is currently in hospital following an accident. Workmen were present at the home decorating the living room, which was causing minor disruption to the residents’ routine and living arrangements. One resident was observed to have lost weight and looked really well. The residents have limited verbal communication skills and were not able to fully engage with the inspector about the care they receive at the home, however the inspector observed positive interaction between the residents and the care staff. Residents were seen to exercise their right to make choices about how they wished to spend their day. One resident had refused to go to the day–centre. The overall atmosphere in the home was very relaxed despite the disruption. The inspector spent time talking with the manager and staff and had access to all areas of the building/grounds, records and policies and procedures. Although the inspector was not inspecting the premises standard it was noted that the flat does not have a kitchen sink fitted. The garden hedges have been cut back, and this has exposed the garden to passers by and has left the residents with absolutely no privacy. The overall outcome was that the residents were being well cared for. What the service does well: The needs of the residents are understood and met by the care staff. Residents are consulted and able to participate in the day–to–day activities within the home. Care staff respect residents’ confidentiality. Care staff support residents to access the local community. Residents are encouraged and supported to maintain contact with family members and friends. Daily routines within the home are focussed on the needs of the residents. Care staff are aware of the need for privacy when providing personal support. Overall the home provides residents with warm, safe, comfortable surroundings and home improvements are ongoing. The home is well lit, has good ventilation and there are sufficient toilet/bathroom facilities. There is adequate shared space. Care staff are aware of their roles and responsibilities and are committed to self-development and training. The home is well managed. The views of the residents are sought. Policies and procedures are regularly reviewed and updated. The home’s record keeping safeguards the welfare of the residents. Greengates DS0000012494.V251406.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Greengates DS0000012494.V251406.R01.S.doc Version 5.0 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 Greengates DS0000012494.V251406.R01.S.doc Version 5.0 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 and 5 The individual needs and aspirations of prospective residents are assessed prior to admission. There was no evidence that residents had individual contracts or terms and conditions of their placement. EVIDENCE: The home has an admissions policy and procedure, which has been updated this year. The most recent resident was an emergency placement, however the manager stated that a meeting was held within 24 hours and information was gathered from the resident, his relative and care manager. The manager also consulted with the previous care home. Needs assessment records were seen. A care plan had been drawn up using information from the assessment. All four residents’ files were found not to contain a contract or terms and conditions of their placement. Greengates DS0000012494.V251406.R01.S.doc Version 5.0 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): 8 and 10 In the context of participation residents are able to be consulted about minor aspects of the running of the home but would not in the main have an understanding of policies and procedures. Care staff have been trained in the area of confidentiality, however only one resident in the home may have the capacity to understand the concept of confidentiality. EVIDENCE: One resident has been fully involved in the preparation of the semiindependent flat and has chosen decorations and furnishings and fittings of his choice. The residents in the main home have been consulted by staff re: the colours for the living room paint and carpets etc. The manager has recently introduced residents’ meetings. Residents are encouraged by the staff to undertake household tasks during the week, with one resident taking full responsibility for the upkeep of their bedroom. The home has a confidentiality policy and procedure which is available to staff. Care staff confirmed that they understood confidentiality and that it had been part of the mandatory training. Care staff were aware of the need to inform Greengates DS0000012494.V251406.R01.S.doc Version 5.0 Page 10 residents of the need to break confidentiality on a “need to know” basis i.e. adult abuse concerns. Greengates DS0000012494.V251406.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 13, 15 and 16 Residents have the opportunity for personal development, however there was no written evidence that this takes place. Residents get out and about in the local community. The residents are able to maintain family links and develop new friendships. Care staff support the rights of the residents and support them to be involved with all aspects of their daily lives. EVIDENCE: In discussion with care staff the inspector found that residents were given the opportunity to develop new skills. One member of staff stated that they had been trying to help one resident with their verbal communication skills and had involved the learning disability nurse who has made a referral for speech therapy input. Care staff confirmed that residents are encouraged to maintain skills. One resident is being introduced to the day centre service to enable them to meet different people and learn new skills. The resident files did not contain personal development plans. Two residents have been on holiday to Bournemouth this summer. A member of the bank staff stated that the residents do regularly go out shopping, out on trips in the home car around the island and visit pubs to listen to music and for Greengates DS0000012494.V251406.R01.S.doc Version 5.0 Page 12 meals. All residents are registered to vote. Care staff have the opportunity to spend individual time with residents. The home also has a key-worker system enabling one member of staff to get to know a resident very well. Staff support the residents to visit their family members, one member of staff takes a resident to visit their parent in an older persons’ home once a week. One resident told the inspector that they were going to see their mum on Saturday. Family members are welcome at the home and are invited to attend meetings. The residents do not have any individual friendships and nobody is in an intimate relationship. One resident was observed to spend time in the garden or in their bedroom and preferred to be alone, whilst another resident spent their time in the kitchen and chose to go out in the home car for a ride when the staff went to the day centre to collect another resident. Care staff were observed to have good relationships with the residents and understood their methods of communication and met their needs accordingly. One member of staff who had a key-worker role stated that the person he supports is involved with the cleaning of their bedroom on a weekly basis. All bedrooms are fitted with locks but the residents do not have the responsibility of holding the key. Care staff support residents to open their mail. Greengates DS0000012494.V251406.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The care staff are aware of the individuals’ care needs and support them in the way they prefer. EVIDENCE: Care staff were observed interacting positively with residents throughout the day. Care staff offered residents choices about how they wished to spend their day. One resident had chosen not to go to the day centre. All aspects of personal care are undertaken in the privacy of residents’ bedrooms or the bathroom. Individual personal support needs are known and understood by the care staff and details are written in care plans. Care staff confirmed that residents are able to go up to bed at night and get up in the mornings at times they choose. When out shopping residents are encouraged to make choices about clothing, toiletries etc. Additional specialist support is provided to the residents from the learning disability nurse, chiropodist and psychologist. The home operates a key-worker system that enables care staff to take overall responsibility for the welfare of an individual resident. Greengates DS0000012494.V251406.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 There have been no complaints since the previous inspection. Residents are given information on how to make a complaint, however information with regards to how to contact CSCI was missing. The residents are protected by the home’s policy and procedures however at present the policy does not comply with the Isle of Wight Adult Protection procedures. EVIDENCE: The home has a complaints policy and procedure, which is provided by the Somerset Care Group. The complaints book is kept in the kitchen. The last recorded complaint was made in 2004 and was from a neighbour. There is a complaints document for residents entitled “Seeking Your Views” this does not inform the residents about CSCI. The home had a copy of the Somerset Care Group (SCG) adult protection procedures. There was an Islecare policy and procedure and the Isle of Wight Adult (IOW) Protection Procedures. The policy on making referrals in the SCG did not comply with the IOW procedures. One member of care staff spoken with confirmed that they had received adult abuse training in 2004. The member of bank staff stated that they knew how to recognise abuse. Both care staff interviewed were aware of the “whistle-blowing” policy. There had been an allegation of abuse made by a resident and this was found to be unfounded. Each resident has a building society account. Residents’ monies are kept secure. Individuals’ monies are kept separately and all financial transactions are recorded and receipts of spending are kept. Greengates DS0000012494.V251406.R01.S.doc Version 5.0 Page 15 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): 25, 26, 27 and 28 The residents’ bedrooms were individually personalised and reflected their needs and lifestyles. Bedrooms were well furnished and promoted residents’ independence. There are sufficient toilet/bathroom facilities to provide sufficient privacy. The communal spaces within the home complement and supplement the residents’ individual rooms. EVIDENCE: The inspector had access to three of the residents’ bedrooms and found them to be well decorated and comfortably furnished. Each bedroom was of a good size and hand-basins were fitted. Each room was personalised to reflect the individuals’ hobbies/taste. All rooms were fitted with electrical sockets and electrical equipment was evident. The bedroom doors are fitted with locks but residents do not have the responsibility of holding the key. There is one bathroom/toilet facility, which is shared by three residents; this is on the first floor and close to bedrooms. The flat has a bathroom/toilet ensuite for the sole use of one resident. The bathroom is fitted with a lock to ensure privacy. Greengates DS0000012494.V251406.R01.S.doc Version 5.0 Page 16 There is one sitting room, which is a good size. There are plans to make the kitchen into a kitchen/diner. There is a large garden to the side and rear of the home. The resident in the flat does not share the communal facilities. Greengates DS0000012494.V251406.R01.S.doc Version 5.0 Page 17 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): 31, 32 and 36 Care staff are aware of their individual roles and responsibilities within the home to meet the needs of the residents. Residents benefit from a competent and qualified staff team. The staff team are well supported by the manager, however formal supervision has not been done on a regular basis. Supervision is available on request by staff. EVIDENCE: Roles and responsibilities for individual duties are available to care staff. The more experienced staff are aware of the home’s day-to-day routines and also pass this information verbally to bank staff. Key-workers have additional roles and responsibilities. Islecare ’97 Ltd provided care staff with job descriptions. Care staff are aware of the home’s policies and procedures and these are available in the office for reference. Care staff have been provided with a code of conduct from Islecare ‘97 Ltd. The home employs eight staff not including the manager. The manger stated that two care staff have completed Learning Disability Award Framework LDAF training induction and foundation courses and that four in all had completed the induction course. Certificates have not yet been issued. Three of the care staff have completed National Vocational Qualification (NVQ) at level 3 in care. Three staff are undertaking NVQ level 2 and two are waiting to be registered on the course. The care staff were observed to be approachable, good listeners and communicators and were interested in their job. Greengates DS0000012494.V251406.R01.S.doc Version 5.0 Page 18 In discussion with one member of staff they confirmed that they had been receiving regular formal supervision but that this had been on request. The inspector viewed three staff files and found that supervision records indicated that formal supervision has not been undertaken on a regular basis. The manager explained that priority had been given to other areas of running the home, and that he had been extremely busy. Annual appraisals were undertaken in August 2004 and records were seen. Care staff are provided with staff handbooks, which give details of grievance and disciplinary procedures. Greengates DS0000012494.V251406.R01.S.doc Version 5.0 Page 19 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): 38, 39, 40 and 41 Residents are beginning to see the benefits of the manager’s leadership and management approach within the home. Residents views are sought and the home endeavours to develop the service around residents’ needs. The home’s record keeping and policies and procedures safeguard the residents’ rights and best interests. EVIDENCE: The registered manager spends time during the week covering shifts to enable him to work alongside staff and to understand the residents’ needs. The office door is always open and staff can approach the manager for advice/support. The manager was observed in effective communication with staff and residents. Care staff are made aware of their roles and responsibilities within the home. The manager invites relatives to meetings if residents wish them to attend. The home is currently being refurbished as part of a development plan. Islecare ‘97 Ltd undertake an annual audit of the service and residents are consulted by way of a questionnaire. There was no evidence available to suggest that feedback is provided. Care staff are able to share ideas about the Greengates DS0000012494.V251406.R01.S.doc Version 5.0 Page 20 running of the home with the manager. Policies and procedures are regularly reviewed and updated. Residents and their relatives are supplied with questionnaires from CSCI to obtain their views. The home has monthly audit visits made by Islecare ‘97 Ltd and CSCI are sent notification. Greengates DS0000012494.V251406.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x 1 Standard No 22 23 Score 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x 3 x 3 Standard No 24 25 26 27 28 29 30 STAFFING Score x 3 3 3 3 x x LIFESTYLES Standard No Score 11 2 12 x 13 3 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 x x x 2 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Greengates Score 3 x x x Standard No 37 38 39 40 41 42 43 Score x 3 3 3 3 x x DS0000012494.V251406.R01.S.doc Version 5.0 Page 22 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 2 Standard YA5YA1 YA11 Regulation 5 (1) (c) 12 (1) (a) Requirement Each resident must be provided with a contract or terms and conditions of their placement. Residents must be given opportunities to learn new life skills and a record should be kept to provide monitoring of progress. Details of how to complain to CSCI must be made available in the “Seeking your Views” document. The home’s adult protection policy and procedures must incorporate the Isle of Wight adult protection policies and procedures. The bathroom requires new flooring, and grouting needs attention in some areas. The bath panel must be repaired or replaced. The bathroom door must be repaired or replaced. (previous timescale of 30/09/05 not met) The hole in the laundry wall must be repaired. Damaged plaster to laundry walls to be replaced. (previous timescale of 30/09/05 not met) DS0000012494.V251406.R01.S.doc Timescale for action 31/01/06 31/01/06 3 YA22 22 (a) 31/01/06 4 YA23 12 (1) (a) 31/01/06 5 YA24 23 (2) (b) 31/01/06 6 YA24 13 (3) 31/01/06 Greengates Version 5.0 Page 23 7 YA36 18 (2) The manager must ensure that care staff receive formal supervision at least six times a year. 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Greengates DS0000012494.V251406.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA 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 Greengates DS0000012494.V251406.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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