Inspection on 21/04/05 for Greengates

This inspection was carried out on 21st April 2005.

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

Greengates 29/11/06

Greengates 02/11/05

Greengates 22/11/04

Greengates 19/05/04

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

CARE HOME ADULTS 18-65 Greengates 697-699 Southmead Road Filton South Glos BS34 7QY Lead Inspector Melanie Edwards Unannounced 21 April 2005 09:45 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. Greengates D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Greengates Address 697-699 Southmead Road Filton South Glos BS34 7QY 0117 9236067 Aspects & Milestones Trust 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) Mrs Jennifer Alcock Care Home Nursing for Younger Adults 11 Category(ies) of MD Mental Disorder registration, with number of places Greengates D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate up to 11 persons aged 18 years and over who have mental disorder and are receiving nursing care. Staffing Notice dated 20/05/1999 applies Manager must be a RN on parts 3 or 13 of the NMC register Date of last inspection 22-Nov-2004 Unannounced Brief Description of the Service: Milestones Trust operates Greengates Care Home, which is registered to provide nursing care to 11 adults with a mental disorder between 18 and 65 years old. The property is located in a busy residential area, close to some local shops and amenities. There are 11 single bedrooms of various sizes, all of which have sinks. There are parking spaces and grounds to the side and rear of the house. Greengates D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector was able to meet six of the ten residents currently living at the Home. Residents were seen initiating conversations with the staff on duty and it was apparent that staff and residents have developed ‘warm’ trusting relationships. The majority of the Home was viewed; it was noticeable how relaxed and comfortable residents looked in their environment. What the service does well: What has improved since the last inspection? What they could do better: The resident that occupies the bedroom with a large number of cigarette burns in the carpet would benefit from its replacement. The resident that occupies the bedroom with what appears to be a large damp area on the wall would benefit from its re-decoration/repair. Greengates D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 Page 6 Residents and staff would benefit if all staff working in the Home on a casual basis follow the Homes procedure for the preparation and serving of food and specifically the need to wear suitable protective clothing. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Greengates D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 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 Greengates D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 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) 1,2,3 The Home provides prospective residents with relevant information to assist them to make an informed choice about the Home prior to admission. The Home is also able to meet resident’s individual needs. EVIDENCE: To find out how the Home assesses peoples range of needs, including mental health needs, two individual residents assessment records were inspected. The Home carries out assessments based on the idea of ‘person centred planning’ meaning the views and wishes of residents where possible are at the centre of all care provided. There was detailed information recorded about service users range of care needs. The assessments had been regularly reviewed and updated; demonstrating residents changing needs are closely monitored by staff. Residents are activity involved in the assessment process, and sign care documentation in agreement with care that is provided. The inspector was able to speak to six residents to seek their views of the care they receive. All the residents asked were positive in their views of the staff and the care they provide. The staff on duty demonstrated they were understanding and sensitive when assisting residents with their needs. Greengates D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 Page 9 Greengates D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 Page 10 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) 6,7,8,9, The Home is able to meet residents changing needs, and actively supports and involves them, in the planning, and delivery of care. EVIDENCE: To review the care how care is provided two residents care plans were inspected. The care plans contained a range of information, and included information showing how to support the service users to meet their health care needs. Care plans also addressed the psychological needs of the service users, and detailed how to respond to the person if they were distressed or agitated in mood. There was information written by the residents, which demonstrated they had been actively involved in deciding what they felt their care needs were. Residents were asked their views about the Home, the service they receive and the way that staff assist them. All of the residents who were asked were positive in their views of staff and of the Home .One resident said they thought the Home was ‘very nice’ and the staff were ‘very good.’ Greengates D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 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) 12,13,15,16,17 Generally residents are provided with a healthy and well balanced diet. The Home supports residents to be a part of the local community, and also ensures individuals rights are maintained. EVIDENCE: The service users menu was reviewed to see the range of meal choices the Home offers. The choices seen were nutritionally well balanced and varied. However three residents who were asked, expressed a negative view of the lunchtime meal choice of mushrooms in a cream sauce on toast. The inspector observed that the meal was not well presented. A number of residents spoke very positively about the cook who works at the Home, who was on a day off, on the day of the inspection. Residents said she was a very good cook. She also supports residents who wish to, to make their own cakes. Mrs Alcock said she has allocated the task to a member of staff to organise the preferred way, either by post or in person, which residents who wish to, can vote at the forthcoming general election in May 2005. This should ensure that service user’s legal right to vote is maintained. Greengates D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 Page 12 Greengates D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 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 standard(s) 18,19,20 The Home supports residents to meet their emotional needs in the way individual residents prefer. The Home operates a safe system for the handling and administration of resident’s medication. EVIDENCE: The procedures for the administration, storage and disposal of medication were reviewed to monitor the Homes systems for the handling of medication. The medication administration charts of four residents were looked at in detail. There was a photograph of the service users maintained with each record, to ensure medication is dispensed to the correct person. The medication administration charts were legible up to date, and contained the signature of the dispensing registered nurse, demonstrating residents medication is administrated safely, the reasons for any omissions had also been written on the charts. Up to date records were also being kept of all medication being received into the Home, and medication being returned to the issuing pharmacy, showing there are safe systems in place to monitor how much medication is held in the Home. Greengates D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 Page 14 The inspector observed staff supporting and assisting residents in a very respectful and sensitive manner. Residents can attend regular review meetings about their care needs if they so wish. There was also written evidence in the care records that showed the preferred day-to-day routine of residents and their particular likes and dislikes. The plans of care were detailed and stated the preferred manner in which to assist the residents to meet their mental health and social needs. It was also evident that resident’s felt able to exercise choice about the time they got up and the manner in which they were assisted by staff. Greengates D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 Page 15 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) 22,23 Resident’s views are listened to, and the Home works hard to try and ensure residents are protected from abuse or harm. EVIDENCE: A copy of the procedure for residents to make a complaint is given to each resident and includes the contact details for the Trust and the area office of the Commission for Social Care Inspection, if someone is not happy with the outcome of a complaint investigated by the Home. The inspector viewed the complaints book record, to ascertain how the Home responds to complaints. There had been two new complaints recorded since before the last inspection, which related to instances of verbal and physical anger between residents, residents had made the complaints to staff .The Home evidently support residents to express their views about matters of concern they have. The record included the details of how the complaints were to be dealt with. There was written information in the individual staff training records to show that staff had attended training on issue related to protection of vulnerable adults from abuse in the last twelve months. The Trust are clearly committed to ensuring staff are up to date in their understanding of the principle of the protection of vulnerable adults from abuse. Greengates D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 Page 16 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) 24-30 The environment is adequately suitable for meeting the needs of residents EVIDENCE: The Home is two houses that have been converted into one property, built over two floors, which can be accessed by stairs only. The building is over one hundred years old and is not purpose built. The inspector viewed the majority of bedrooms and all the communal areas. There is dinning room situated on the ground floor, as well as a television lounge and a designated ‘smoking’ lounge, this is a popular room as a number of residents are smokers. Residents were observed sitting in the communal areas looking very relaxed and comfortable in the environment. Facilities were adequately clean and tidy when viewed. However two bedrooms were seen that require attention, in one room there is a large area of the top left side of the wall that has a ‘damp’ patch, in the second room the carpet has a large number of cigarette burns on it. Greengates D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34. A skilled and well-qualified staff team supports residents, and residents are actively involved in the recruitment of new staff, and this process is safe and protects residents. EVIDENCE: The Home has commenced inviting residents to take part in interviewing prospective new employees. Mrs Alcock said that two residents had recently taken part in interviews and had asked candidates a range of worthwhile and relevant questions .The residents concerned are to be commended for assisting the Trust in this way. There was evidence that staff had attended a range of recent training in subjects relevant to the needs of service users, staff are evidently committed to increasing their knowledge and understanding of mental health care issues. Greengates D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 Page 18 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) ,38,39,42,43 The Home is well run, with competent financial management, and resident’s views are actively taken into account by management in the day-to-day running of the service. Residents and staffs health and safety are protected in the Home. EVIDENCE: Records are kept in the office and this room is kept locked when not in use ensuring residents confidential information is held securely. Generally all the records reviewed were found to be well maintained and in order. Other records have been referenced elsewhere in this report, demonstrating well organised management in the Home. There are health and safety procedures in place for staff and residents to follow to promote health and safety within in the Home. Greengates D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 Page 19 The fire logbook record showed that the range of required fire safety checks were being carried out, and were up to date, helping to ensure the safety of people who are in the building is maintained. A copy of Mrs Alcock’s business plan for the Home for the forthcoming year was seen. The plan was detailed and informative, and demonstrated Mrs Alcock has planned for residents, staff, and the needs of the Home, for the forthcoming year. The certificate of employees liability insurance was in date and on display. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 Greengates Score 4 3 3 Standard No 24 25 26 27 28 29 30 Score 3 3 2 3 3 x 3 Version 1.20 Page 20 D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc 9 10 LIFESTYLES 3 3 Score STAFFING Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 3 x x 3 3 Greengates D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 Page 21 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 26 Regulation 23. 2(b)(e) Requirement Timescale for action By 22.06.05 By 22.07.05 2. 26 The required work must be carried out, to ensure the bedroom identifed at the inspection, is damp free. 23.2(b)(e) The carpet in the bedroom identifed at the inspection must be replaced. 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. Refer to Standard 17 Good Practice Recommendations All staff involved in the preparation and serving of food should wear suitable protective clothing. Greengates D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 Page 22 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos BS32 4RG 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 D56 D05 YA UV S20333 Greengates V217431 210405 Stage 4.doc Version 1.20 Page 23 - 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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