Inspection on 03/10/07 for Greengates

This inspection was carried out on 3rd October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 17/03/09

Greengates 10/07/06

Greengates 12/10/05

Greengates 09/06/05

Greengates 01/02/05

Greengates 19/05/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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 Annie Kentfield Unannounced Inspection 3rd October 2007 11:00 Greengates DS0000012494.V347448.R01.S.doc Version 5.2 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.V347448.R01.S.doc Version 5.2 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.V347448.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greengates Address 96 Monkton Street Ryde Isle Of Wight PO33 2DD 01983 564418 01983 564418 mandy.minshull@islecare.org 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 Ltd Mrs Amanda Minshull Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th July 2006 Brief Description of the Service: Greengates is a residential home providing care and accommodation for up to five adults with a learning disability. The home is a detached two-storey property situated in a residential area of Ryde, a short walk from local shops, beach and leisure facilities. Also close are Ryde town centre, bus station and the railway station. There is a good-sized garden that is laid mainly 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 owned by Islecare 97. The current scale of charges starts at the Local Authority care band 2 and there are additional charges for transport, hairdressing, toiletries, chiropody and papers/magazines. The home is fully accessible on the ground floor with stair access to the first floor. Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is a summary of information that we have asked for or received since the last inspection of Greengates in July 2006. Included in this report is information received from the registered manager in the Annual Quality Assurance Assessment (AQAA). This is a self-assessment form that all services are required to complete that provides information on how well outcomes are being met for people who use the service, and also provides some statistical information. We visited the home on 3rd October 2007 for about 4 hours. Although this was an unannounced inspection, the manager was contacted the afternoon before the visit to ensure that there would be some residents and staff at home. During the visit we met two of the residents, support staff, and the registered manager, and looked at some of the records. Comment cards were sent to the residents and care staff in advance of the visit. We received 5 comment cards from residents (completed with support from staff) and 5 comment cards from support staff. All feedback about the home was positive. What the service does well: What has improved since the last inspection? Since the last inspection the manager has become the registered manager for Greengates and another small care home close by. The manager is clear about her role of registered manager and is committed to making sure that she meets with all of the residents and staff at least once every week, in both homes. Improvements have been made to the home environment: • The ‘flat’ has been provided with facilities to support more independent living • The laundry wall has been repaired and decorated • Improvements have been made to the garden In addition: • The Quality Assurance process has been developed in a format suitable for residents in the home • Work is ongoing to develop information for residents in accessible formats • Development is ongoing in ‘person centred’ support plans Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Greengates DS0000012494.V347448.R01.S.doc Version 5.2 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.V347448.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. In the event of a new resident moving into the home, the manager would make sure that prospective residents are invited to visit the home beforehand and there is a process of assessment to ensure that the home would be suitable for any new residents. The service has now produced a contract and information for residents in an accessible format and it is planned for this to be developed in practice. EVIDENCE: There have not been any new residents moving into the home since the last inspection so this standard was not assessed during the inspection visit. However, the manager confirmed in the AQAA that people who live in the home would be consulted before a new resident moved in. The AQAA also recorded plans for improvement to “continue to develop support plans and provide information for residents in suitable formats”. The inspector was shown the new ‘Agreement’ that has been developed using a pictorial format with photos of the resident, the home, and the manager. The agreement sets out clearly what services will be provided and how information about the resident will be recorded and stored. The new agreement is a positive development and the home must now ensure that this is put into practice for the benefit of the residents. Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 9 Greengates DS0000012494.V347448.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Positive work in the home is ongoing in developing person centred support plans for each resident. This is almost completed. The new plans are being written with the residents and their key workers and demonstrate that residents are consulted with and supported to make decisions about all aspects of their lives both in the home, and in the community. EVIDENCE: Residents are encouraged and supported to participate in the daily routines of the home as much as possible and one resident said they had some days at home and liked to be involved in keeping their room clean and tidy with the support of their key worker. The development of a person centred approach to resident support plans has taken a long time for Islecare to put into practice. However, after a long period of trial and practice, it is evident that the new support plans are in place Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 11 for some residents with a plan for all residents to have individual person centred support plans as soon as they can be discussed, agreed, and written by the residents and their key workers. We looked at some of the support plans and these are comprehensively and clearly set out with regular monthly reviews of residents’ goals and aspirations and how these will be met. The support plans are set out from the residents’ perspective, in the first person, and there is additional information in the form of a photo diary that shows what each resident likes to do and what is important to them. The photo diaries contain lots of good pictures of the residents at home, with friends and family, or doing activities they like at Day Centre or in the community, such as shopping for food, or for clothes. Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy a range of leisure and social activities. Visitors are always welcome and residents are supported to maintain regular contact with family and friends. Residents have choice and variety of good quality food/menus. EVIDENCE: Residents are able to choose to attend a number of local recreational and social events and there are regular trips out for bowling, cinema, shopping etc. As a small home, decisions about going out are made informally on a day-today basis depending on the weather, and what residents would like to do. One resident said they liked being at home and going shopping and another resident likes to spend regular and planned time with family and friends. Staff in the home support the residents to do activities of their choice by providing Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 13 information so that residents can make informed choices, and by providing one to one support when residents want to go out. The support staff give help with communication skills – some of the residents and staff use Maketon. There are plans to develop photo cards to assist residents who do not use speech or Maketon. Consideration should be given to making this a priority task for the benefit of those residents who would be likely to use the photo cards to aid communication and express their choices. The Annual Quality Assurance Assessment (AQAA) reports that the service will try to access more community-based projects that residents wish to be involved in and “continue to work in a person centred way to make sure that residents have access to those activities they want and like to do”. There is a weekly menu and meals are eaten in the kitchen/diner. Residents said the food is good and they have lots of choice each day – there are always alternatives available. Residents have free access to the kitchen and can help themselves to fruit and snacks whenever they want to. The staff explained that some shopping is done weekly and there is always fresh fruit and vegetables. Some of the residents like to help with the weekly shopping. Residents said that they can lock their bedroom doors if they want to and that staff and other residents respect the right to privacy and private space. There are occasional resident or house meetings – and these are part of the home’s quality assurance system for seeking feedback from the residents on what they want to happen in the home. Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care staff are aware of individual care needs and support is offered in the way that residents choose. The health care needs of the residents are met by the home. Medication is safely stored and dispensed and staff have received training in the safe handling of medication. EVIDENCE: Residents are supported to be as independent as possible and staff provide discreet support and prompting with all aspects of personal care and personal hygiene. One resident said that staff help him with shaving but he liked to spend some time in the bath on his own. The bathrooms and bedrooms have call alarm systems so that residents can ask for help if they need it. Since the last inspection one of the bedrooms has been fitted with an en-suite shower, as this is what the resident prefers. Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 15 Support plans record any healthcare checks or GP visits and staff accompany residents to any appointments. A visiting chiropodist provides regular care for feet and fingernails. All health care needs are recorded in an individual Health Action Plan and regularly reviewed. It is evident that care staff are very aware of the service users’ health and care needs and have developed informal ways of good communication. We saw that staff are also aware of residents’ individual preferences, for example, where staff are aware of any anxiety about going to the dentist, particular support and care is provided to help the resident. Medication is securely stored in the kitchen. Although the storage of medicines in kitchen cupboards is not recommended because heat and humidity may affect the medicines; the cupboard is not near any direct sources of heat or humidity and temperatures in the cupboard are checked several times a day, and the kitchen is well ventilated. We found that medication records and policies and procedures were up to date, only one medicine that is prescribed to be given ‘as and when’ (PRN) did not have a separate written protocol or guidance for staff and the manager said this would be actioned immediately. Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse or harm and their views are listened to and acted on. EVIDENCE: We saw that the home are actively seeking the views of the residents – this happens informally in regular discussion between the residents, staff and manager, and more formally in the customer satisfaction questionnaire that the service has recently developed, in a format that is accessible for the residents. The service have been pro-active in looking at ways to support the residents to develop and understand their individual rights and responsibilities, for example, some of the residents are doing a drama workshop that is looking at different ways of understanding the idea of ‘complaints’. There is also a CD that residents can listen to about the complaints procedure. In the comment cards, the residents said they would speak to their key worker, the manager, or their care manager if they were unhappy about anything. The manager is due to attend a 2-day course for trainers in delivering ‘Safeguarding’ Awareness to all of the staff. This will support the policies and procedures in place for ensuring that residents are protected from harm or the risk of abuse. Previous inspections of Islecare services have found that there are thorough recruitment procedures in place to make sure that satisfactory checks are in place before new staff work with the residents. This ensures further protection for the residents. Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 17 Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home environment is comfortable and safe for the residents. The home is clean and tidy and attention is given to ensuring good hygiene and procedures to control infection or the risk of cross infection. EVIDENCE: The home environment has improved since we last visited the home; the laundry walls have been repaired and decorated, there have been improvements to the bathrooms and toilets and the ‘flat’ has been fitted with cooking facilities and is awaiting a washing machine. The garden area has been tidied and improved and there are plans to further landscape the garden with shrubs and plants. There is a shortage of storage space and staff facilities in the home but there is an office to store records securely. Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 19 We found that the home environment is comfortable for residents and consideration is always given to respecting resident’s privacy and need for a private and quiet space to go to when wanted. The ‘flat’ has it’s own open plan kitchen/diner/sitting area, and there is a comfortable sitting room and kitchen/ diner in the other part of the building. All of the residents have their own bedroom and these are furnished and decorated according to individual choice and preference. Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an ongoing staff training programme, thorough recruitment procedures and systems for staff supervision to ensure that the service can meet the support needs of the residents. EVIDENCE: A new member of staff confirmed that the induction and training for new staff is good and they felt well supported in their introduction to the home and working in the home. The staff-training programme covers all of the basic areas of safe working practice and the manager looks at additional training that is specific to supporting the residents in the home. Staff receive regular formal supervision and appraisals. In the AQAA, the manager confirmed that all potential new staff visit the home before being offered any position. “During the last visit, one of the residents showed the prospective new member of staff round the home with minimal assistance from myself”. In the kitchen, there is a notice board with photos of Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 21 the staff and who is working that day because residents like to know who is on duty and when their key worker will be in the home. We have found in previous visits to the home that the recruitment procedures for new staff are thorough and new staff do not start working in the home until satisfactory checks and references are in place. Recruitment procedures are managed centrally from the Islecare main office. Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run in the best interests of the residents. The health and safety of the residents and staff is promoted and protected and records are of a good standard and routinely completed to meet the relevant regulations. EVIDENCE: Comments from staff and residents, and observation of practice in the home shows us that the manager is efficient, organised and approachable. The manager’s time is divided between two homes and she has a stated commitment to meet with all of the residents and members of staff in both homes, at least once every week, and makes herself available for residents and staff to talk to whenever necessary. The organisation of the service is also regularly monitored by the registered provider (Islecare). Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 23 The manager is committed to ongoing professional training and has recently completed a course in promoting sexual health and awareness of sexual orientation. The AQAA demonstrates an awareness and understanding in practice of equality and diversity issues and there is a stated commitment to “continuing to recognise people as individuals and respect their right to make choices”. The home has been inspected by a number of other statutory agencies since the last inspection and these reports demonstrate that the home is meeting fire safety regulations and good standards in food safety and food hygiene. The home has received a five star rating for food hygiene. The manager meets relevant health and safety requirements and the required records are well maintained. We noted that portable electrical equipment in the home had not been tested since 2005 and the manager confirmed that this would highlighted for the provider to address as a safety issue. All other maintenance checks were up to date. The system for managing residents’ monies was recently inspected by Social Services as part of their contract monitoring process, and systems and records were found to be thorough and safe. We saw evidence of systems of quality assurance and the development of a new satisfaction survey for residents in a more accessible format. The feedback and results of the survey will be summarised and used to plan changes as a result of ‘listening’ to the residents. Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 X 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Greengates DS0000012494.V347448.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 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 © 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.V347448.R01.S.doc Version 5.2 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!