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Inspection on 13/10/05 for Greenhills

Also see our care home review for Greenhills for more information

This inspection was carried out on 13th October 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

From discussions with the two staff during this inspection visit it was quite apparent that they are committed to meeting the needs of the people living at Greenhills and provide a service tailored around the abilities, interests and needs of the individual residents. The two residents and staff were observed throughout the visit and were relaxed and enjoying each other`s company. The support worker was actively working side by side with one of the residents encouraging and supporting them to be involved in daily tasks and decisions. Further evidence of this level of commitment and participation with residents was recorded in the residents` individual files/folders. Each resident participates in a range of day services and leisure activities, which encourage and contribute to the resident`s personal development and confidence to achieve a community presence. The range of holidays planned and organised with the individual residents is commendable and it was clear from discussions and the records that a lot of thought and consultation went into these arrangements. Residents are actively encouraged to maintain contact with their families and friends and a long-standing friend of one of the residents visited during this inspection.

What has improved since the last inspection?

Staff continue to maintain the quality of services provided to the residents at Greenhills. The interior decorations are kept fresh with new curtains and duvets being regularly replaced. A work experience placement for a student nurse has been arranged and the staff are looking forward to this as they feel it keeps them on "their toes" and up to date with any knew ideas in the delivery of services and facilities for residents.

What the care home could do better:

Within the resident`s folders there are different style forms and templates and it is recommended the older style forms should be replaced with those currently in use. Staff continue to develop the presentation of resident`s plans and consideration needs to be given to greater use of photographs, symbols and graphics and where possible encourage residents to sign their plans. This would further evidence their participation in developing and reviewing their own plans. It is hoped the planned works to develop Greenhills will come to fruition in the near future.

CARE HOME ADULTS 18-65 Greenhills 32 St Andrews Road Bridport Dorset DT6 3BQ Lead Inspector Marion Hurley Unannounced Inspection 13th October 2005 10:30 Greenhills DS0000020469.V252884.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 Greenhills DS0000020469.V252884.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. Greenhills DS0000020469.V252884.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Greenhills Address 32 St Andrews Road Bridport Dorset DT6 3BQ 01308 422159 01308 422159 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) Dorset Residential Homes Christopher John Stone-Stevens Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Greenhills DS0000020469.V252884.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th March 2005 Brief Description of the Service: Greenhills is a registered care home that provides accommodation and specialist nursing care for 9 learning disabled people. The home is operated by Dorset Residential Homes, a registered charitable trust that operates a number of care homes in Dorset. Greenhills is located in a residential area close to the town centre of Bridport. It is a large detached property that has been carefully extended and adapted to meet the needs of service users; the home does not stand out from neighbouring properties in any way. The home has 3 floors, the main communal rooms and some bedrooms being on the ground floor, remaining bedrooms on the 1st floor and an office and storage area on the 2nd floor. Most of the service users have lived at Greenhills for a number of years and some also know each other by sharing previous accommodation. As the home is registered to provide nursing care, the home is in the charge of a qualified nurse at all times; staffing is provided throughout each 24 hour period, including ‘waking’ night staff. Greenhills DS0000020469.V252884.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection has been undertaken as part of the statutory inspection process in accordance with the Care Standards Act, 2000. Greenhills was assessed according to the Care Home for Adults (18-65) National Minimum Standards. The overall time spent to complete the inspection process was a total of six hours, three of which were spent at the Home. Neither the Registered Manager nor Deputy were on duty. However one qualified nurse and one support worker were available throughout the inspection. Two residents were at home and both participated in the inspection in their individual ways. The inspector was grateful to both staff and the residents for their commitment and openness during the visit. What the service does well: From discussions with the two staff during this inspection visit it was quite apparent that they are committed to meeting the needs of the people living at Greenhills and provide a service tailored around the abilities, interests and needs of the individual residents. The two residents and staff were observed throughout the visit and were relaxed and enjoying each other’s company. The support worker was actively working side by side with one of the residents encouraging and supporting them to be involved in daily tasks and decisions. Further evidence of this level of commitment and participation with residents was recorded in the residents’ individual files/folders. Each resident participates in a range of day services and leisure activities, which encourage and contribute to the resident’s personal development and confidence to achieve a community presence. The range of holidays planned and organised with the individual residents is commendable and it was clear from discussions and the records that a lot of thought and consultation went into these arrangements. Residents are actively encouraged to maintain contact with their families and friends and a long-standing friend of one of the residents visited during this inspection. Greenhills DS0000020469.V252884.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. Greenhills DS0000020469.V252884.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 Greenhills DS0000020469.V252884.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): None of the above standards were assessed. No service users have been admitted to the home since the last inspection. The key standard will be assessed at the next inspection visit. EVIDENCE: Greenhills DS0000020469.V252884.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): 6, 7, & 9 • Each resident has a file, which is “his or her folder”. These include the resident’s individual support plans providing details of how their health, personal and social needs can be met whilst living at Greenhills. • Residents are encouraged to participate in the decisions affecting their lives, encouraging an understanding of the shared responsibilities of life at Greenhills. The level of participation and independence is based within a risk assessment framework according to each person’s specific needs and abilities and interests. EVIDENCE: The three care and personal support records read during the inspection highlighted and demonstrated how each resident is encouraged and enabled to make decisions about all aspects of their lives. Residents are supported to make decisions affecting their daytime activities and staff described how one person has decided, “to retire”. Two residents were present throughout this inspection visit and were observed enjoying the company of the two staff at Greenhills. One resident sat with the inspector whilst “their folder” was read and they made a valuable contribution confirming their likes and dislikes. Greenhills DS0000020469.V252884.R01.S.doc Version 5.0 Page 10 Their folder appeared to accurately reflect the residents needs, wishes, likes/dislikes and the preferred way they needed and liked to receive support to manage their daily life. The three folders, which were read, reflected the different and individual levels of support each person receives. In addition to everyone’s Folder each person has a file, which contains charts used for monitoring health needs and their Daily Living Notes. The Registered Manager and staff need to explore ways to develop and produce a simple plan for each resident possibly through the use of graphics, photographs and symbols which may make the plans more accessible for each resident and help them identify their different activities and special interests. Discussions with the staff clearly indicated their knowledge and understanding of the residents in the Home and reflected the positive practise of involving residents and genuinely working side by side with each person. However, the records do not entirely do justice to this work and should contain more references to the process of consulting with each person in forming and reviewing their individual plans. Risk assessments are individually written according to the persons needs, abilities and comprehension of situations. These were included in each person’s Health, Safety and Well Being Plan. Greenhills DS0000020469.V252884.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, 12, 13 & 14 • Residents attend a variety of Day Services, which provide further opportunities to participate with their peers in age appropriate activities. • Residents join in local community events, and access local amenities and facilities for their personal and recreational needs, which encourage and promote an important prescence in the local community. • Greenhills enable residents to participate in a wide range of activities reflecting their different interests. EVIDENCE: Evidence from the resident’s records read on the day indicated that each person has a full and varied weekly routine that includes activities away from the home including attendance at day services and accessing community resources. One resident was able to tell the inspector of their trips to the local shops. All the residents have summer holidays and staff discussed how these are planned with each person according to their interests, abilities and personal needs. For one person a long weekend suits their interests and needs others Greenhills DS0000020469.V252884.R01.S.doc Version 5.0 Page 12 have been on a touring holiday to Ireland and two travelled to Cyprus and another is shortly off to Berlin. Residents are encouraged to learn and maintain their independent skills and are encouraged to participate in everyday practical tasks for example on the day of the inspection one resident was putting the shopping away with the help of staff. Discussions with staff demonstrated their commitment and understanding of involving residents even though for some residents this may mean observing rather than doing but staff clearly recognised this to be equally important and a source of stimulation. Records showed residents access the local Library, Leisure centre, and access nearby towns for trips to the Cinema, Ten Pin Bowling and Hydro Swimming. Some residents are members of the local Gateway and Phab clubs. Greenhills DS0000020469.V252884.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 & 19 • Residents receive personal flexible support according to their individual and changing needs. The details of the support and the resident’s preferences were noted in their individual records to ensure that all staff provide a consistent approach when supporting each resident. • The healthcare needs and general well being of the residents are carefully monitored and maintained and the records provided current information. EVIDENCE: Residents are not able to take control of their own healthcare needs, however there were clear records which indicated staff ensure residents health and well being is carefully monitored and there was evidence from both the records and in discussion with staff of good multi-disciplinary work with allied professionals. Resident’s personal care needs are recorded and their preferences are described in their Folders and daily notes. Medical charts showed that Health needs are monitored and any change in patterns or routines recorded to ensure staff are aware and respond to the resident’s changing needs. Each resident has a named nurse and support worker as their “key workers” and this system of designated workers help provide consistency and continuity in the support provided to the residents. Greenhills DS0000020469.V252884.R01.S.doc Version 5.0 Page 14 Staff spoken with during the course of the inspection demonstrated a good understanding of the personal and healthcare needs of the residents living at Greenhills. All current medication was listed and a record of all health related appointments i.e. Doctor, Dentist, Optician available with the records. Greenhills DS0000020469.V252884.R01.S.doc Version 5.0 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 the following standard(s): Neither of these standards were assessed at this inspection and will be assessed at the next inspection. EVIDENCE: Greenhills DS0000020469.V252884.R01.S.doc Version 5.0 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 the following standard(s): 30 • On the day of this inspection Greenhills was clean and hygienic providing a safe environment for both residents and staff to live and work in. EVIDENCE: A tour of the home was completed and Greenhills was found to be well maintained and in good repair. All communal areas, and bathrooms were viewed and some of the resident’s bedrooms. The home is comfortably furnished and on the day of the inspection was clean and hygienic. The grounds and external fabric of the building look to be well maintained. All staff share the responsibility for maintaining the cleanliness of the home. Greenhills DS0000020469.V252884.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): None of these standards were assessed at this inspection visit. EVIDENCE: Greenhills DS0000020469.V252884.R01.S.doc Version 5.0 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 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): 42 • Staff ensure safe working practises to safeguard and protect the residents as far as practical in all aspects of daily living by ensuring the environment is maintained to a safe standard and support is appropriately provided to each resident according to their needs and abilities. EVIDENCE: Records seen in the course of this inspection indicated that health and safety monitoring and checks were regularly undertaken. Records showed that services and equipment were being inspected at the required intervals and these were further verified during the tour of the home. From discussions with the staff it was evident they are fully aware of their responsibilities for the practical day-to-day health and safety issues for both residents and the staff. Staff also confirmed that all statutory training relating to health & safety was regularly undertaken including COSHH, Manual Handling, Personal Safety & Awareness, Food Hygiene and Fire Prevention Training. The latest Fire Drill had been successfully completed in June 2005. Greenhills DS0000020469.V252884.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 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 x x x x Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Greenhills Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x DS0000020469.V252884.R01.S.doc Version 5.0 Page 20 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 Greenhills DS0000020469.V252884.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Greenhills DS0000020469.V252884.R01.S.doc Version 5.0 Page 22 - 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!