Inspection on 10/10/05 for Greens (The)

This inspection was carried out on 10th 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 no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Greens (The) 10/05/07

Greens (The) 23/08/05

Greens (The) 03/08/04

Greens (The) 27/04/04

Greens (The) 20/01/04

Similar services:

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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 Greens (The) The Greens 388 Chessington Road West Ewell Epsom Surrey KT19 9EG Lead Inspector Joseph Croft Unannounced Inspection 10th October 2005 10:00 Greens (The) DS0000013658.V255296.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 Greens (The) DS0000013658.V255296.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. Greens (The) DS0000013658.V255296.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Greens (The) Address 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) The Greens 388 Chessington Road West Ewell Epsom Surrey KT19 9EG 020 8224 3313 Mr Navaratnam Pakthyiendra Mrs Sharmini Pakthyiendra Mrs Sharmini Pakthyiendra Care Home 3 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (1) of places Greens (The) DS0000013658.V255296.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be 30 - 65 YEARS although one person may be over the age of 65 and fall within the category LD(E) 23rd August 2005 Date of last inspection Brief Description of the Service: The home is registered to accommodate a maximum of three residents of either gender all of whom have learning disabilities. The registered age range of the residents accommodated is thirty to sixty five years, although registered provision is also made for one resident aged over sixty five years. The home is privately owned and registered to Mr and Mrs Pakthyiendra. The home is a detached property set in a residential area off a main road and is close to local facilities and amenities. The home provides a caring and supportive service in a homely and comfortable environment. The home is decorated and furnished to a very good standard and has a large well maintained garden. Greens (The) DS0000013658.V255296.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection of the year 2005 – 2006. It will be necessary to view both inspection reports for 2005 – 2006 to obtain a full understanding of the extent to which the home meets The National Minimum Standards for Younger Adults. One inspector undertook this unannounced inspection on the 10th October 2005. The duration of the inspection was three hours. As part of the inspection process in depth discussion took place with the registered manager, one member of staff was formally interviewed, and care plans, risk assessments and the menu were sampled. Whilst there was evidence that care plans are reviewed, there was a requirement made at the previous inspection that is yet to be met. Risk assessments are comprehensive and regularly reviewed. It must be noted that all of the residents have profound learning/communication difficulties. Attempts were made to ascertain their views with the support from staff, but residents did not want to communicate on this occasion, therefore evidence for this inspection was obtained from the manager, staff and records. Six requirements were made, three of which are carried over from the previous inspection. What the service does well: The home provides a very good standard of accommodation, which is homely, tidy, clean and comfortable. The home’s menus offer a choice of meals with plenty of fresh fruit and vegetables each day. The home works well with residents who have profound learning disabilities. Greens (The) DS0000013658.V255296.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. Greens (The) DS0000013658.V255296.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 Greens (The) DS0000013658.V255296.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): EVIDENCE: These key Standards were assessed at the previous inspection. Greens (The) DS0000013658.V255296.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): 7 Residents are provided with assistance to make some decisions, however, there is no recorded evidence of when decisions have made by other people on behalf of residents. EVIDENCE: The manager stated that due to the profound learning/communication difficulties, residents are not always able to make decisions for themselves. Staff, care managers and residents’ parents and families make decisions about residents’ lives. However, it was evident in care plans sampled that the reasons decisions are made by other people are not recorded. A requirement has been made in regard to this. During discussions one member of staff stated that although residents have limited communication skills, choices are offered, and assistance is provided to help choices to be made. The manager stated that residents’ parents and family manage their finances. Greens (The) DS0000013658.V255296.R01.S.doc Version 5.0 Page 10 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): 15, 16 and 17 Family and friends are encouraged to visit the home. Meals offered provide choice and variety. EVIDENCE: The manager stated that family and friends are always welcome to visit the home. One resident’s mother visits every Sunday, and spends time in the resident’s bedroom or goes outside the home to the local community. Discussions with the member of staff interviewed verified this. Residents are taken into the local community by staff to have meals, visits to pubs, and do shopping at the local supermarket. The manager and staff stated that due to the needs of the residents, they are not able to form intimate personal relationships with other people. The manager stated that residents help with household chores such as dusting or handing vegetables to staff in the kitchen. Staff in the home were observed to respect residents’ privacy through knocking on bedroom doors and waiting for a response before entering. Staff and residents address each other by first names. Residents were observed to be able to spend time in their bedrooms after lunch when they could have a sleep or just be alone. It was observed that Greens (The) DS0000013658.V255296.R01.S.doc Version 5.0 Page 11 keys were left in bedroom doors. The manager stated that due to the low levels of understanding, residents do not hold keys to their bedrooms. This was recorded in care plans. Residents have unrestricted access to the lounge, kitchen/dining room and the garden. Smoking and alcohol are not permitted in the home. The menus were viewed and found to offer balanced and appetising meals. Residents have a choice of main meal each day, and plenty of fresh fruit and vegetables are provided. Drinks and snacks are recorded on the menu, and are available throughout the day. Residents were observed having a morning drink and snack. Daily records of cooking and fridge/freezer temperatures were evidenced. The manager stated that residents help in regard to preparing food is limited for safety reasons. The staff spoken to state that residents are provided with meals they ask for. Greens (The) DS0000013658.V255296.R01.S.doc Version 5.0 Page 12 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 home ensures residents receive personal support in they way prefer and require. EVIDENCE: The manager and staff interviewed stated that personal care is undertaken in private and with respect at all times. Care plans evidenced did not provide detail of how personal support is to be provided to residents. A requirement has been made in regard to this. The home only employs female staff that cater for the needs of all three residents. The staff member interviewed stated that bed times and waking times are flexible, however, two residents attend day centres during the week, so they have to be up and ready in time to attend these. Residents, with staff support, choose their own clothes and hairstyles. One resident was observed to request help with applying her make up. Residents’ likes and dislikes were recorded in care plans, but these were last updated on the 25th February 2005. A requirement has been made that care plans be updated on a six monthly basis. The manager stated that the GP reviews residents’ needs every three months and makes referrals to the appropriate health care professionals as needed. Greens (The) DS0000013658.V255296.R01.S.doc Version 5.0 Page 13 Greens (The) DS0000013658.V255296.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): EVIDENCE: These key Standards were assessed at the previous inspection. Greens (The) DS0000013658.V255296.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): EVIDENCE: These key Standards were assessed at the previous inspection. Greens (The) DS0000013658.V255296.R01.S.doc Version 5.0 Page 16 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): EVIDENCE: These key Standards were assessed at the previous inspection. Greens (The) DS0000013658.V255296.R01.S.doc Version 5.0 Page 17 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): EVIDENCE: These key Standards were assessed at the previous inspection. Greens (The) DS0000013658.V255296.R01.S.doc Version 5.0 Page 18 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 X 2 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Greens (The) Score 2 X X X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000013658.V255296.R01.S.doc Version 5.0 Page 19 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 YA10 Regulation 15 (2) (b) Requirement That the residents care plan referred to in the previous report is reviewed. This requirement is carried over from the previous inspection and must be complied with. The reasons for decisions being made by other people on behalf of residents must be recorded in care plans. Details of how personal support is to be provided to residents must be recorded in care plans. Care plans must be updated on a six monthly basis. The contact address and telephone number of the Commission For Social Care Inspection Surrey Local Office must be included in the residents pictorial complaint procedure. This requirement is carried over from the previous inspection and must be complied with. That a twenty-eight day response time is included in the homes complaint procedure. This requirement is carried over DS0000013658.V255296.R01.S.doc Timescale for action 10/11/05 2 YA7 12 (2)(3) 15 12 (1) (2) 15 (2) 22 (2) 10/11/05 3 4 5 YA18 YA18 YA22 10/11/05 10/11/05 10/11/05 6 YA22 22, (4) 10/11/05 Greens (The) Version 5.0 Page 20 from the previous inspection and must be complied with. 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 Greens (The) DS0000013658.V255296.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Greens (The) DS0000013658.V255296.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. 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