Inspection on 28/01/09 for Greenside Court

This inspection was carried out on 28th January 2009.

CSCI found this care home to be providing an Good service.

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

Greenside Court 23/11/06

Greenside Court 23/02/06

Greenside Court 21/09/05

Greenside Court 10/03/05

Greenside Court 28/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Key inspection report Care homes for adults (18-65 years) Name: Address: Greenside Court Greenside Greasbrough Rotherham South Yorkshire S61 4PT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Christine Rolt     Date: 2 8 0 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: Greenside Court Greenside Greasbrough Rotherham South Yorkshire S61 4PT 01709558465 01709556277 tduke@exemplarhc.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Greenside Health Care Ltd care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia physical disability Additional conditions: 20 mental disorder places must be used only for clients with Huntingdon`s Disease. The admission of clients with a diagnosis other than Huntingdon`s Disease must be agreed with the NCSC prior to placement. (This is not intended to be restrictive, rather to support and recognise the specialist services provided at this Home) Date of last inspection Brief description of the care home Greenside Court is a care home with nursing which caters for twenty adults, with physical or mental disabilities, including a 10 bedded unit specially designed for people with Huntingtons Disease. The home was purpose built in 2003, and is situated in Greasbrough, a residential area of Rotherham, and is near to local shops and facilities. The home is on two floors connected by stairs and a passenger shaft lift. Each floor is Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 0 20 20 Brief description of the care home similarly designed, with en-suite bedrooms for single occupancy, lounges, dining room and other communal facilities including a computer room and a visitors room. Aids and adaptations are available throughout the home to meet peoples needs. There are gardens around the home including a level patio area with seating and barbecue facilities. Fees range from £1,000 to £3,000 per week. Hairdressing, toiletries, chiropody and newspapers were not included in the fees. This information was provided during the site visit on 28th January 2009. Information about the home including the Statement of Purpose, Service User Guide and last inspection report was available in the main entrance. Care Homes for Adults (18-65 years) Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two stars. This means that the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This was a key inspection and comprised information already received from or about the home and a site visit. The site visit was from 9.30 am to 4.15 pm. The manager completed an Annual Quality Assurance Assessment (AQAA) before the site visit. This document gave her the opportunity to tell us what the home did well, what had improved and what they were working on to improve. Various aspects of the service Care Homes for Adults (18-65 years) Page 6 of 25 were then checked during the site visit. Care practices were observed, a sample of records was examined, a partial inspection of the building was carried out and service provision was discussed with the manager. The majority of people living at the home were seen throughout the day and several were chatted to. The care provided for three people was checked against their records to determine if their individual needs were being met. Questionnaires were also sent to the home and several were completed and returned. All information, opinions and comments were considered for inclusion in this report. The inspector wishes to thank people living in the home, the staff and the manager for their assistance and co-operation. Care Homes for Adults (18-65 years) Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People only moved into the home after their needs had been assessed and they had been assured that the home could meet their needs. Evidence: A copy of the statement of purpose, service user guide, the last inspection report and other relevant information was displayed in the entrance foyer. The manager said that this information was also available on each unit. Three peoples files were checked and these contained information to verify that their needs had been assessed. The information provided good detail of each persons individually assessed needs covering physical, emotional, health and social needs. Files also contained peoples preferences, known routines and likes and dislikes. Care Homes for Adults (18-65 years) Page 10 of 25 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples assessed and changing needs were reflected in their care plans. Evidence: Care plans contained information of each persons identified physical, emotional and health needs and provided specific information of how these needs were to be met. Care plans were reviewed and updated monthly. Risk assessments had good details of how risks were being managed and minimised and these were reviewed regularly. Information on peoples files showed that they had choices e.g. mealtimes suited to individual needs, information on preferred hot and cold drinks and how these were to be served. Two people seen on the day said that they were satisfied and could make their own decisions. Care Homes for Adults (18-65 years) Page 11 of 25 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were able to participate in activities both inside and outside the home. Their rights were respected and choices were generally offered. Evidence: Routines within the home were flexible and people said they made their own decisions of how to spend the day. The home had a minibus and the manager said this was used to take people out into the community. On the day of this site visit a person was seen returning to the home after an outing. The manager said that the home employed two Life Skills Co-ordinators and promoted life skills programmes. However, there was no information of this on the three files seen during the inspection. A programme of activities was displayed but this was in small print and too high on the wall for people to see. Peoples hobbies and leisure activities were listed in their assessments but there was not always information in the care plan of how they were incorporated into peoples daily routines. This was discussed with the manager during Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: the site visit. Peoples interactions with staff indicated that their rights were respected. The completed surveys showed that people considered that staff always treated them well. Contact with family and friends was encouraged and people could meet in the privacy of their bedrooms or a quiet lounge if they wished. Meals looked good and two people said that they enjoyed the meals. If people needed assistance with meals, the care plans provided detailed information of how this was offered. The Speech and Language Therapy Department was also consulted for specific issues. The home had a menu on the wall in the dining room but this was too small for people to read and no choice was shown. The manager said that staff informed people individually what the meal on offer was and if they did not want this then they were asked what they would like to eat. A menu board in a format to meet peoples needs and showing the main meal and the alternatives would provide a positive choice, give people time to consider the choices and also remind them of the meals on offer. Care Homes for Adults (18-65 years) Page 13 of 25 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People received the personal support they preferred and their physical, emotional and health needs were met. Medication practises ensured that people were protected. Evidence: There was good information in care plans of how peoples physical, emotional and health needs and wishes were to be met. Assessments had identified peoples social needs and preferred leisure activities but these were not always included in plans of care. The inclusion of these would demonstrate person centred planning. Daily records provided some good personal information but did not always verify that peoples needs had been met. The need for consistency was discussed with the manager who said that this would be done. All records were signed and dated by the relevant staff members. Peoples files contained all the relevant information of health needs, appointments with health professionals and outcomes. Sometimes only health professionals designations were recorded. It was recommended that peoples names were also recorded to prevent confusion particularly where more than one person from a group practice was involved with the person. Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: Medication was stored correctly. The manager said that the home promoted self administration of medication and had a policy on this but at the time of this site visit none of the people living in the home were capable of doing this safely. All medication that was checked tallied with the Medication Administration Record (MAR) charts. The home carried out weekly stock checks of all medication and this is good practice. Controlled drugs were stored and recorded correctly. Medication that required refrigeration was kept in a medication refrigerator and the temperature was recorded daily. This is good practice. Peoples medication files contained their photograph and any allergies and also information of household remedies that could be used for that person. This is good practice. A member of staff was asked what each of the medicines for a particular person were prescribed for. He was able to state what the health problem was and how the particular medication helped the person. Care Homes for Adults (18-65 years) Page 15 of 25 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were protected from abuse and were confident that their complaints would be dealt with to their satisfaction. Evidence: The home had a complaints policy and procedure. People were confident that any complaints would be dealt with. People were satisfied with the care they received and there were no outstanding complaints. The home had safeguarding procedures in place and all staff had undertaken adult safeguarding training. Staff who were interviewed were able to define abuse and knew what to do if they suspected abuse. There were no allegations of abuse. The manager had followed the correct procedure for a previous allegation of abuse. She had recently been informed that the person referred to the Protection of Vulnerable Adults (POVA) had been placed on the POVA list. Care Homes for Adults (18-65 years) Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People lived in a clean, safe and pleasant environment. Evidence: The home was clean and tidy and there were no offensive odours. There were no health and safety hazards on the day of the site visit. Personal risk assessments were in place for equipment used. Bedrooms had been personalised by their occupants. There were various communal rooms including a quiet lounge, a smoke lounge, a computer room and a Snoezelen Room. Aids and adaptations were available throughout the home. Liquid soap and paper towels were available to reduce the risk of cross contamination. Care Homes for Adults (18-65 years) Page 17 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment procedures were robust and staff were trained and competent to provide the relevant support to meet peoples individual and joint needs. Evidence: The home was well staffed on the day of the site visit. Staff who were interviewed considered that there were sufficient staff to meet peoples individual needs. This meant that people could follow their own programmes in the home and in the community. Staff were enthusiastic about their roles. Some staff had recently completed National Vocation Qualification in Care and some were undertaking this training. Twenty two staff had received training in Huntingtons Disease. There was evidence on files and through talking to staff that they received training and were kept up to date with current practices. The manager said that she also took advantage of free training for the benefit of staff. This was offered by health professions and Rotherham College. According to information in peoples care plans, some people coming to live in the home had learnt Makaton in the past. This is a simplified sign language. It was suggested that staff learn this to enhance their communication skills with people living in the home. Recruitment records were checked for three members of staff. Criminal Record Bureau Care Homes for Adults (18-65 years) Page 18 of 25 Evidence: disclosures were made available. All relevant information was available. The procedure and length of time for keeping Criminal Record Bureau disclosures was discussed and it was recommended that these be kept securely on each persons individual file with their other private and confidential information. Correspondence related to interviews and contracts of employment was available. The recruitment procedure was robust and all documents were stored securely. Care Homes for Adults (18-65 years) Page 19 of 25 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was run and managed in the best interests of people living in the home. Evidence: The manager was registered with the Commission for Social Care Inspection. She had completed the National Vocational Qualification Level 4 in Management and also achieved the Registered Managers Award. The home had a quality assurance monitoring system in place to ensure that the home was run in the best interest of people living in the home. Evidence of the systems in place to promote this was seen during the site visit. This included checks of the environment, medication checks, finance checks, analyses of accidents, peoples care plans, staff files and training records, meetings and audits by external organisations. Questionnaires were sent out annually to staff, people living in the home, their relatives and stakeholders in the community. Results were published and displayed in the entrance hall. The home also produced a newsletter. The home had a staff training matrix that identified when staff needed to attend Care Homes for Adults (18-65 years) Page 20 of 25 Evidence: training. Mandatory health and safety training for staff was updated yearly as per the company policy, which is good practice. Fire safety training was updated every six months and fire drills were held regularly. A fire drill matrix identified when staff needed to attend training and be included in fire drills. Peoples files also contained information of how they would be assisted to be removed from the building in the event of a fire. Staff confirmed that their training needs were met. Certificates were available to verify that systems and equipment within the home were serviced and maintained within the required timescales. Care Homes for Adults (18-65 years) Page 21 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 22 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 12 If the home is providing group activities, the information should be more prominently displayed to raise peoples awareness of the activities on offer. The provision of menu boards in suitable formats with a choice at each meal would inform and remind people of the meals on offer and give them time to make their choices. The inclusion of leisure activities in care planning will ensure person centred care. Where there are no apparent injuries following an accident or fall, it is recommended that close monitoring is recorded on a 72 hour monitoring charts. Daily records should consistently provide information that peoples individual care needs have been met. This will verify that all staff are meeting peoples identified needs as stated in their care plans. It is recommened that peoples names as well as their designations be included in health care notes. This will prevent any confusion at a later date Learning Makaton would enhance staff communication Page 23 of 25 2 17 3 4 18 19 5 19 6 20 7 35 Care Homes for Adults (18-65 years) Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations skills. Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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