CARE HOME ADULTS 18-65
Greenwood Lodge Care Home 49-55 Gotham Lane Bunny Nottingham NG11 6QJ Lead Inspector
Mr Steve Hunnybun Unannounced Inspection 28th February 2006 02:00 Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 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 Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 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. Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Greenwood Lodge Care Home Address 49-55 Gotham Lane Bunny Nottingham NG11 6QJ 0115 9847575 0115 9213672 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) MGB Care Services Limited Care Home 17 Category(ies) of Learning disability (17) registration, with number of places Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 8th September 2006 Brief Description of the Service: Greenwood Lodge is a home for people with learning disabilities, some of whom have additional physical disabilities. Most of the residents are under 65 but a few are over and have regular reviews. The accommodation is provided on two floors and all but one of the bedrooms is single. The home is situated in the village of Bunny, which has limited public transport links. There are secured gardens at the home and car parking to the front and side of the building. A recently added portacabin provides extra office space and a relaxation and craft room for residents. Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second statutory unannounced inspection this year and took place over approximately three hours. The key National Minimum Standards were all covered at the last inspection so the inspector covered those standards for which requirements or recommendations had been made. This report therefore reflects this with a great deal of progress having been made to a significant number of requirements and recommendations. The inspector also saw examples of positive work in a number of documents that have had pictures included to improve accessability. What the service does well: What has improved since the last inspection?
The statement of purpose now contains a privacy and dignity statement and information on obtaining inspection reports. Staff are sensitive to residents’ needs when supporting them at mealtimes. All residents have been referred for wheelchair assessments to ensure that they have appropriate equipment. Staff have been made aware of the importance of correct use of mobility equipment. A very useful document has been developed to record complaints. This includes pictures to improve accessibility. The adult protection issue mentioned in the last report has been referred and investigated to a satisfactory conclusion. Window restrictors have now been fitted. The entrance hall and stairs have been partly decorated. The lounge and dining room have been very pleasantly decorated. Radiator covers have been fitted in communal areas. Staff use a range of methods to enhance residents’ privacy and dignity when supporting them. Water temperatures are monitored and were within safe limits. All rugs that presented a trip hazard have been removed. The home has a redecoration programme that is thorough and comprehensive. All freezer casings have been cleaned. Staff wear protective clothing in the kitchen and have attended infection control training. Liquid soap is provided for staff but not left in bathrooms to minimise the risk to residents. The manager works up to three days a week on administrative tasks. A handyperson is employed to cover all homes in the group. All staff files examined contained references and CRB checks. Epilepsy awareness training has been organised. Staff receive regular individual and group
Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 Page 6 supervision and can discuss issues informally with the manager. Residents’ views and opinions are sought and the home is monitored to ensure good quality care. All records regarding residents and the home generally are up to date and accurate and are kept at the home. Staff have training regarding infection control. All fire checks are carried out, the portakabin has been assessed and the home has a risk assessment for fire. The home is to be assessed for the safety of the water system. All furniture has been moved away from radiators. 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. Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 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 Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 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): 1 Prospective residents have useful information on which to make a choice about living at the home. EVIDENCE: The statement of purpose is a useful document and now includes a privacy and dignity statement and information regarding accessing inspection reports. A comprehensive residents’ guide is available in picture format for which the home is commended. Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 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): None of the standards in this section was examined on this occasion. They were looked at during the last inspection when they were met. EVIDENCE: Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 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): 17 Staff are sensitive to residents’ needs when supporting them at mealtimes. EVIDENCE: A recommendation was made at the last inspection that staff are seated when supporting residents at mealtimes. This was discussed at a staff meeting and staff are now sensitive to residents needs when providing support. Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 Page 11 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): 18,20 Residents receive individual, appropriate personal care. Residents are protected by the home’s medication policy. EVIDENCE: Staff were observed at the last inspection using wheelchair equipment inappropriately, including using chairs that did not belong to the resident in question. This was covered in a staff meeting following the inspection and residents have been referred for OT assessments to ensure that they have appropriate mobility equipment. Medication profiles are kept on file for residents; the inspector saw these. Records of the temperature in the medication trolley are kept. These were also seen. The inspector also saw records of staff training regarding the handling of medication. Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 Page 12 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): 22,23 Service users’ views are listened to and acted on. Service users are protected from abuse and appropriate action is taken when it is suspected that it may have occurred. EVIDENCE: The inspector was shown a form for recording complaints that is very useful. It includes pictures to improve accessibility for residents. The home is commended for this. A requirement was made at the last inspection that an issue be referred to the local adult protection team. This was done and the investigation has been concluded. All documentation regarding this has been forwarded to the home’s lead inspector. Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 Page 13 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): 24,25,26,27,30 The home is homely, comfortable and safe however some areas require attention as detailed in the report. Bedrooms suit residents’ lifestyles but again require some attention as detailed. Bathrooms are suitable and private but need redecorating. The home is clean and hygienic. EVIDENCE: The following requirements and recommendations regarding the premises were made at the last inspection: Window restrictors have now been fitted. The entrance hall and stairs have been partly decorated. The lounge and dining room have been redecorated and the carpet replaced. The lounge seating has not yet been replaced. Radiator covers have been fitted in communal areas but not bedrooms. The laundry has been checked for damp and no evidence was found, the laundry does need redecorating. Locks without thumb-turns have not been replaced. Staff use a range of methods to enhance residents privacy and dignity when bathing. The bathrooms referred to have not been decorated.
Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 Page 14 Water temperatures are monitored and were found to be within safe limits. The individual water heaters in bedrooms are to be removed as part of a programme of redecoration. The bedroom intercoms are to be replaced as part of a programme of redecoration. The carpet in GH’s room will be replaced when it is redecorated. Bedroom furniture is being replaced or repaired as part of an on-going programme that takes into account the National Minimum Standards. All rugs have been removed to minimise trip hazards. There is a programme of redecoration that is on going. Those areas that have not yet been decorated will be as part of this programme. All freezer casings have been cleaned. Staff wear appropriate protective clothing when going into the kitchen. Soap is used in bathrooms after supporting residents. It is not left out, as several residents have been risk assessed as likely to drink it. Staff are trained in infection control. Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 Page 15 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): 32,34,35,36 Residents are supported by competent staff. Residents are protected by the home’s recruitment policy. Staff are appropriately trained to meet residents’ needs. Staff are supported and supervised. EVIDENCE: The manager has up to three administrative days a week at the home. A deputy also supports her in the management of the home. The home has access to a handyperson who works at all homes within the company. The manager stated that this is a working arrangement. All staff files examined by the inspector contained the necessary references and Criminal Records Bureau checks. Epilepsy awareness training has been arranged for staff. Formal supervision is offered to all staff and the manager has an open door policy, staff are able to discuss issues where necessary. Group supervision sessions are also used at the home. Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 Page 16 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): 39,41,42,43 Residents’ views are sought when planning the service. The home has robust record keeping policies and procedures. Residents’ health and safety are promoted. Residents benefit from competent management. EVIDENCE: The inspector was shown a copy of the ‘Quality of Life’ template that is to be used to assess residents’ needs. The home is monitored through regular unannounced visits; the inspector saw reports from these. The views of relatives and other stakeholders are also sought as part of this process. All records required are kept at the home at all times. The inspector saw a comprehensive and useful cleaning schedule that evidences the cleaning that happens within the kitchen. Staff have training regarding infection control. The programme is partly taught and partly distance learning and appears very useful. The inspector saw records of fire checks that were up to date and accurate. An up to date certificate of electrical circuit testing was seen. An appointment has been made for an independent company to check the water system for leigionella and safe temperature control. The Portakabin has been assessed for fire safety. All furniture has been moved away from hot radiators.
Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 Page 17 The home has generic risk assessments for fire safety and has been advised by the fire department that individual risk assessments for residents are unnecessary. Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 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 Standard No Score 1 4 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 1 25 3 26 2 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 X X X 3 X 3 3 3 Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 Page 19 Yes. 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. 2. 3. Standard YA24 YA24 YA24 Regulation 23 23 23 Requirement Repair and replace the lounge suites/seating Repair, replaster and refurbish the bathrooms as stated in the report. Re-decorate all residents bedrooms identified to the manager, prioritising Ms Bedroom. Timescale for action 30/04/06 30/04/06 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard YA24 YA24 YA24 YA24 YA26 Good Practice Recommendations It is recommended that the decoration of the entrance hall and stairs be completed. It is recommended that radiator covers be fitted in bedrooms. It is recommended that the laundry be decorated. It is recommended that any locks that do not have thumb turns for exit access be replaced. It is recommended that a new system of intercoms is fitted in residents’ bedrooms.
DS0000026441.V285225.R01.S.doc Version 5.1 Page 20 Greenwood Lodge Care Home 6. 7. 8. YA26 YA26 YA26 It is recommended that the carpet in GH’s room be replaced when the room is decorated. It is recommended that the water heaters are removed from bedrooms when they are decorated. Ensure that all residents have the required furniture and equipment in their bedroom as stated in the standard unless there is a justified reason for this, which should be detailed within the individuals care plan. Greenwood Lodge Care Home DS0000026441.V285225.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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