Inspection on 18/05/05 for The Green

This inspection was carried out on 18th May 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.

Other inspections for this house

The Green 04/12/08

The Green 17/01/07

The Green 09/02/06

The Green 01/03/05

The Green 09/09/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

Kestrel House, St Anne`s Opportunity Centre,

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 THE GREEN Ravenswood Village Nine Mile Ride Crowthorne Berkshire RG45 6BQ Lead Inspector Katy Brown Unannounced 18 May 2005 @ 10:45 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 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 Stationary 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. THE GREEN H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Green Address Ravenswood Village Nine Mile Ride Crowthorne Berkshire RG45 6BQ 01344 755568 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Norwood Ravenswood Foundation Ms Christine Terry Care Home 15 Category(ies) of Learning Disability (LD) registration, with number of places THE GREEN H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 01/03/05 Brief Description of the Service: The Green cares for fifteen adults with learning disabilities. It is set in Ravenswood Village, which is a Jewish community. The Greens underpinning ethos is derived from the Jewish faith and the beliefs practices and values of Judaism underpin all aspects of residents lives. The home is unique in that it is a complex of individual flats built in a semicircle around a central building, which is used as the communal parts of the home. All of the flats are individually personalised to reflect the interests and preferences of the users and they are large enough to be a bed sitting room. Most service users have their own fridge and tea/coffee making facilities and their own televisions and audio equipment. The home has its’ own vehicle and service users are able to access public transport, as appropriate. THE GREEN H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over four hours. There have been no additional visits made since the last announced inspection. A tour of the premises took place and staff records, residents’ care records and some of the homes’ records were inspected. Five members of the staff on duty, seven of the fifteen residents, and one visitor were spoken to. What the service does well: The home has a group of staff that have a clear understanding of residents needs and provide a good level of support to help them to make choices and decisions that affect their lives. Some of the residents have difficult behaviours and the staff manage this very well. The residents are comfortable and relaxed with staff and staff respond to their needs in a way that makes them happy. Residents that were spoken to say that staff treat them very well and that they are happy living at the home. The residents enjoy a variety of activities including horse riding and swimming and most of them are employed by Ravenswood village on a part-time basis. The residents preferred choice of meals are included within the menus and the residents say that the food is tasty and there is always enough to eat. Residents that were spoken to say that they are comfortable making complaints and that the staff and the manager take their concerns seriously and do what they can to resolve any issues. THE GREEN H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 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. THE GREEN H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection THE GREEN H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 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 standard(s) 3 The staff employed at the home and the services and facilities that are available to residents do meet their assessed needs. EVIDENCE: Individual records are kept for each resident and an inspection of the records for four residents’ living at the home, confirmed that their identified needs were being met and that specialist support had been implemented when required. Residents said that they are happy at the home and that staff and the manager are able to meet their needs. They discuss their goals with their key workers and have regular meetings to identify whether their goals have been met and set new ones when required. THE GREEN H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 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 standard(s) 6, 7 and 9 Residents are provided with a good standard of care and do take part in the care planning process and decisions that affect their lives. EVIDENCE: Individual plans of care are available for all residents and they contain all the information about their personal care and social care needs. Discussion with residents’, staff and visitors indicated that residents’ needs are being met and that clear plans and guidance is in place. Risk management plans and behavioural guidelines have recently been reviewed and updated and residents confirmed that they are supported to take sensible risks. Residents that were spoken to said that they do attend care review meetings and that they are involved in decisions that are made about their care. One resident said that he was having his review meeting that day and another resident said that he had attended his review meeting the previous week. Some residents are provided with advocates and others have befrienders. The deputy manager confirmed that residents would be provided with advocacy support if required. THE GREEN H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 Page 10 THE GREEN H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 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 standard(s) 12, 15 and 17 Residents take part in a variety of activities and college courses and maintain relationships with families and friends. Meals provided at the home are varied, well balanced and nutritious and meet the assessed needs of residents. EVIDENCE: All residents have individual activities programmes, which enable them to be aware of what things they will be doing each day. The activities that are currently provided include, horse riding, swimming and bike riding. External activities are accessed via the village transport system, which provides unlimited use of local facilities. Most of the residents work in Ravenswood Village in various capacities and one resident is employed outside of the Village within the local community. Some residents also attend college courses where they study IT and cookery. Staff support residents’ to write letters and make contact with friends and family and residents confirmed that they are able to use the telephone when they wished. Visits by friends and relatives are encouraged at the home and staff always make visitors feel welcome. Staff that were spoken to said that THE GREEN H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 Page 12 they have a good relationship with relatives and keep them up to date with relevant information. A record is kept of the residents’ dietary requirements and meals are provided in a way that reflects their cultural and identified needs. Residents’ likes and dislikes are incorporated in the menu planning process and residents confirmed that they are served with filling tasty meals that reflect their preferred tastes. THE GREEN H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 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 standard(s) 18 and 19 The residents’ are provided with a good standard of flexible care that reflects their identified wishes and meets their health needs. EVIDENCE: The residents’ needs, likes and dislikes are clearly identified and managed appropriately by staff. Up to date information is available that reflects the current changes in need for some residents’. Residents’ that were spoken to confirmed that they receive a good standard of care and that staff know what they liked and disliked. The home is dependent on agency and bank staff; however, residents confirmed that there is consistency with the additional staff that work there. Residents are supported to take control of their healthcare needs and a record is kept of all health related visits. Records that were inspected indicate that care staff and the manager have a good relationship with healthcare professionals and referrals are made when required. A visitor confirmed that the staff do provide her with updated information and that the residents are well cared. THE GREEN H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 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 standard(s) 22 and 23 There has been significant improvement in the way that staff manage complex behaviours and the residents views are listened to and acted on. Residents’ and visitors are confident that their complaints will be taken seriously and investigated properly. EVIDENCE: Residents and visitors that were spoken to said that they would be comfortable making a complaint as they believed that their complaint would be taken seriously. All residents have a copy of the complaints procedure and residents that were spoken to say that staff always tried to resolve any issues or concerns that they had raised or identified. The manager and staff keep a record of complaints that are made; however, they do not always identify who made the complaint or what the nature of the complaint was. Neither does the record include the contact details of the person who made the complaint. This makes it difficult to track the progress of the complaint and the manager is unable to inform the individual of what action the home is taking. There have been three complaints made at the home since the last inspection and all three have now been resolved. The CSCI has not received any complaints in respect of this service. All permanent staff receive training in the Abuse of Vulnerable Adults and Whistle blowing as part of their induction. Staff confirmed that since the previous inspection, they have received specialist training and amended guidelines that enable them to support residents’ with complex needs. They also discuss any changes in need during weekly staff meetings and residents’ records are updated accordingly. As a result, the number of violent THE GREEN H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 Page 15 altercations between some residents’ at the home has now ceased and aggressive outbursts have reduced. A resident that was spoken to say that he is now happier living at the home and that he feels safe. Another resident said that she did not like to hear people shouting as it upset her; however, she acknowledged that staff manage the incidents well, when other residents became noisy and disruptive. THE GREEN H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 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 standard(s) 30 The home is clean and hygienic and free from infection. EVIDENCE: There are policies available for the control of infection that support staff in their day-to-day practice and a tour of the premises identified that the home is clean and hygienic. The residents’ take responsibility for cleaning their own bungalows, although staff do provide support with domestic tasks when required. The laundry facilities are situated in a separate part of the home and the laundry is washed and dried by staff within the premises. Residents are able to attend to their own laundry if they wish. THE GREEN H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 35 The home has an effective staff team with a range of skills and experience. Staff receive a good induction and a variety of training, that enables them to provide a good service to the residents that live there. EVIDENCE: There were a number of vacancies in the team at the time of the visit and agency and bank staff are employed to fill gaps in the roster. There is also a volunteer who works at the home on a regular basis. The staff have a wide range of skills and experience and work well together. Staff that were spoken to say that they are more confident now they have received training in deescalation techniques and challenging behaviour. The staff on duty were observed demonstrating a good knowledge and understanding of the residents’ needs. Residents say that there are staff available when they need them and they are not made to wait for lengthy periods of time when they require support. A resident said, “ All the staff are nice and kind”. Staff that were spoken to, confirmed that they receive training and induction that helps them meet the needs of residents and said that they are provided with refresher training when required. THE GREEN H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 Page 18 Inspection of records identified that new staff including agency and bank, receive an induction when starting work at the home to enable them to become familiar with residents and their needs and also the homes policies and procedures. THE GREEN H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, 41 and 42 The manager and staff at the home do seek the residents views and opinions and ensure that they are reflected in the way that the home is run. The safety and welfare of residents’ is met through the health and safety policies and care practices at the home. EVIDENCE: There is no formally accredited quality assurance system in place in Ravenswood Village; however, there is a system of lay visitors with a quality assurance remit on behalf of the organisation. Lay visits are made to the home quarterly and a report is provided to the manager and to senior management about their findings. Records of the proprietor’s representative visits indicate that the home is providing a satisfactory level of care to the residents and any deficits in the service are addressed promptly. THE GREEN H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 Page 20 Relatives are able to voice their views and opinions at regular meetings held at Norwood Ravenswood (The provider organisation), which is based in London. An inspection of the homes records identified that the records that are required by regulation are maintained, accurate and up to date. The home has satisfactory health and safety policies and procedures in place and an inspection of records identified that regular maintenance checks are completed for equipment used at the home. The fire officer visited the home in January 2005 and no requirements were made. Regular fire checks and drills are carried out at the home. THE GREEN H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 Page 21 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 3 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 x x 3 x 3 Standard No 31 32 33 34 35 36 Score x x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 THE GREEN Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x 3 x 3 3 x H52-H01 11334 The green V217225 180505 Stage 4.doc Version 1.30 Page 22 NA 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 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. 1. Refer to Standard 22 Good Practice Recommendations That the manager and staff record the nature of the complaint and the contact details for the complaintant when recording complaints made about the home. 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