CARE HOME ADULTS 18-65
The Green Ravenswood Village Nine Mile Ride Crowthorne Berkshire RG45 6BQ Lead Inspector
Katy Brown Unannounced Inspection 9th February 2006 2:50 The Green DS0000011334.V282988.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 The Green DS0000011334.V282988.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. The Green DS0000011334.V282988.R01.S.doc Version 5.1 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 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) green@norwood.org.uk bucketsandspades@norwood.org.uk Norwood Ravenswood T/A Norwood Mrs Christine Terry Care Home 15 Category(ies) of Learning disability (15) registration, with number of places The Green DS0000011334.V282988.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 18th May 2005 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 residents and they are large enough to be a bed sitting room. Most residents have their own fridge and tea/coffee making facilities, their own televisions and audio equipment. The home has its own vehicle and residents are able to access public transport, as appropriate. The Green DS0000011334.V282988.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over one day. There have been no additional visits made since the last unannounced inspection. A tour of the premises took place and residents’ care records and some of the homes’ records were inspected. Seven residents, a volunteer and a visitor were spoken to during the visit. One member of staff and the manager were also spoken to. What the service does well: What has improved since the last inspection? What they could do better:
The information about the residents is not available in one place in their files, making it difficult to identify what care is required for them as individuals. This is a recommendation that has been made. The Green DS0000011334.V282988.R01.S.doc Version 5.1 Page 6 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 DS0000011334.V282988.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 The Green DS0000011334.V282988.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 & 2. Residents are provided with the information that they need prior to moving into the home. All residents receive care needs assessments outlining the service that they require. EVIDENCE: The statement of purpose and the service user guide include the information specified in the Care Homes Regulations. The documents are reviewed and updated on an annual basis and enable the residents and stakeholders to gain an insight to the services provided. All the residents that live at the home had received care needs assessments prior to their admission. There have been no new admissions to the home since the previous inspection. The Green DS0000011334.V282988.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): 6 & 8. All residents have been provided with plans of care although, the information outlining their specific care needs is not collated in one specific place and can make it difficult to identify all the support that is required. Residents are supported to make decisions in which way the home is run. EVIDENCE: Plans of care are available for all residents and they contain all the information about their personal care and social care needs. This information however, is not available in one place and can make it difficult to identify all the support that is required. Discussion with residents’, staff and volunteers indicated that the residents’ needs are being met and that clear plans and guidance is available. Care plans are regularly reviewed and residents confirmed that they do attend their reviews of care. The residents say that they do attend house meetings at The Green and discuss a variety of things that affect their lives while living at the home. There are also monthly meetings held in Ravenswood Village to enable the residents to have a say in how the village is run.
The Green DS0000011334.V282988.R01.S.doc Version 5.1 Page 10 There is a key worker system in place where workers are provided with an opportunity to explore important issues individually with the residents. Residents said that changes are made when they are dissatisfied with things. The Green DS0000011334.V282988.R01.S.doc Version 5.1 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 & 16. The residents take part in a variety of activities and are provided with opportunities to take part in and explore local community events. The staff ensure that the residents are treated with respect. EVIDENCE: Most of the residents do attend college outside of the Village and also take part in a variety of educational and leisure pursuits. Staff encourage the residents to take part in a variety of community activities including, trips out for meals, the cinema and bowling. Some residents also regularly visit the library, the local pub, town centre and local shops. Some residents’ spoke about their planned holidays and one resident is being joined on her trip by her boyfriend. The staff were observed interacting well with the residents and have a very good understanding of their needs. The residents are relaxed and comfortable with the staff and frequently approach them. Staff treat the residents kindly and with respect; they are also very patient with them. The residents say that they enjoy living at the home and that they like and trust the staff. The
The Green DS0000011334.V282988.R01.S.doc Version 5.1 Page 12 volunteer and the visitor that were spoken to said that the staff provided a good standard of care and that the residents were well cared for. The Green DS0000011334.V282988.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 & 21. The residents’ are protected by the homes’ policies and procedures for the administration and management of medication. The staff manage illness and death of the residents sensitively and in accordance with their wishes. EVIDENCE: The home has satisfactory policies and procedures in place to enable staff to administer medication safely to the residents. Currently there are two residents that self-medicate. A trained member of staff always administers medication and the completed reports that were made by the pharmacist during the previous visits, did not indicate any concerns. A resident who lived at The Green has recently died. His wishes were adhered to and his funeral arrangements were in accordance with his cultural specifications. Family members and the residents were frequently updated about his condition while he was in hospital and a senior manager from the village, gathered the residents together to tell them the sad news that he had died. The residents said that the senior manager encouraged them to talk about their feelings and were given support if they were upset. The Green DS0000011334.V282988.R01.S.doc Version 5.1 Page 14 The residents speak openly about his death and have placed photographs and items that they can remember him by, on a table in the lounge area. The residents also met together to talk about what they would like to do and have agreed to plant a tree in the garden in his memory. The gentleman’s family have been invited to the memorial service and tree planting ceremony. The Green DS0000011334.V282988.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22. Residents views are listened to and both 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 who were spoken to said that staff always resolved any issues or concerns that they had raised or identified. The manager and staff keep a satisfactory record of complaints that are made and records indicate that the residents do make complaints. The CSCI has not received any complaints in respect of this service. The Green DS0000011334.V282988.R01.S.doc Version 5.1 Page 16 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24. The residents live in a safe environment that is able to meet their needs. EVIDENCE: A tour of the premises identified that the home is well decorated and the furniture looks nice. All the residents have their own bungalows with en-suite facilities, fridges, televisions and musical equipment. The lounge and dining room are combined although the area is extremely spacious enabling the residents to eat and relax without being in too close proximity to each other. A warm and homely atmosphere presents throughout the environment. Some residents spoke of their bungalows recently being decorated and advised that they were involved in the selection of the colour scheme. There is a spacious garden that is available for the residents; vegetables and plants are being grown and residents enjoy taking part in the planning and development of the garden. The Green DS0000011334.V282988.R01.S.doc Version 5.1 Page 17 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 & 34. Competent staff support the residents’ and the recruitment procedures and practices within Ravenswood Village protect the residents. EVIDENCE: The residents confirmed that staff at the home are able to meet their needs and that they are always willing to help and offer advice when required. The home has a staff compliment that is a rich mixture of experience and skills and knowledge. Some of the staff at the home have NVQ level 2 or NVQ level 3 in care. Others are scheduled to commence the qualification. The home has a satisfactory recruitment policy in place. The recruitment practices within Ravenswood are robust and protect the residents that live there. The Green DS0000011334.V282988.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37. The manager is competent and the home is well run. EVIDENCE: The staff, visitors and residents say that the home is well run and the manager is liked and trusted. The manager of the home has completed the Registered Managers Award, has NVQ level 4 in management and the Assessors Award D32-D33, she is also an internal verifier. She has 15 years experience working with people with learning disabilities and has continued her professional development by attending refresher training and attending weekly management meetings and workshops. The Green DS0000011334.V282988.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 3 2 3 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 3 23 X ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 4 3 X X X X X X The Green DS0000011334.V282988.R01.S.doc Version 5.1 Page 20 N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations That the information that outlines the type of care that is required for the residents is kept in one place to enable staff to access the information more easily. The Green DS0000011334.V282988.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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