Care Home: 6 Greenford Walk

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What the care home does well Greenford walk provides people with high standards of care and support. People living at the home are encouraged to be as independent as possible. The home has excellent systems in place to introduce new people to the service, ensuring that the process is as relaxed as possible for both existing and new residents. In the main the care records looked at were good, those that had been completed fully contained very detailed information. People`s health needs are well met and people are encouraged and supported to manage their own medication where possible. There are good social and leisure opportunities available for people living at the home. The home is well furnished and decorated and provides a homely environment for the people living there. The home has a committed staff team, who are well trained and very committed to providing a user led service. There are clear policies and procedures in place and good systems to manage the health, safety and well being of people living and working at the home. What has improved since the last inspection? A new shower room has been fitted and new furniture has been purchased for the lounge. Decoration is ongoing. The home continues to review its services and puts in place an annual business plan which details any improvements. What the care home could do better: It is commendable that of the National Minimum Standards examined, that so few areas have been identified as in need of improvement. Of these standards examined, no requirements have been made. The care records for some of the people accommodated should be more detailed. All staff should receive a minimum of six supervision sessions each year. It is recommended that the home`s quality assurance systems are further developed so that the views of relatives and other professionals can be sought. Key inspection report Care homes for adults (18-65 years) Name: Address: 6 Greenford Walk 6 Greenford Walk Thorntree Middlesbrough TS3 9NX     The quality rating for this care home is:   three star excellent 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: Tanya Newton     Date: 1 1 0 3 2 0 1 0 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 22 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 22 Information about the care home Name of care home: Address: 6 Greenford Walk 6 Greenford Walk Thorntree Middlesbrough TS3 9NX 01642251518 01642218279 greenfordwlk@walsingham.com www.walsingham.com Walsingham Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: One named service user over the age of 65 years. Date of last inspection Brief description of the care home 6 Greenford Walk is registered as a care home with the Care Quality Commission to provide care and accommodation for up to 6 people who have a learning disability. The home is situated in a local authority estate within walking distance to local amenities. It is a detached house having a large fenced garden to the rear and a garden to the front with parking space. The service at Greenford Walk is provided by Walsingham, a registered charity. There is no registered manager at present. The fees for living at 6 Greenford Walk are £908.00 per week. Please contact the service for up to date information regarding fees. 6 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 22 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: three star excellent 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 inspection was unannounced and carried out over five hours. All of the key standards were looked at. Prior to the inspection the home were asked to complete an annual quality assurance assessment (AQAA) which provides the commission with information about the service. During the inspection we spoke to people living and working at the home. We looked at a number of records including peoples individual care files and staff records. We took a tour of the building and checked the homes medication systems. We also sent out surveys to seek the views of people living and working at the home, we received six back from staff and five from people living at the home. Comments received within surveys or during discussions have been included within the report. Care Homes for Adults (18-65 years) Page 5 of 22 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 6 of 22 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 7 of 22 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their individual aspirations and needs assessed before they are admitted to the home. Evidence: Three sets of records were looked at, all of which include a copy of the care managers assessment. The home has a clear admission process in place and has good systems which introduce people to the home over a prolonged period of time. This includes a number of visits to the home for meals and overnight stays. Existing residents are asked for their views on any prospective new resident and these views are recorded. One of the people living at the home said, I looked around before I moved in, its a nice place to live. All five surveys received from people living at the home said that they were asked if they wanted to move into the home and that they received enough information about the home before moving in. Care Homes for Adults (18-65 years) Page 8 of 22 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some of the care plans in the home need to be updated to ensure that they contain sufficient detail to meet peoples needs. People are supported to make decisions and choices regarding all aspects of their lives. Evidence: Three care files were looked at during the inspection. The deputy manager of the home informed us that care files were in the process of being updated onto a new format. The amount of information recorded in care plans was inconsistent. We looked at the files for the three most recent admissions. One was extremely well completed and contained lots of detail about how the individuals health and personal care needs should be met. The individual had been involved in writing sections of this plan and had signed their agreement. One of the other files examined was for someone who was admitted to the home in November. The information in sections of this plan were quite limited and it is expected that further detail and information should have been recorded after 4 months. The home need to ensure that care plans are all up to date and reflect the care needs of all people living at the home. Care Homes for Adults (18-65 years) Page 9 of 22 Evidence: People living at the home are supported to make decisions and choices in all aspects of their lives. Again all five surveys received from residents confirmed this. One person said, I can do what I want, when I want. I have been in a few places and this is the best. Care plans in the main, reflect the ways in which people are supported and encouraged to make decisions and choices. The home has a rotational system for meals so that each individual gets to choose what goes on the menu and to help buy ingredients and cook. Another person living at the home said, the staff will do anything for me. People living at the home are encouraged and supported to take risks. One of the people spoken to said, I go out alone, I like to use the bus, but I dont like to cross the road so staff come and meet me. Risk management is included within each individual care plan. Care Homes for Adults (18-65 years) Page 10 of 22 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. There are good social and leisure opportunities available for people living at the home. Evidence: Staff working at the home said that there were good links with the local community. People attend church. They participate in community meetings and go on outings with the community centre. Some people attend day services. Comments from people include, I go out to coffee mornings, I like to go out during the day, I go shopping. I go on holidays and outings and I am going to see a concert in May, I go into town alone, I travel on the bus, I go to a day centre twice a week, I like going to church on a Sunday. I like going to the pub and I am going to Redcar tonight for my tea. There is plenty going on here. I get visitors. Comments in surveys included, they look after me, they take me out and take me on holidays and they do anything I ask them to. Care Homes for Adults (18-65 years) Page 11 of 22 Evidence: The homes AQAA states, We actively promote community participation. We support people to develop & nurture relationships with those that are important to them. We provide the appropriate support to enable the individual to carry out their chosen activities. People are supported to maintain contact with family and friends. The home has open visiting arrangements and contact is further maintained through telephone calls and letters. Each person living at the home has their own key for their bedroom as well as the front door. This ensures people privacy. The telephone is also answered by people living at the home. People living at the home take in turns to plan the days menu and that includes shopping for items and cooking tea with support from staff where this is required. This ensures that everyone gets to choose a meal that they want to eat. Alternatives are always available and healthy diets are encouraged. Meals are very much a social occasion and everyone helps with jobs, be it setting the table or washing up. The homes AQAA states, We have sought specialist advice for individuals with Diabetes, accessed easy information material on this subject, and promote healthy eating. Care Homes for Adults (18-65 years) Page 12 of 22 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has good systems in place to support people with their health needs. There are good systems to manage medication and support from other professionals is sought where this is required. Evidence: The home has good records in place to support peoples health needs. There is clear input from a range of other professionals where this is required. The homes AQAA states, All appointments take place at the practitioners office (no in-house appointments). We receive specialist support from Consultant Psychiatrist, CPN, Dietitian,Sensory loss support team. Positive reports have been received from health professionals regarding the level and manner of support we provide. Good systems are in place for the management of medication. All staff who administer medication have completed training. All medication and a list of side effects are recorded and each person living at the home has an individual my health book which details all areas of health needs. People are supported and encouraged to manage their own medication and there is detailed risk management in place to support this. Care Homes for Adults (18-65 years) Page 13 of 22 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. The people who live in the home can be confident that their concerns and complaints are dealt with appropriately and sufficient safeguards are in place to protect them from abuse. Evidence: There are good systems in place to enable and support people to raise any concerns should the need arise. Each person living at the home is given a copy of the complaints procedure. The procedure is produced in an accessible format for individuals living at the home. Comments from people living at the home include, I have no complaints, this place is excellent and I tell the staff if I have any problems. All five surveys received confirmed that people knew who to speak to and how to complain, should they have any problem. The home has a comprehensive adult protection procedure. This gives staff the support they need to make a referral should this be required. The staff spoken to during the inspection said that they would have no hesitation in whistle blowing (telling someone)if they saw or heard anything inappropriate. All staff have received training in adult protection. Care Homes for Adults (18-65 years) Page 14 of 22 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. The home is clean and well maintained. it is furnished and decorated to a high standard and provides a homely environment to the people living there. Evidence: Greenford Walk is a six bedroom detached home that offers people a very warm, homely and comfortable environment to live. The home is clean, nicely furnished and decorated to a high standard throughout. Adaptations and equipment are provided where required. One of the people living at the home showed their bedroom to the inspector. It was personalised with their own items which reflected the individuals hobbies and interests. Bedroom doors have locks fitted to ensure peoples privacy. The home has a large enclosed garden so that people can sit outside and enjoy the warmer weather. One of the people said, the house is always clean. The AQAA states, New seating has been purchased for the main lounge, and the lounge and dining room have been re-decorated. A new shower room has been installed in the downstairs bathroom to meet the changing needs of the people we support. New beds and curtains have been purchased. Care Homes for Adults (18-65 years) Page 15 of 22 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. Staff numbers and skill mix are appropriate to meet peoples needs. Staff are competent to do their jobs and the homes recruitment procedures help to protect people. Evidence: There are eight staff currently employed. There are always two staff on duty and three if the needs of people living at the home dictate. All staff go through a through recruitment process. Each staff file has a pro forma in place from Human Resources which confirms that two references and a police check have been carried out. Records are also held at the home. Not all of the staff supervisions were up to date, this was confirmed by the person in charge during the inspection. Comments from staff include, We all work well together as a team, I enjoy working here, its a good place to work, I feel that it is an efficiently run home, with a good staff team and I would recommend it to anyone. I would not be adverse to a family member using it if it became necessary and I have good support and get good feedback from my manager. I develop my skills through the on going training. Care Homes for Adults (18-65 years) Page 16 of 22 Evidence: Four of the staff surveys raised concern about recruitment, particularly the time it takes to employ staff when there are vacancies. One staff member said that there should be more bank staff to cover holidays. The AQAA states, Over 50 of the staff team have Level 2 NVQ or above. The individuals who live here demonstrate positive inter-action with staff. We provide an open environment where peoples views are sought on all aspects of their care. Care Homes for Adults (18-65 years) Page 17 of 22 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 has good management systems and the home is run in the best interests of those living there. Evidence: The home does not currently have a registered manager. They do have a someone who is in the process of applying for this position. The home has some good systems in place to seek the views of people living and working at the home. They should consider ways of gaining feedback from relatives and other professionals. Discussions with people during the inspection and observations made confirm that the home is being run very much around the interests and needs of the people living there. The AQAA states that all staff receive an annual appraisal, regular supervision and team meetings, as well as access to training & development opportunities. The low staff turn-over demonstrates that staff are content with the level of support they receive and their job role. Staff have adapted very well with the change of managers Care Homes for Adults (18-65 years) Page 18 of 22 Evidence: they have experienced in the past 12 months. A sample of health and safety records were looked at, these included portable appliance testing, the gas safety certificate, electrical wiring certificate and water temperature checks. All were all up to date. Fire records were also looked at. Care Homes for Adults (18-65 years) Page 19 of 22 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 20 of 22 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 2 3 6 36 39 The care records for some of the people accommodated should be more detailed. All staff should receive a minimum of six supervisions each year. Quality assurance systems should be further developed to include the views of relatives (where appropriate) and other professionals. Care Homes for Adults (18-65 years) Page 21 of 22 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. 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