Care Home: Genesis Residential Home

What the care home does well People living in this home said they are very happy, they like the staff and feel supported when making decisions about how they live their lives. Staff have a good knowledge of the care and support people need to help them be as independent as possible. Staff are given training opportunities to give them the necessary skills to provide appropriate care and support. What has improved since the last inspection? Staff have attended a training session in the home on understanding equality and diversity needs. The re-decoration programme has continued with the front of the building being re-decorated and the original cast iron guttering restored. First floor corridors and one bedroom have also been re-decorated, the dining room has been re-furbished and new carpets have been fitted to the hall, stairs and landing. Quality assurance systems have been put in place and questionnaires have been given to residents and their relatives. What the care home could do better: Information should be included in the statement of purpose regarding how the service aims to meet equality and diversity needs of residents and how people can access our reports once published. Care plans must be person centred and focus on risk management, they must include changing needs and personal goals to ensure residents know how these will be achieved. An intimate care policy should be written for staff to follow making sure people are able to choose whether personal care is given by male or female staff. Management should seek out opportunities for residents to find paid or voluntary work and to have access to further education courses. CARE HOME ADULTS 18-65 Genesis Residential Home 2 Station Street Donington Spalding Lincolnshire PE11 4UQ Lead Inspector Elisabeth Pinder Unannounced Inspection 30 October 2007 10:00 th Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 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 Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 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. Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Genesis Residential Home Address 2 Station Street Donington Spalding Lincolnshire PE11 4UQ 01775 820431 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) Mr Biswanand Oozageer Mrs Rajkumari Oozageer Mr Christopher Rampley Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (2) Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Condition of Registration One place registered for MD(E) is only valid for the period that the named service user lives in the home. This registration will then revert back to MD. 23rd May 2006 Date of last inspection Brief Description of the Service: Genesis is situated on the main street in the village of Donington, Spalding, close to shops, churches, the library and other amenities. The home is owned by Mr and Mrs Oozageer. The home owners have a brochure available, which is used to promote the home. The brochure highlights that the home provides accommodation and personal care for eight residents who have a mental health condition. Two of the eight beds are for residents who are over 65 years of age, although one of these is only for the length of stay of that individual. The home is three floors high and was originally a family home. All of the bedrooms are occupied singly and have either en suite or wash hand basins in place. One spacious bedroom on the ground floor has en suite facilities. Car parking for visitors is located at the back of the home; this area also provides a garden for residents use. A small garden at the front of the home gives direct access to the High Street. The current weekly fee range is £361.40 - £451.77. Additional costs are made for hairdressing, toiletries, magazines/newspapers and transport. Contributions are made towards holidays. These are all private arrangements and the costs are met by individual residents. Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit to the home was undertaken by one inspector and formed part of a key inspection, focusing on all the key standards. Throughout this report the terms ‘we’ and ‘us’ refer to The Commission for Social Care Inspection (CSCI). The visit lasted approximately five and a half hours and took into account previous information held by us including the previous inspection report, their service history, monthly reports written by one of the providers and records of any incidents that had been notified to us since the last inspection. Prior to the visit the providers had returned their Annual Quality Assurance Assessment (AQAA) and this will also be mentioned throughout this report. Six ‘have your say about’ questionnaires had been returned from residents and comments from these will also be used throughout this report. The main method of inspection used was ‘case tracking’ which involved selecting three residents and tracking the care they received through looking at their records in detail and observing staff that provide their care. What the service does well: What has improved since the last inspection? Staff have attended a training session in the home on understanding equality and diversity needs. The re-decoration programme has continued with the front of the building being re-decorated and the original cast iron guttering restored. First floor corridors and one bedroom have also been re-decorated, the dining room has been re-furbished and new carpets have been fitted to the hall, stairs and landing. Quality assurance systems have been put in place and questionnaires have been given to residents and their relatives. Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 6 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 summary of this inspection report can be made available in other formats on request. Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 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 Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People coming into this service have access to a range of information to help them make a decision about moving into the home and procedures are in place to ensure people are only admitted after a full needs assessment has been carried out. EVIDENCE: Information written in the AQAA indicates that sufficient information is available regarding meeting prospective residents’ needs. Each person has access to the statement of purpose, service user guide and charter of rights. Prospective residents have opportunity to visit the service and meet with other residents and staff. The manager said he visits prospective residents to carry out an assessment to make sure their needs can be met by this service. The majority of residents’ questionnaires received prior to the visit indicated that they were asked if they wanted to move into the home and half indicated they were given enough information so they could decide if it was the right place for them. Since the previous inspection there has been one emergency admission and information was obtained verbally from the mental health team and a plan of care was written using this information. This person no longer lives in the home and those spoken with could not remember their admission. Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 9 The statement of purpose and service user guide was looked at and these did not give clear details on how people can access our reports once published or how the service aims to meet equality and diversity needs. The manager agreed to look into this. Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Care plans are not person centred and concise, therefore, peoples needs may not be met. EVIDENCE: Care plans examined contained basic information mainly relating to physical needs. They were not person centred and did not contain sufficient detail about social needs or focus on residents meeting their goals and aspirations, or record how they are supported to take risks. Information taken from the AQAA indicated that care plans are regularly updated and risks are assessed and managed responsibly. However, this was not clear in the care plans examined, although it is acknowledged that they had been reviewed and signed by individual residents. A discussion was held with one of the owners and the manager regarding individual care plans and risk assessments containing more detail and agreed strategies should also be recorded and both agreed to address this. Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 11 Staff spoken to had a good knowledge of the support that residents need although no specific training in mental health had been given. The manager said that he has regular updates from the local mental health team and passes any information on to staff. Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. This service provides residents with activities to suit their needs. They are supported by the staff team to be a part of the local community and are able to maintain and develop relationships of their choice. Peoples rights are respected and their health and wellbeing is promoted. EVIDENCE: Information provided in the AQAA read ‘effective links are established in the village, annual holidays are arranged and procedures are in place to support and encourage family links.’ During the visit residents told us that they are supported to undertake activities within the home and local community. One resident was going out to the library and to the shop and said how much they enjoyed this. Another resident said they enjoyed going out with the manager and another said they liked to go out to see their family. Events and activities Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 13 are on display and include attending a ‘Christian Fellowship’ held across the road, skittles, bingo and a singer coming into the home. Regular meetings are held where residents contribute to the running of the home, the last being held on 19th September 2007 and discussions centred around holidays, the redecoration programme and quality assurance questionnaires. At the moment no one is doing any paid or voluntary work or attending any further education courses and the manager said that this is an area where he would like to see residents having access to opportunities. Residents said they look forward to their holidays and confirmed that they are always able to choose where they go. Menus seen showed that all nutritional needs are catered for and a good choice of food is offered. Residents told us that meals are good and they have the option to choose and make alternatives to the main menu. Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The healthcare needs of people the service supports are being met and residents are protected by safe medication procedures. EVIDENCE: Information provided in the AQAA indicated that residents are supported by community psychiatric nurses, an occupational therapist and care managers. During the visit care records seen confirmed this and the physical needs of residents were clearly identified. The manager said that residents are encouraged to self-medicate wherever possible, however, all are currently being supported with medication and staff administering medicines have undertaken relevant training. One resident said “I get my medication when I need it and it is always correct’. Procedures are in place for the receipt, recording, storage, handling, administration and disposal of medicines and no issues had been raised in the report from the home’s community pharmacist after their visit undertaken on 8th June 2007. Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 15 Records showed visits to the dentist and chiropodist. Specialist support and advice is sought when necessary and equipment provided to aid mobility and independance. A discussion was held regarding developing an intimate care policy for staff to follow making sure people are able to choose whether personal care is given by male or female staff and the manager agreed to do this. Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People using this service are protected by the procedures in place for handling complaints and allegations of abuse. EVIDENCE: The home has a complaints policy and procedure in place together with a list of advocacy services. The majority of residents ‘have your say about’ questionnaires indicated that staff listen and act on what is said. No complaints have been received since the last inspection and people spoken with said they know who to speak to if something is worrying them and they are always taken seriously. The marjority of staff have undertaken training regarding safeguarding adults and staff spoken with had a clear understanding of the types of abuse. A discussion was held regarding the new revised addition of the Lincolnshire County Council Safeguarding Adults procedure and the manager agreed to obtain a copy and will ensure staff have an update of the contents of this document including the reporting process. There has been one allegation reported to safeguarding adults since the previous inspection and this has been dealt with appropriately. Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People living in this home live in a clean, pleasant and hygienic environment and they are able to personalise their rooms. EVIDENCE: Questionnaires received prior to the visit indicated that the majority of people living here feel the home is always fresh and clean. Health and safety assessments are carried out by an external agency and an improvement plan is written and kept under review. However, a window in the first floor bathroom was seen to open very wide and this was brought to the attention of the manager who agreed to fit ‘blocks’ limiting the opening width immediately and check all other windows. Three residents showed us their rooms and it was clear that they had been personalised in the way each wished with individual possessions and pictures. Communal areas seen were all clean and comfortable and there was a relaxed atmosphere in the home. Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 18 Since the last inspection the front of the building has been redecorated, the dining room refurbished and new carpets fitted to the hall, stairs and landing. One bedroom and first floor corridors have also been redecorated. The Manager confirmed that future improvements include an upgrade of the main electrical system and conversion of a fourth bedroom to include an ensuite facility. The owners are also planning to build five further rooms onto the existing building. Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People living in this home are protected by robust recruitment procedures and staff numbers are in sufficient quantity for them to be able to care for people currently living here. The service recognises the importance of training to ensure staff are knowledgeable and equipped to meet the needs of residents. EVIDENCE: Information provided in the AQAA indicated that there is a continuity of staff with only one staff member leaving in the last year. Robust recruitment procedures are in place and residents were involved in the recent recruitment of a deputy manager. There are currently six residents living in the home and two staff are on duty throughout the day and one ‘sleep in’ staff member at night. Another member of care staff is on call and the manager and owner available for advice. People spoken with said there is always someone around if you need them, they knew who their key-worker was and confirmed that they get on well with them. Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 20 There is a mixed age range, gender and ethnicity of staff and the majority of residents questionnaires indicated that they are ‘always’ treated well by staff. Information taken from the AQAA showed that 60 of care staff have achieved a National Vocational Qualification (NVQ), which is a recognised training award in care. Other training has included, the Mental Capacity Act, equality and diversity, induction training, fire and health and safety. Records also showed that staff receive regular supervision and staff confirmed this during discussions. Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home has a competent and committed manager who understands the needs of each individual resident. EVIDENCE: The manager has been in post for a number of years and has completed his Registered Managers Award. He is committed to improving the service for residents and has recently sent out quality assurance questionnaires to residents and is now developing questionnaires to send out to General Practitioners (GP’s), social workers and community psychiatric nurses. The results of these surveys will then be collated and an annual development plan will be written. Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 22 Staff said the manager is very supportive and always available, residents also spoke highly of him. Information provided in the AQAA showed that policies and procedures are available relating to the health, safety and welfare of residents and listed the dates they were reviewed. A discussion was held around using the Department of Health guide ‘Essential Steps’ to access the current infection control management and the manager agreed to look into this. Records showed that equipment is regularly checked and dates are recorded on the AQAA. Regular fire training is held, the last being on 1st October 2007. Accident/incident records are in place and we have been informed of any incidents that require reporting. Residents files are stored securely in a locked office. Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 23 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 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A 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. Refer to Standard Good Practice Recommendations Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Genesis Residential Home DS0000002656.V355319.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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