Care Home: Green Lane

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What the care home does well The staff are knowledgeable about the needs of the residents and good interaction was observed. The residents spoken to were happy with the care they received. Good records are kept and were available for inspection and they offer a person centred approach. The home was well maintained and welcoming. There are good systems in place to protect all who live, work and visit the home. What has improved since the last inspection? There have been a number of areas of the home that have been redecorated and new carpets have been laid since the last inspection improving the appearance of the home for the benefit of the residents. Staff have continued with there training to ensure they maintain their skills and are able to continue to meet the residents needs. The Boots monitored dosage system has been introduced for the medication administration and the processes have been reviewed to prevent medication errors happening. What the care home could do better: They need to continue with trying to recruit permanent staff. Continue with the plans already in place that include training, continue with the redecoration plan, and look at other recreation facilities available to the residents in consultation with them. CARE HOME ADULTS 18-65 Green Lane 17 Green Lane Leverstock Green Hemel Hempstead Hertfordshire HP2 4SA Lead Inspector Mrs Alison Butler Unannounced Inspection 27th November 2007 10:00 Green Lane DS0000070226.V355137.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 Green Lane DS0000070226.V355137.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. Green Lane DS0000070226.V355137.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Green Lane Address 17 Green Lane Leverstock Green Hemel Hempstead Hertfordshire HP2 4SA 01442 230384 01442 232903 pdavey@grooms-shaftesbury.org.uk www.grooms-shaftesbury.org.uk Grooms-Shaftesbury 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) Paula Davey Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Green Lane DS0000070226.V355137.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th October 2006 Brief Description of the Service: Green Lane (No.17) is a residential care home provided by GroomsShaftesbury.It is registered for five service users with learning disability. It is a converted building which is situated in a quiet residential road in the village of Leverstock Green, which is close to the town of Hemel Hempstead. The M1 and the M25 Motorways are nearby. There is a parking area in the front of the building. The administrative office, kitchen, dining room and lounge are all on the ground floor. All the bedrooms are of single occupancy and they are situated on the first floor. The bathrooms and toilet facilities are nearby. There is a large garden and patio to the back of the building. The garden is mainly laid to lawn with mature trees and plants around the borders. Information regarding the services provided are avaialble in the Statement of Purpose and Service User Guide. For these, up to date fee information and a copy of the CSCI inspection report please contact the home manager. Green Lane DS0000070226.V355137.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced was conducted by one inspector. This inspection has been conducted following the new registration of the service, as the provider has now become Grooms-Shaftsbury. This report has been written from information received by the Commission and previous inspections. Where information remains the same this has been brought forward into this inspection report. All residents were at home as the day centre was closed for the day. Most of the inspection was spent talking with the residents and staff on duty. Care records were also examined. What the service does well: What has improved since the last inspection? There have been a number of areas of the home that have been redecorated and new carpets have been laid since the last inspection improving the appearance of the home for the benefit of the residents. Staff have continued with there training to ensure they maintain their skills and are able to continue to meet the residents needs. The Boots monitored dosage system has been introduced for the medication administration and the processes have been reviewed to prevent medication errors happening. Green Lane DS0000070226.V355137.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. Green Lane DS0000070226.V355137.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 Green Lane DS0000070226.V355137.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An admission procedure is in place, to ensure that prospective residents needs can be met prior to moving into the home. EVIDENCE: There have been no admissions to the home for some time. However there is an admissions procedure in place, that states a full assessment must be carried out to ensure that the persons needs can be met prior to admission. Individuals are admitted to the home on a trial basis after which time a review would be held and a decision made on both parties to ensure the home was suitable and the individual wants to live at Green Lane. Green Lane DS0000070226.V355137.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect that the care plans reflect their individual goals and choices and that staff know how to meet these aims. Residents are involved in all aspects of life within Green Lanes and retain an independent lifestyle as appropriate. EVIDENCE: The residents were seen to interact well and helping each other in the running of the home. One resident was seen to ensure that they all received a drink and then collected the cups to return them to the kitchen. Two residents had been out to do the weekly shop and were supported by staff, in returning home they assisted in the putting away of the shopping. The care plans examined gave the action required by staff to meet individual’s needs and how to manage any challenging behaviours that may appear. Those Green Lane DS0000070226.V355137.R01.S.doc Version 5.2 Page 10 examined had recently been reviewed and risk assessments allowed individuals to take part in an independent lifestyle where possible. As communication is difficult staff meet with people on a one to one basis to discuss their care needs and a record is made appropriately. The majority of the residents are able to understand what is being said to them although they may have difficulty in verbalising their needs they use facial expression and gesticulation which shows they are able to express their wishes Green Lane DS0000070226.V355137.R01.S.doc Version 5.2 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. 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. The residents can expect to be encouraged to take part in the local community and take part in leisure activities of their choice. The residents are offered a healthy diet, a choice of menus and the opportunity to participate in the preparing of meals. EVIDENCE: The residents are offered a variety of social activities and they are detailed within their care plans. They all attend the day centre between 3-5 days depending on their choice. They all enjoy the disco on a Friday night at the Jim Macdonald centre. Staff will support them where appropriate to attend activities of their choice. Green Lane DS0000070226.V355137.R01.S.doc Version 5.2 Page 12 Residents have all had a holiday during this last year and they are involved in the choosing and planning of these trips. Devon and Bognor Regis have been their choices this year. Visits to their families are encouraged to visit and transport is provided by the home for visits to family if necessary. There is pictorial library to aid residents in choosing the weekly menu. They are also encouraged to help in the preparation and serving of meals where possible. Green Lane DS0000070226.V355137.R01.S.doc Version 5.2 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. 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. Residents can be assured that they will receive the care in the way they prefer. Medication administration is administered in accordance with the homes policies and procedures, which maintains residents safety. EVIDENCE: Care plans provided details of the action required by staff to meet individual’s needs. There are plans in place for managing difficult behaviours and they are written giving details of how the individual best responds to bring the behaviour under control. The information is written in the “I” format for example “I like to……………” “I am able to choose…………”. All visits to health professionals are recorded within the care plan and any action recorded appropriately. There have been two recent errors in medication, which both resulted in an internal investigation. This has resulted in the procedure being up dated and additional training being held. All medication is administered with two staff present and a countersignature is required for administer medication. Green Lane DS0000070226.V355137.R01.S.doc Version 5.2 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. 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. Appropriate procedures are in place to ensure that residents are protected from abuse. A complaints procedure is in place and staff ensure residents views are sought to identify and address any issues. EVIDENCE: Staff all receive training in safeguarding adults and refresher training is being arranged this coming year to update staff. Green Lane have received no complaints since the last inspection. Due to the fact that the residents have minimal communication key workers have set up one to one time to discuss with individuals about their care and what they would like to do. The staff are knowledgeable about the residents and are able to identify if they are unhappy. Green Lane DS0000070226.V355137.R01.S.doc Version 5.2 Page 15 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. The home provides a clean and welcoming environment, which meets the residents’ needs. EVIDENCE: The home is well maintained. A number of new carpets have been laid throughout and various areas have been decorated. There is a good standard of cleanliness throughout the home. Liquid soap is available to prevent the spread of infection. Green Lane DS0000070226.V355137.R01.S.doc Version 5.2 Page 16 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. There is a supportive and effective staff team in place who receive training to enable them to meet the needs of the residents. EVIDENCE: The care of the residents has been met with adequate number of staff. The staff are knowledgeable about the needs of the residents and good interaction was observed during the inspection. Previous inspections have shown that the required information has been obtained prior to a member of staff starting employment this is to protect the residents as far as is possible. There is a rolling training programme in place and good records are held. The manager ensures that all staff receive the required training to enable them to carry out their role in confidence. There are plans in place to have 80 of the staff to have achieved an NVQ award level 2 or above in the next 12 months. Green Lane DS0000070226.V355137.R01.S.doc Version 5.2 Page 17 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 is well run and the health, safety and welfare of residents, staff and visitors is promoted and protected. EVIDENCE: The manager has achieved the Registered Managers Award. She continues to update her skills by regularly attending refresher training. During the coming 12 months she is to complete a Management Essentials Programme, which look at various management tasks including managing people, discipline and grievance and recruitment etc. There is an open door policy and regular staff meetings take place and minutes are taken to ensure that everyone is kept updated on issues that have been raised. Risk assessments are reviewed and updated appropriately to protect all who live, work and visit Green Lane. Green Lane DS0000070226.V355137.R01.S.doc Version 5.2 Page 18 A yearly quality questionnaire is sent to all parents and stakeholders and a report is complied with the findings and an action plan put in place to address any issues. Green Lane DS0000070226.V355137.R01.S.doc Version 5.2 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 X 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 3 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 Green Lane DS0000070226.V355137.R01.S.doc Version 5.2 Page 20 No 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. Refer to Standard Good Practice Recommendations Green Lane DS0000070226.V355137.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Inspection Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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. 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