Care Home: Green Lanes Projects

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What the care home does well People living in this home are encouraged to live an active life, taking up opportunities for education and employment and following their personal leisure interests. Their rights and responsibilities are respected and there are clear risk assessments designed to keep people safe from harm while respecting their right to independence. The home is well maintained and provides a clean, attractive homely environment. What has improved since the last inspection? All of the five requirements made at the last inspection have been met. Improvements have taken place in the following areas: training, improved menus, improvements in meeting individual cultural needs. The impression gained in talking to staff was that there was a commitment to improving the service. What the care home could do better: The area where the home needs to improve in order to meet the needs of the people living there are: training in the Mental Capacity Act, an audit of all staff files to ensure that all relevant documents are on the correct staff files. The registered person must provide a monthly management visit report in accordance with Regulation 26 of the Care Homes Regulations 2001. Key inspection report Care homes for adults (18-65 years) Name: Address: Green Lanes Projects 40 Myddleton Road Wood Green London N22 8NR     The quality rating for this care home is:   two star good 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: Diaman Balraj     Date: 0 5 0 6 2 0 0 9 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 23 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) 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 23 Information about the care home Name of care home: Address: Green Lanes Projects 40 Myddleton Road Wood Green London N22 8NR 02088290996 02088290996 green.lanes@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Pangisani Mabhena care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Green Lanes Project is a registered care home providing care for up to six men and women who have a learning disability. The home is registered to care for adults between the ages of eighteen and sixty five years. The home is a large three storey house in Haringey, North London. The home is well situated for buses and overland trains and is a short bus ride away from the underground station at Wood Green. Service users of the home have easy access to local shops, churches, cafes etc within walking distance. The house has six single bedrooms with ensuite facilities and a large lounge, kitchen diner, conservatory and garden. The house is decorated and furnished to a good standard. The aim of the home is to empower individuals to live as independently as possible according to their preferences and abilities. The home currently has five residents, one woman and four men. The fee for living at the home ranges from #850 to #2200 per week, depending on the level of care provided. Following Inspecting for Better Lives, the provider must make information available about the service, including inspection reports, to service users and other Care Homes for Adults (18-65 years) Page 4 of 23 Over 65 0 6 Brief description of the care home stakeholders. Care Homes for Adults (18-65 years) Page 5 of 23 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: two star good 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 took place on the 5th June 2009 and lasted one day. The inspection was unannounced and consisted of the following: Tour of the home. Inspection of two residents and staff files. Inspection of records and policies in the home. Discussing and seeking clarification of care issues with the manager. Talking with three members of staff. Observing the interaction between staff and residents. Reading surveys about the home written by two residents, 3 members of staff and one health care professional. Care Homes for Adults (18-65 years) Page 6 of 23 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 7 of 23 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 8 of 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in this home can be assured that their needs and aspirations will be assessed before they move in and regularly thereafter. Evidence: In order to assess whether peoples individual needs and aspirations had been assessed, We read the assessments of 2 of the five people currently living in the home. Their needs were fully assessed. Risk assessments were comprehensive and related to each individuals needs. We also spoke with the manager and a member of staff who demonstrated how the needs and aspirations of a particular resident matched the needs recorded in his file. The home currently has one vacancy and the manager explained that assessments of prospective residents are discussed with the staff team to ensure they are involved in the assessment process. Care Homes for Adults (18-65 years) Page 9 of 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from comprehensive risk assessments and care plans which address all their needs. Evidence: Three residents care plans and risk assessments were inspected in detail. Risk assessments were of a good standard and very comprehensive. Care plans addressed the persons needs in a number of different areas and were clear for staff to follow. Religious and cultural needs were addressed in the care plans. Examples seen at this inspection were access to Indian and Nigerian films, African and Turkish food introduced on the menu and religious needs addressed. Cultural needs were recorded in care plans. Residents are able to discuss changes they would like in Key working sessions when their needs are reviewed. In the case of residents who have challenging behaviour written contracts regarding behaviour have been written and signed. people are encouraged to make decisions for themselves on a day to day basis and where this is not apropriate this is recorded. Residents who are able travel independently and others are escorted by staff to college and for their leisure activities. There was Care Homes for Adults (18-65 years) Page 10 of 23 Evidence: evidence that everyone is encouraged to be as independent as they are able. Care Homes for Adults (18-65 years) Page 11 of 23 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. Residents are supported to have a good quality of life following their own individual interests and maintaining their own relationships. Their rights are respected. Evidence: The inspector was able to observe the interaction between staff and residents and spoke to one resident. All other residents were out for the day at college when the inspection took place. Two completed questionnaires were received from residents. These had been completed with staffs help. Questionnaires were also received from three members of staff and one health care professional. The responses were positive about the quality of care. All five residents were enjoying a good quality of life and received support from staff to follow their interests. All five attend college on a part time basis. Staff escort them on public transport and give them the support they need. The home has a collaborative relationship with the colleges and meet with tutors regularly to monitor Care Homes for Adults (18-65 years) Page 12 of 23 Evidence: progress and sort out any problems. Service users have regular trips to the cinema and use local libraries and shops. Residents are well supported to live their lives according to their own wishes with risk assessments in place where needed for their own safety. The home supports service users to keep in contact with family and friends and offers support with personal issues. The home has links with a social club for people with learning difficulties and a dating agency for people with learning difficulties which residents may want to use. The residents are encouraged to be as independent as possible. If a resident is at risk in the community a clear risk assessment is put in place. This is reviewed on a regular basis. As a result of a review a resident was allowed greater independence in the local community. The information gained from daily records, care plans relating to the three residents showed the inspector that people were being supported to make choices about their daily activities and lifestyle. A resident who enjoys acting and drama benefits from the support of a member of staff who is experienced in this field. The menus inspected showed that it was varied and nutritious and reflected the cultural preferences of residents. Residents also liked going to the Carribean centre where they could enjoy a good meal. One resident stated that he/she liked going to the Indian Restaurant to enjoy a good curry. Care Homes for Adults (18-65 years) Page 13 of 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents physical and mental health needs were being met, using specialist services where required. Residents are protected by the safe administration of medication. Evidence: Residentspersonal support needs and preferences are recorded in care plans. Staff interviewed demonstrated knowledge of residents preferences and how these were met. One resident said he was satisfied with the personal support he received from staff. Three service users files were inspected for evidence of their health needs being addressed. There was evidence that physical and mental health needs were being met. Records were kept of appointments with a dentist, optician, GP and specialist services, ie speech and language therapist, continence advisor and psychiatrist. Mental and physical health needs were recorded appropriately. Medication is administered by staff who have had an administration of medication assessment. Two staff administer the medication and sign that they have done so. The medication administration records checked were in order. None of the current residents are able to self medicate at this time. Care Homes for Adults (18-65 years) Page 14 of 23 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. People living at the home can be assured that their views, their safety and protection from abuse are taken seriously by the home. Evidence: The home has a complaints policy which meets the required national minimum standard. The complaints form is user-friendly. There is a written procedure for staff to follow should there be any allegation or incident of abuse. This adult protection procedure and the emergency telephone numbers for each service users placing authority and the local adult protection officer are easily accessible to staff. Both the manager and a senior member of staff demonstrated a good understanding of the procedures to be followed. The two members of staff interviewed also stated that they would report any allegation of abuse to the manager. In the case of residents who have been subject to abuse prior to coming to this home there are written risk assessments and careful practice which is agreed with the placing authorities of each individual. All staff with the exception of one staff member have attended training in the protection of vulnerable adults. Care Homes for Adults (18-65 years) Page 15 of 23 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. Residents are provided with a homely, well maintained environment. Evidence: The home blends in well with other houses on the street and is well situated for public transport and local amenities. The inspector looked at all communal rooms and five bedrooms. All rooms are well decorated and furnished with good quality furniture. The general cleanliness of the home was of a good standard. The house is attractively furnished and homely. A computer is provided along with television and music facilities and there is a designated smoking area. A garden is available for residents use. Care Homes for Adults (18-65 years) Page 16 of 23 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. Residents benefit from well supported and supervised staff but must ensure that all recruitment records are available to support the quality of the recruitment practice. . Evidence: The Inspector met with two staff, one of whom was newly recruited and examined training and supervision records and staff files. Two staff have completed NVQ 2 in Health and Social Care and one the NVQ level 3. Five staff have followed POVA training, mental health, manual handling and safeguarding adult procedure. The home has also devised a positive behavioural support plan. Only one staff member has followed the Mental Capacity Act 2005 course. It is required that the manager and all staff members attend this course in order to further improve the quality of care to residents. The inspector checked 2 staff files including recruitment records. The records of a newly appointed member of staff showed that a POVA check had been carried out. The organisation was awaiting the CRB check. The manager stated that the staff was always on a shift working under the supervision of another member of staff and would not be left on their own. The inspector noted that there was only one reference for this member of staff. The manager stated that two references had been received and tried to locate the second reference. It was absent from the file on the day of inspection on 5th June. On the 12th June the manager emailed the inspector stating that he had Care Homes for Adults (18-65 years) Page 17 of 23 Evidence: found the second reference dated 10th May 2009. The manager stated that he had misplaced it in another staff file. It is required that the manager carries out an audit of all staff files to ensure that all relevant documents are on the correct staff files. Care Homes for Adults (18-65 years) Page 18 of 23 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. Residents benefit from a home where there is a commitment to ensure the best interests of residents. Evidence: The manager started employment at the home on 8th December 2008. He stated that he had submitted an application to CQC on 4th June 2009. Comments received from residents surveys indicated that they were satisfied with the management of the home. The inspector saw evidence in files that key workers meetings are held on a regular basis to consult residents on their satisfaction and future plans and wishes. The fire equipment was checked on the 20th March 2009. The Gas safety check on 27th August 2008. Fire drills and checks of door guards are undertaken weekly. There are written guidelines for staff regarding how to support an individual resident in responding to a fire drill. The inspector did not see monthly management reports on the conduct of the home. This is required under Regulation 26 of the Care homes Regulations 2001. Care Homes for Adults (18-65 years) Page 19 of 23 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 23 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 1 32 19 It is required that the all staff attend the Mental Capacity Act. To ensure that the care provided to residents takes into account the rationale of the Act. 30/07/2009 2 34 19 It is required that the 30/07/2009 manager carries out an audit of all staff files to ensure that all relevant documents are on the correct staff files. To ensure the effectiveness of the recruitment practice. 3 42 26 The registered person must 31/07/2009 visit the home and provide a written report on the conduct of the care home. To ensure the welfare of residents. Care Homes for Adults (18-65 years) Page 21 of 23 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 Care Homes for Adults (18-65 years) Page 22 of 23 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 23 of 23 - 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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