Care Home: Greenacres

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What the care home does well Residents are cared for in a homely environment within the Norfolk village of Felthorpe. Each of the resident`s bedrooms contains their own personal possessions and is decorated according to their taste. The home has a small loyal staff team to care for the three residents. This friendly staff team appear to know the residents` needs and help them to remain as independent as possible, offering support when required. Residents are encouraged to continue with their own hobbies and interests. Care plans are presented in a person centred format with clear records in place to ensure that residents` needs and lifestyle preferences are being met. What has improved since the last inspection? The home was issued with four requirements from the last inspection carried out in May 2007. The manager has dealt with all of these requirements. Due to the current mix of residents the manager has increased staff hours to ensure that they are appropriately assisted and have the option when and where they wish to go out. This has increased the choice offered to the residents. The manager receives supervision from the operational director of the company, audits the home`s quality assurance, although this has not yet been published, and monitors residents` nutritional and social needs. The lounge has been redecorated, the carpet and three-piece suite have been replaced and the dining area has new flooring replaced. The garden has been regenerated with two of the residents making the decisions in regard to flowerbeds and updating the garden furniture. What the care home could do better: The home could improve its quality procedures by formalising an annual quality survey, and writing an annual report that current and prospective residents and their families could read, otherwise there were no requirements issued after this site visit to the service. CARE HOME ADULTS 18-65 Greenacres The Street Felthorpe Norwich Norfolk NR10 4DQ Lead Inspector Hilda Stephenson Unannounced Inspection 15th May 2008 02:00 Greenacres DS0000068107.V364473.R02.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 Greenacres DS0000068107.V364473.R02.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. Greenacres DS0000068107.V364473.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenacres Address The Street Felthorpe Norwich Norfolk NR10 4DQ 01603 754451 01603 400418 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) New Boundaries Community Services Ltd Robert James Rolland Jenner Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Greenacres DS0000068107.V364473.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th May 2007 Brief Description of the Service: Greenacres is a three bed roomed home which was registered as a care home in August 2004. The home is situated in the village of Felthorpe, which is a few miles from the city of Norwich The home provides care and support for 3 residents with learning disabilities. Bedrooms are located on the ground and first floors. There are communal lounge, dining and kitchen areas. There is a bathroom with integral shower. Residents living in the home access a combination of day services, including those operated by the proprietor. The home has its own transport. The charges range from £1153.61 to £1605.32 per week. Copies of inspection reports are available to residents and their representatives from the home’s office. Greenacres DS0000068107.V364473.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This visit to Greenacres took place during the day on the 15th May 2008 as an unannounced inspection to check the outcomes of the key standards. These key standards were inspected, although not all the elements within the standards were examined. The evidence gathered to publish this report was obtained by speaking to all three residents, two staff and the manager during the day, and checking through care records, medication records, policies and procedures. The manager returned the annual quality assurance assessment, which provided written information about the home since the last inspection.Further evidence was gathered from comments received through the comment cards that were returned to the office from residents, relatives and staff prior to the visit. During this site visit a tour of the building and grounds was undertaken and found the home to be clean, tidy and very well decorated throughout. The manager has looked after the home for approximately two years and also manages two other small homes in the local area. All of the current residents attend formal day services for the majority of the week with transport provided by the local authority. What the service does well: Residents are cared for in a homely environment within the Norfolk village of Felthorpe. Each of the resident’s bedrooms contains their own personal possessions and is decorated according to their taste. The home has a small loyal staff team to care for the three residents. This friendly staff team appear to know the residents’ needs and help them to remain as independent as possible, offering support when required. Residents are encouraged to continue with their own hobbies and interests. Care plans are presented in a person centred format with clear records in place to ensure that residents’ needs and lifestyle preferences are being met. Greenacres DS0000068107.V364473.R02.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Greenacres DS0000068107.V364473.R02.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 Greenacres DS0000068107.V364473.R02.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Prospective applicants to the care home will be given good information and clear documentation will be issued to those accepted for residency using appropriate communication methods so people understand what service they can expect. EVIDENCE: The home has updated the statement of purpose to include the manager’s details, the facilities provided at the home and specifically how an advocate can be obtained to assist residents with their finances and daily decisions. Two residents care records were seen to check the assessment and admission process. One of the resident’s introduction to the home up to the time they moved in on a permanent basis took up to six months, allowing the resident time to feel ‘at home’ and comfortable with other residents and staff. The assessment records showed evidence that the resident was always involved with making decisions about their care, advocates were used to help advise, and in one case family involvement was included. The manager and team leader initially visit any prospective resident to ensure that the home can offer the facilities for them. A detailed assessment format is undertaken with information including the personal care needs, social needs and any mental health or medical input, including simple likes and dislikes of Greenacres DS0000068107.V364473.R02.S.doc Version 5.2 Page 9 the resident. They also ensure that they will be able to live alongside other residents living at the home, so the admission process can take time, and as previously mentioned can take up to six months, to ensure that the residents’ needs are foremost. Greenacres DS0000068107.V364473.R02.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are treated with dignity and respect and receive personal care to meet their assessed needs. Care needs are reviewed on a regular basis. EVIDENCE: Two resident’s care plans were thoroughly examined and found to contain clear, concise information regarding the physical, mental and social needs of each individual. The residents’ likes and dislikes are recorded along with a detailed personal profile. The care plans also contain risk assessments, which provide guidance to staff about how to manage situations assessed as being of medium to high risk. The residents are aware of the care records and participate whenever they can. The care plans are reviewed on a regular basis to ensure that any changing needs are carried out. Greenacres DS0000068107.V364473.R02.S.doc Version 5.2 Page 11 Daily comments are recorded detailing information about a range of issues on a daily basis, and this information aids staff with continuity of their care. Staff was observed to treat the residents very well and encouraged them to take part with the day-to-day running of the home. During the week the residents are out at various day centres or jobs and tend to take part with the chores during the evenings and weekends. Greenacres DS0000068107.V364473.R02.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are encouraged to maintain contact with relatives and friends and continue with their own hobbies. Social activities are adapted to suit residents’ individual tastes and the staff arrange a varied calendar of social activities and outings. All residents are offered choices of meals promoting choice and involvement for residents in the day to day life of the home. EVIDENCE: The home is situated within the village of Felthorpe with minimal facilities within walking distance. The home now has their own transport to enable residents more access to the outside environment. All of the residents attend formal day services for the majority of the week with transport provided by the local authority, with one resident having paid employment. Greenacres DS0000068107.V364473.R02.S.doc Version 5.2 Page 13 Each resident continues to participate in shopping trips and planning the week’s meals. The home has increased the staffing levels to two care staff, to ensure that residents can choose what they wish to do during the time when they are at the home. This has improved the number of outings with each one being recorded. The care plans contain information about the residents’ friends and family and the arrangements in place to enable the residents to maintain contact with the people who are important to them. All residents are supported by the staff to visit family and friends or for them to visit the resident at the home. Staff tend to plan the meals at the weekend with the residents and buy accordingly when they go for their shopping trips. Alternative meals are accessible if residents change their mind. Staff with the help of one resident was preparing the evening meal during this visit to the home, and each resident had their wishes respected when it came for them to eat. One resident stated ‘I really enjoyed that’ after eating prawn risotto and a dessert. The food supplies seen contained fresh fruit and vegetables, with the menu displayed in the kitchen containing a varied nutritious diet. The last Environmental Health visit issued no requirements. Greenacres DS0000068107.V364473.R02.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents can be confident that their health and social needs can be met. Safe medication administration procedures are in place to ensure residents receive the correct prescribed medical treatment. EVIDENCE: The care plans contain clear guidelines to enable staff continue to assist residents with their personal care and social care needs. The care plans contain details about how the physical and emotional health needs of the residents are to be met and the staff spoke about how they have a good understanding of this. Residents are assisted by staff to attend hospital, GP or other medical appointments when this is required. The medication records were checked for the three residents at the home and were found to be accurate. Improvements in medication administration guidelines have been implemented since the last inspection. Staff have received training regarding safe procedures on medicines. The team leader Greenacres DS0000068107.V364473.R02.S.doc Version 5.2 Page 15 continues to be responsible for the ordering and checking of medication stored in the home. Greenacres DS0000068107.V364473.R02.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are confident that the manager would deal with their complaints satisfactorily and staff have received training in dealing with abuse which helps protect residents. EVIDENCE: The written documentation received from the manager had recorded three complaints since the last inspection. These minor complaints were recorded within the complaints log and had been dealt with satisfactorily. One resident stated ‘that they would tell staff when they were upset about anything, and were confident that it would be sorted’. The complaints procedure is contained within the statement of purpose and is in a format that residents are able to understand. The manager stated that an updated version was to be sent out to relatives. The home has a book to record compliments. Staff had all been trained or attended the adult protection training, and this issue was discussed and researched within the NVQ training. One member of staff confirmed that she had received adult protection training and was clear about her responsibilities if there were any allegations of abuse. The manager also stated that the agency staff who are brought in to cover, receive appropriate training to ensure that residents are protected from abuse. Greenacres DS0000068107.V364473.R02.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents live in a safe, clean and well-maintained home. EVIDENCE: The home consists of three bedrooms for the residents who have them decorated in colours of their choice. The communal areas consist of a bathroom, toilet and shower, a spacious kitchen and a lounge with combined dining area. There is a large garden at the rear of the home. The manager spoke about the areas of improvement since the last inspection. There is a new comfortable three-piece suite and carpet in the lounge. The kitchen has been redecorated, and the tumble drier has been replaced. The residents can also enjoy more choice with television programmes with a digibox in place. Greenacres DS0000068107.V364473.R02.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There are competent well-trained staff caring for residents and the home has a good clear recruitment procedure in place to help ensure the protection of vulnerable adults. EVIDENCE: Staff files were checked and showed records that the home follows a good clear recruitment procedure obtaining references and the required police check before staff commenced duty. There was sufficient staff on duty that were competent to fulfil their roles. Both members of staff were spoken to and had achieved the NVQ level 3 they both spoke of the training courses they had attended. The training records corresponded with the extensive training that they had undertaken. During the day when the residents are attending the day care centres, there are no staff at the home. When residents return two staff are on duty, with night covered by a waking member of staff. Greenacres DS0000068107.V364473.R02.S.doc Version 5.2 Page 19 The manager uses agency staff on an occasional basis to cover staff holidays and sickness; records show that the same person is booked so that residents have some continuity with their care. The agency member of staff is included with some of the relevant training offered at the home. Greenacres DS0000068107.V364473.R02.S.doc Version 5.2 Page 20 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents live in a home that is managed with their best interests at heart and the maintenance of safety records helps ensure residents’ health, welfare and safety needs are promoted and protected. EVIDENCE: The manager has completed NVQ level 4 in management and intends to commence the Registered Managers Award. He has managed the home for nearly two years and also provides management to the organisation’s two nearby homes. The home’s team leader supports him and three care staff, using the same member of staff from an agency on an occasional basis to cover staff holiday and sickness. Greenacres DS0000068107.V364473.R02.S.doc Version 5.2 Page 21 One member of staff confirmed the training they had attended included moving and handling, first aid, medication, NVQ 3, POVA, (protection of vulnerable adults) fire safety, autism, handling challenging behaviour and awareness of mental health issues. They also confirmed that they receive supervision with the team leader, with records in place within the staff files. The manager in turn supervises the team leader. A random selection of health and safety records including fire and accidents were checked during this visit and found to be satisfactory. The organisation supports the manager through regular visits to the home. The regulation 26 reports are in place and were read, these gave a clear picture of how the home has been monitored over the past year. The manager will use this information to compile the yearly annual quality assurance, obtaining the opinions from people who use the service to ensure that residents and their relatives can see how the service has performed. All three residents were seen during this visit to the home and comment cards from staff, residents and one relative had been received prior to this visit that confirmed that the home is managed in an open and friendly manner. Greenacres DS0000068107.V364473.R02.S.doc Version 5.2 Page 22 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 3 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 Greenacres DS0000068107.V364473.R02.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 Greenacres DS0000068107.V364473.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Eastern Regional Contact 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. Extracts may not be used or reproduced without the express permission of CSCI Greenacres DS0000068107.V364473.R02.S.doc Version 5.2 Page 25 - 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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