Care Home: Greenbank House Care Home

What the care home does well The staff collects information from the person and other professionals before anyone is admitted into the home to make sure they can meet their needs. Care plans clearly show what support people need to improve their health and lifestyle. Staff make sure people receive their medication safely. Meals are wholesome and choices are available. People are helped to access community services and leisure facilities. Visitors are always welcomed and staff support people maintain links with their families. Staff are respectful and sensitive with people when helping them or when speaking to them. Staff have had Safeguarding Training and staff would be confident in reporting any suspicion of abuse. Staff are being directed and supervised formally and in everyday practice which is improving people`s quality of life. Appropriate checks are carried out before anyone is employed at the home so that people remain safe. Staff make sure that people`s records and personal monies are kept safe. Quality assurance systems are in place and feedback about the service is sought so that the staff can develop people`s lifestyles. All maintenance checks are being completed on a weekly and monthly basis with records kept. Comments from surveys returned to the Care Quality Commission included: Two surveys from people living in the home said,"they were asked if they wanted to move into the home,could do what they want at the weekend,would know who to complain to and said the staff teat them well. Staff felt there was a good team that promotes and practices person centred care and that they had up to date training. What has improved since the last inspection? This is the first inspection since re registration. What the care home could do better: Develop the Service User Guide into different styles that people can easily understand. Make sure each person has a contract that shows the changes in provision. Develop the complaints procedure into an easy to understand style. Improve the house so that is remains a comfortable place to live. Develop access to training for the staff team. Staff felt that they would like more opportunities for training with the new organisation Key inspection report Care homes for adults (18-65 years) Name: Address: Greenbank House Care Home Greenbank North View Terrace Colliery Row Houghton Le Spring Tyne And Wear DH4 5NW     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: Irene Bowater     Date: 2 1 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 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 29 Information about the care home Name of care home: Address: Greenbank House Care Home Greenbank North View Terrace Colliery Row Houghton Le Spring Tyne And Wear DH4 5NW Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Carole OConnor Type of registration: Number of places registered: care home 5 Choices Community Care Services Limited Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 1. The maximum number of service users who can be accommodated is: 5 2. The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD, maximum number of places 5 Date of last inspection Brief description of the care home The home is registered as a care home to provide personal care for five adults under the age of 65 years,it does not provide nursing care. Any health needs are addressed by the use of community health services. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 5 Brief description of the care home It specifically offers services for adults with a learning disability who are ambulant and able to manage the stairs in the building. Greenbank cannot provide accommodation for people who are physically disabled. The house is detached and stands in its own grounds in what could be described as being on the main route from Houghton Le Spring to Chilton Moor. It is only a short walk to the local shops. The busy shopping parade at Houghton Le Spring,which has a range of facilities,is within easy reach. The home has their own transport to facilitate access to these services. The building has two storeys and four of the five bedrooms are on the first floor. Its design and layout ensures that it blends in with the neighbouring houses and there are no features that would indicate that it provides a residential service. The house has a large enclosed garden and patio area and enclosed garage area. Fees are costed on an individual basis. Care Homes for Adults (18-65 years) Page 5 of 29 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: Before the visit we looked at information we have received since the home was re registered. How the service dealt with any complaints and concerns. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service,their relatives,staff and other professionals. We have reviewed our practice when making requirements,to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations,but only when it is considered that people who use services are not being put at significant risk of harm. In future,if a requirement is repeated,it is likely that enforcement action will be taken. Care Homes for Adults (18-65 years) Page 6 of 29 The Visit. An unannounced visit was made on the 21 January 2010.This visit was carried out by one inspector and took four hours to complete. During the visit we: Talked with people who use the service,staff, and the manager. Looked at information about the people who use the service and how well their needs are met. Looked at other records,which must be kept. Checked that staff have the knowledge,skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean,safe and comfortable. We told the manager what we found. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Develop the Service User Guide into different styles that people can easily understand. Make sure each person has a contract that shows the changes in provision. Care Homes for Adults (18-65 years) Page 8 of 29 Develop the complaints procedure into an easy to understand style. Improve the house so that is remains a comfortable place to live. Develop access to training for the staff team. Staff felt that they would like more opportunities for training with the new organisation 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 9 of 29 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 10 of 29 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. Pre admission assessments demonstrate that peoples needs and aspirations are identified and assist the home and the person to make an informed decision about moving into the home. Evidence: The home changed Provider in September 2009.The Statement of Purpose and Service User Guide are currently being up dated to reflect these changes. One person has been admitted in the last year.The care plan shows a very detailed assessment which has been completed by the multi disciplinary team,family and the person. The information shows that the person was at the centre of the admission process and spent time meeting the other people in the home and getting to know the staff. The care plan identifies identified possible risks and risk management strategies have been put in place prior to admission. Care Homes for Adults (18-65 years) Page 11 of 29 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. Choices and risk taking are planned in a person centred and safe way. This means people are able to take risks regarding their lives and have appropriate levels of independence and are protected as far as possible. Evidence: Care plans are in place for each person.They are developed with the individual,their care manager and advocate. The information records all aspects of people personal,social and health care needs within a risk management framework. Risk management plans are in place so that people can lead an independent lifestyle whilst there are clear guidelines in place so that they are supported and protected. Staff are providing information to people so that they can make informed choices and record instances where there have been limitations to prevent injury to themselves or others. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: Care plans are reviewed every six months for those people under 65 years of age.People over 65 have the care plans updated on a monthly basis. All of the plans are being changed as the home has a new provider. Care Homes for Adults (18-65 years) Page 13 of 29 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. Staff supports people to follow their chosen lifestyles ensuring that they have the opportunity for personal development. Evidence: People living in the home are supported and encouraged to maintain good links with their families.One person has been on holiday with their brother,another has weekends away and another has enjoyed going out to lunch.This activity has had to be limited as the car is no longer suitable and there is a risk of falls. Two people attend day centres and one person has a voluntary job in a newsagent and is also working voluntary in a Childrens Society shop and is awaiting to see if the application for paid employment is successful. Two other people are now becoming older and their activities are becoming less Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: however the staff support them in their chosen activity. One person had their birthday party at the Stadium of Light which was enjoyed and they all are involved in shopping and going out for personal shopping . People have some responsibilities in the house doing domestic tasks,for example keeping their rooms clean, helping with meals and making drinks for others and not exclusively for themselves. Staff actively encourage and support people to plan meals.Menus are available and show that they have cereals,toast and hot drinks at breakfast. Lunch is usually sandwiches,soup,yogurts and crisps with the main meal in the evening.The evening meal has included curry and rice,chicken Kievs,chips and peas,pie potatoes and vegetables and spaghetti bolognese Snacks,fruit and drinks are freely available at all times. The daily routines are relaxed with the focus being on the rights and choices of those living in the home. Care Homes for Adults (18-65 years) Page 15 of 29 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. Care is being planned and delivered in a respectful and person centred way. This enables people to fully access healthcare and other services and ensures their needs are supported. Evidence: People living in the home need little in the way of aids and adaptions.One person is becoming less mobile and has been assessed by the Occupational Therapist and has psyiotherapy input. Everyone has access to all NHS services and they are supported to attend heath care practices in the local community.Visits to the GP,dentist,opticians and other health services are recorded in individual care plans. There are clear policies and procedures for staff to follow to make sure people receive their medication safely. Medication is stored in a locked cupboard and administered following medication guidelines.There is a list of staff authorised to administer medicines and the Medicine Administration Records(MAR) showed no gaps in recording. Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: Most staff have completed an Accreditation Medication Course and some have completed the Monitored Dosage System competency training. Care plans show what support people need for managing their own personal care and a key worker system is in place so that people receive consistent support. Care Homes for Adults (18-65 years) Page 17 of 29 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. Good complaints and protection procedures are in place and effectively followed to ensure that people are listened to and protected from harm Evidence: There are complaints policies and procedures in place.How to make a complaint is discussed at the monthly house meetings. Although complaints are in a picture style this could be further developed so that people can fully understand who they can raise concerns to. Three people spoken to said they had no worries and were happy living in the home. Staff have completed Safeguarding training and this is also included during the six month probationary period. The manager has completed Safeguarding Investigation Training and she has also completed a refresher course. There is an appropriate safeguarding of adults policy and staff follow Sunderland Social Services Department guidance in dealing with any alerts that are made. There have been no complaints or safeguarding alerts made to the Commission. Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: Care Homes for Adults (18-65 years) Page 19 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is a clean and comfortable place for people to live.However further investment is needed so that peoples safety is not compromised. Evidence: The detached two storey house is in a residential area,close to public bus routes and local amenities. Externally the gardens and back entrance need a tidy up as there are broken branches old leaves and general litter in both areas. The window frames are also worn with the paint flaking and damage to the wood work. Internally there is a large dining room,lounge,kitchen,separate laundry,one bedroom and bathing and toilet facilities on the ground floor. Upstairs are four bedrooms,bathing and toilets and the staff sleep in room. All areas of the home have been decorated to a good standard and the home is very comfortable and domestic in style. It appears that the fire exit signage was removed when the home was redecorated.This needs to be put back so people know what exit to take in any Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: emergency. The gas fire in the lounge is old and is very difficult to light.It took two staff to ignite it and although a part is on order the fire should be replaced. There is a new domestic kitchen and the boiler has been replaced in the laundry. This has left damage to the flooring and staff say that the floor becomes very slippy when wet.Consideration should be given to replace the flooring as water will get under the broken areas and cause more damage. The bedrooms are all nicely furnished and decorated to individual preferences.One persons room has water damage to the room and wardrobe. Repairs are underway to repair the damage. The upstairs bathroom although domestic in style used to have a bath seat which was fixed to the floor.This has been removed and the flooring is damaged.Also there is a mixture of fitting the tiles need re grouting or replacing and there is no where for anyone to put their bath towels. The home is clean with no odours and staff have had infection control training. Care Homes for Adults (18-65 years) Page 21 of 29 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. Systems around recruitment,selection and training make sure that the people living in the home are safe and their needs are met. Evidence: Staff files are kept centrally so were not seen on this visit.It was confirmed that appropriate references Criminal Record Bureau checks,proof of identity and employment history are checked before employment . Three staff are in their six month probationary period including the new assistant team leader. Files showed that inductions are dated and signed. Mandatory training has included Safeguarding,Person Centred Values and Awareness,Safe Handling of Medication,Health and Safety,Fire,Epilepsy Awareness,Deprivation of Liberty and conflict resolution. During the changes in provider some training has not taken place,however there are plans in place for further training and development during the coming year. There are regular staff meetings and have a minimum of six formal supervisions a year as well as an annual appraisal. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: There has been some difficulty providing a permanent staff team ,however the same bank staff have been used and the home is now fully staffed. Care Homes for Adults (18-65 years) Page 23 of 29 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. Good management systems are in place and used effectively so that the service is run in the best interests of the people who live there. Evidence: The manager is registered with the Commission and is qualified and experienced to manage the service. There is a new provider and the staff team have had to adopt new polices and procedures and ways of working and managing the service.Generally the staff team are working together to develop the quality of support and care for those living in the home. Quality assurance and quality monitoring systems are in place including Regulation 26 visits,monthly checks of care plans,regular meetings and audits of the maintenance of the home. Staff have completed mandatory training and accident and incident records are fully Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: completed. In house maintenance checks and service certificates are up to date. When the house was redecorated the fire signage must have been taken down.This needs to be replaced so that people know where to go should there be an emergency. Care Homes for Adults (18-65 years) Page 25 of 29 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 26 of 29 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 1 5 Ensure that the Statement of Purpose and Service User Guide are amended to reflect the changes in Provider. This will make sure people have all the information they need about the service. 01/03/2010 2 24 13 Ensure that the window 03/05/2010 frames throughout the home are in good state of repair. This will make sure that people live in a safe and comfortable environment. 3 27 23 Ensure that the upstairs 30/07/2010 bathroom is refurbished including replacement of the flooring. This will make sure that people have suitable bathing and washing facilities that meet their needs. Care Homes for Adults (18-65 years) Page 27 of 29 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 4 29 23 The registered persons must 02/04/2010 ensure that the gas fire in the lounge is replaced. This will make sure that the home remains safe. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 3 22 24 30 It is recommended that the complaints procedure is further developed in to picture and audio style. It is highly recommended that the outside areas are cleaned of garden debris and generally tidied up. It is highly recommended that the flooring in the laundry be replaced. Care Homes for Adults (18-65 years) Page 28 of 29 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 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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