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Inspection on 17/05/10 for Church View

Also see our care home review for Church View for more information

This is the latest available inspection report for this service, carried out on 17th May 2010.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Each of the people living at the home has a care plan. We looked at the care plans for three people in some detail. The level of information in care plans was generally good. Care plans included information on how to meet the needs of the person in areas such as their health, communication, mobility, diet and nutrition, and personal care. We found the care plans to be a straight forward document which explained the needs of the person in a good level of detail. We asked the manager to tell us in their self assessment (AQAA) what they do well in ensuring people`s personal and healthcare needs are being met and their response included; `We have a full comprehensive care plan based on all information given by the multidisciplinary team prior to admission, including individual needs, risk assessments, social needs, pressure sores, continence and falls assessments. This is utilised by care staff to ensure needs are met and GP`s and agencies are involved at the appropriate time. All specialist equipment is provided and ready for the service user prior to admission`. `The care plans are reviewed on a monthly basis by a senior care staff or nurses and amendments made as required, changes to the service users care needs are discussed with the individual and their significant others, care plans are audited by the home manager on a monthly basis, regular 3 and 6 monthly care reviews and audits are in place and relatives and service users are encouraged to get involved`. Feedback from people living at the home about how they are supported was generally good. However, we did discuss some negative feedback provided by one person with the manager. The manager agreed to look into this and review the person`s care plan to ensure it reflects their preferred routine and choices.Risk assessments are carried out where a person living at the home is thought to be at risk of harm. These include risks such as falling, the use of bed rails, medication issues, not eating a nutritional diet. Where a risk had been identified then there was a good level of information as to how to manage or reduce the impact of the risk. For example, one person had been assessed as being at risk of developing a pressure area. The person`s care plan then explained in a good amount of detail what steps staff were taking to prevent a pressure area. We then found reference to visits from District Nurses to address pressure areas. These references were not always consistent and this is an area which could be improved. The manager did report that District Nurses maintain their own record but the home`s records should at least include a clearer overview of pressure area care. Overall we found a clear link between identifying a person`s need and ensuring that information on how to meet this was reflected in the person`s care plan. Alongside this we found clear and comprehensive risk assessment information. We found that there was a good audit trail of records to evidence how people are supported. For example, if we noted that a health professional had requested a particular action on the part of the home then we could see that this had been followed up. People living at the home were generally presented as well supported with their personal care and comfort. For example people looked well presented and were wearing appropriate foot wear, spectacles etc. Pressure relieving equipment was being used, hoists were being used to support people with moving and transferring and staff presented as competent when using these. Records showed that people are well supported with their health care needs and are regularly supported to see their GP, nurse, optician etc. A community matron visits the home on a regular basis and district nurses are also called upon to meet the nursing needs of people residing at the home on a residential basis. The home has a complaints policy and procedure which is time scaled appropriately and includes contact details for the Commission. Information on how to make a complaint is provided to people in the `service user guide`. A log of complaints is maintained. This was looked at and showed that complaints have been documented, investigated and responded to. People living at the home who were asked about complaints said that they would let staff know if they were not happy about something. We observed one person who lived at the home approach the manager with confidence to discuss an issue which was causing him some concern. The manager agreed to address the concern with immediate effect and this reassured the service user. An adult protection policy and procedure is in place. This outlined responsibilities for responding to an allegation of abuse and any subsequent investigations. The manager reported that all staff are provided with training on adult protection before they commence work at the home and annual training is provided there after. During discussions with the manager they were able to explain what course of action they would take in the event of an allegation of abuse being made.Accidents and incidents are appropriately recorded and audited. The manager told us that she audits the accident records to identify any patterns or particular concerns and then will ensure appropriate action is taken as a result of any issues identified. The manager of the service told us about what they do well in relation to concerns, complaints and protecting people in their self assessment of the service (AQAA) and this included the following; `At church view we have a clear complaints procedure in place and the details are displayed in the reception area and the service user guide for clients to access. Comments cards are available in the reception area. The home manager holds an open door policy to encourage comments to be raised. The home manager also holds an evening surgery bi-weekly for relatives to be able to raise concerns out of normal working hours. The monthly home audit incorporates a complaint audit and all complaints are reported to the divisional office`. `Service users, relatives and staff are encouraged to speak up if they have a complaint, and all complaints are treated with respect and assurance given that it will be investigated fully and the outcome fed back to the complainant`. `All staff are required to attend SOVA training on a yearly basis, where staff are made fully aware of the different types of abuse and how to report concerns. Policies and procedures are in place for staff to be aware of how

What the care home could do better:

Whilst care plans provide a good level of information on the person`s personal care and health needs we did note that there was little if any reference to the person`s social and emotional needs and their preferred routines. The manager said that she had identified this as a shortfall and was in the process of reviewing care plans with an aim to make the information in them more person centred. We carried out a tour of the home whilst conducting the inspection and we noted that there was not enough seating in the communal lounge areas to accommodate all of the people living at the home. The home has one main lounge and one smaller lounge and a conservatory. Together these rooms do not provide enough seating for all of the people using the service. Some people were sat in the conservatory but this was quite a hot room and one person told us that they found it uncomfortable but the staff hadn`t asked them where they wanted to sit and there was no space left in the lounge. This was raised with the manager at the time of the visit. The registered person must review the shared communal space and ensure this can meet the needs of the people living at the home and can accommodate their needs comfortably and safely.

Random inspection report Care homes for older people Name: Address: Church View Green Lane Liverpool Merseyside L13 7EB two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme 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 review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Debbie Corcoran Date: 1 7 0 5 2 0 1 0 Information about the care home Name of care home: Address: Church View Green Lane Liverpool Merseyside L13 7EB 01512280997 Telephone number: Fax number: Email address: Provider web address: churchviewnh@schealthcare.co.uk www.southerncrosshealthcare.co.uk Name of registered provider(s): Name of registered manager (if applicable) Miss Heather Jean May Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ashbourne (Eton) Limited care home 50 Number of places (if applicable): Under 65 Over 65 0 50 dementia old age, not falling within any other category Conditions of registration: 6 0 The registered person may provide the following category/ies of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP (maximum number of places: 50) Dementia - Code DE (maximum number of places: 6) The maximum number of service users who can be accommodated is: 50 Date of last inspection Brief description of the care home Church View is a care home that provides care and support for up to forty four residents who require nursing or personal care and six residents who require personal Care Homes for Older People Page 2 of 9 0 2 1 2 2 0 0 9 Brief description of the care home care for dementia. Comfortable accommodation is provided over three floors with an attractively decorated lounge, dining room and conservatory for residents use. There is also a small separate lounge for residents who wish to smoke. The dementia unit has its own lounge with a small dining area. The home is situated close to all amenities including shops, cafes and a library. Bus and train stations are nearby. There is ample car parking to the front of the home and a garden which is easily accessible. Residents have access to a good standard of equipment to assist them with their mobility and a call system with an alarm facility is available throughout the home. The weekly fee rate for accommodation is dependent on the level of care required. Care Homes for Older People Page 3 of 9 What we found: We carried out this visit unannounced. During the visit the majority of the people living at the home were met and a number were spoken with on a one to one basis. We also sent surveys to people living at the home and a number of these were returned to us prior to this visit. A sample of records for people living at the home were looked at. These help to show us how peoples health and wellbeing are being promoted. We also looked at other records including accident records, the complaints log and complaints and safeguarding policies and procedures. A tour of the home was carried out which included all communal areas. The manager returned a self assessment of the service prior to this visit. The self assessment enables the service provider to inform us of what they do well, where they have improved and where they can improve in the future. It also includes information on how they promote equality and diversity, how they seek the views of people living at the home and includes data on staffing and health and safety. The self assessment is referred to as an Annual Quality Assurance Assessment (AQAA). Some of the information in this has been used to inform the findings of the inspection. What the care home does well: Each of the people living at the home has a care plan. We looked at the care plans for three people in some detail. The level of information in care plans was generally good. Care plans included information on how to meet the needs of the person in areas such as their health, communication, mobility, diet and nutrition, and personal care. We found the care plans to be a straight forward document which explained the needs of the person in a good level of detail. We asked the manager to tell us in their self assessment (AQAA) what they do well in ensuring peoples personal and healthcare needs are being met and their response included; We have a full comprehensive care plan based on all information given by the multidisciplinary team prior to admission, including individual needs, risk assessments, social needs, pressure sores, continence and falls assessments. This is utilised by care staff to ensure needs are met and GPs and agencies are involved at the appropriate time. All specialist equipment is provided and ready for the service user prior to admission. The care plans are reviewed on a monthly basis by a senior care staff or nurses and amendments made as required, changes to the service users care needs are discussed with the individual and their significant others, care plans are audited by the home manager on a monthly basis, regular 3 and 6 monthly care reviews and audits are in place and relatives and service users are encouraged to get involved. Feedback from people living at the home about how they are supported was generally good. However, we did discuss some negative feedback provided by one person with the manager. The manager agreed to look into this and review the persons care plan to ensure it reflects their preferred routine and choices. Care Homes for Older People Page 4 of 9 Risk assessments are carried out where a person living at the home is thought to be at risk of harm. These include risks such as falling, the use of bed rails, medication issues, not eating a nutritional diet. Where a risk had been identified then there was a good level of information as to how to manage or reduce the impact of the risk. For example, one person had been assessed as being at risk of developing a pressure area. The persons care plan then explained in a good amount of detail what steps staff were taking to prevent a pressure area. We then found reference to visits from District Nurses to address pressure areas. These references were not always consistent and this is an area which could be improved. The manager did report that District Nurses maintain their own record but the homes records should at least include a clearer overview of pressure area care. Overall we found a clear link between identifying a persons need and ensuring that information on how to meet this was reflected in the persons care plan. Alongside this we found clear and comprehensive risk assessment information. We found that there was a good audit trail of records to evidence how people are supported. For example, if we noted that a health professional had requested a particular action on the part of the home then we could see that this had been followed up. People living at the home were generally presented as well supported with their personal care and comfort. For example people looked well presented and were wearing appropriate foot wear, spectacles etc. Pressure relieving equipment was being used, hoists were being used to support people with moving and transferring and staff presented as competent when using these. Records showed that people are well supported with their health care needs and are regularly supported to see their GP, nurse, optician etc. A community matron visits the home on a regular basis and district nurses are also called upon to meet the nursing needs of people residing at the home on a residential basis. The home has a complaints policy and procedure which is time scaled appropriately and includes contact details for the Commission. Information on how to make a complaint is provided to people in the service user guide. A log of complaints is maintained. This was looked at and showed that complaints have been documented, investigated and responded to. People living at the home who were asked about complaints said that they would let staff know if they were not happy about something. We observed one person who lived at the home approach the manager with confidence to discuss an issue which was causing him some concern. The manager agreed to address the concern with immediate effect and this reassured the service user. An adult protection policy and procedure is in place. This outlined responsibilities for responding to an allegation of abuse and any subsequent investigations. The manager reported that all staff are provided with training on adult protection before they commence work at the home and annual training is provided there after. During discussions with the manager they were able to explain what course of action they would take in the event of an allegation of abuse being made. Care Homes for Older People Page 5 of 9 Accidents and incidents are appropriately recorded and audited. The manager told us that she audits the accident records to identify any patterns or particular concerns and then will ensure appropriate action is taken as a result of any issues identified. The manager of the service told us about what they do well in relation to concerns, complaints and protecting people in their self assessment of the service (AQAA) and this included the following; At church view we have a clear complaints procedure in place and the details are displayed in the reception area and the service user guide for clients to access. Comments cards are available in the reception area. The home manager holds an open door policy to encourage comments to be raised. The home manager also holds an evening surgery bi-weekly for relatives to be able to raise concerns out of normal working hours. The monthly home audit incorporates a complaint audit and all complaints are reported to the divisional office. Service users, relatives and staff are encouraged to speak up if they have a complaint, and all complaints are treated with respect and assurance given that it will be investigated fully and the outcome fed back to the complainant. All staff are required to attend SOVA training on a yearly basis, where staff are made fully aware of the different types of abuse and how to report concerns. Policies and procedures are in place for staff to be aware of how to report any abuse or neglect. We have comprehensive policies and procedures on protection of vulnerable adults and all staff are encouraged to read. 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 set out on page 2. Care Homes for Older People Page 6 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 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, 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 20 23 The physical design and layout of the premises must meet the needs of people using the service. To ensure people are provided with appropriate accomodation which promotes their health and wellbeing. 25/06/2010 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 7 Care plans should be reviewed and updated to reflect the social and emotional needs of the person and their preferred routines. Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. 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