Inspection on 08/09/05 for 15 Osborne Road

This inspection was carried out on 8th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

15 Osborne Road 01/02/07

15 Osborne Road 26/01/06

15 Osborne Road 10/02/05

15 Osborne Road 29/06/04

15 Osborne Road 17/02/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 15 Osborne Road 15 Osborne Road St Annes Lancashire FY8 1HS Lead Inspector Lesley Plant Unannounced 08 September 2005 3.00 pm 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 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 Stationary 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. 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 15 Osborne Road Address 15 Osborne Road, St Annes, Lancashire, FY8 1HS Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01253 712547 United Response Mr Stephen Turner Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10.2.05 Brief Description of the Service: 15 Osborne Road is a small care home for adults with learning disabilities, registered for three people. The well-established national charitable organisation United Response is the registered provider. The home is a detached two-storey house, with an excellent range of communal living space and good access to local services and amenities. The organisation provides a vehicle to enable individuals to take part in leisure activities and access amenities. The staff team provide support in all aspects of daily living according to assessed needs and as identified via the care planning process. People are supported and encouraged to develop their independence and take part in all aspects of community living. The service adopts an active support approach, in a stable environment, which enhances opportunities for personal growth and development. The staff team are supported by an experienced management team and an organisation, which clearly values its employees, and the people they support. 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced, started at 3.00 pm and took place over three and a half hours. Three members of staff, including the team manager were spoken to and time was spent with the two people living at the home. The inspector also observed people being assisted with their tea and medication being administered. The two people living at the home have complex needs, including specific sensory and communication needs and are unable to complete comment feedback cards. Care records and some of the written policies were viewed. A tour of the building also took place. What the service does well: What has improved since the last inspection? What they could do better: A copy of the Statement of Purpose and Service User Guide must be kept at the home, available for any interested person. Although there are regular internal reviews a full care plan review should take place at least every six months, using the person centred method of care planning. This would ensure that people living at the home have support to 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 6 achieve longer term goals and dreams. It is the responsibility of the registered manager to ensure progress is made. 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. 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 2 Good information about the home is provided, which will help people to make decisions about where they live. Thorough assessments ensure that identified needs can be met. EVIDENCE: The Statement of Purpose and Service User Guide have been reviewed, updated and improved. These provide clear information, include photographs and pictures and meet the required standard. Copies have been sent to the Commission for Social Care Inspection. Copies of these documents must also be kept at the home, as required by regulation. Although there have been no recent admissions to the home there are good systems in place for gathering assessment information. Files show that good pre admission information had been gathered for the people currently living at the home. This includes details of personal care, medical information, health issues, financial status, likes and dislikes and communication needs. A Social Services assessment also takes place. Information gathered during the assessment is then used to formulate the care plan. 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 7 Internal reviews give a good overview of well being, however the lack of regular person centred planning could lead to longer term goals not being fulfilled. Staff support individuals to make decisions about their daily activities. EVIDENCE: Each person has a named key worker and records show that a monthly internal review of each person living at the home takes place. This looks at health, medication, food, diet, moods, behaviour, activities and community presence and is a good overview of what has taken place. One individual had a full care plan review in February 2005, involving his parents, key worker, the team manager and social worker. Actions identified have been followed up, although progress in finding and purchasing a suitable bike has been slow. The other person living at the home has not had a full review since August 2004, although staff have been responding to changes and offering new activities such as college “taster” courses. Although there are regular internal reviews a full care plan review should take place at least every six months, using the person centred method of care planning. This would ensure that people living at the home have support to achieve longer- term goals and dreams, and would also provide an opportunity for all supporters, including relatives, to work together. Person centred planning is particularly important for the two 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 10 people living at the home, as they cannot easily communicate their goals and aspirations. The internal monthly review could be used to monitor progress. Each person living at the home has a communication profile, which guides staff in their day-to-day interaction. These profiles include descriptions of how feelings and emotions are expressed. Staff work closely alongside service users and have got to know their individual communication nuances. These close working relationships promote and allow for individual decision-making during daily activities, such as bed time or where to eat meals. Details of advocacy services are available, however relatives would usually take on this role. Both people living at the home require full support in managing their money. Each person has a written financial log, with details of income and expenditure and regular finance checks take place. The cash held for one individual was checked and the balance was correct. 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15 and 17 Staff provide support for individuals to keep in contact with family members, which helps the people living at the home to sustain these relationships. Nutritious meals help individuals to keep healthy and staff provide good support at meal times. EVIDENCE: Records show that staff keep good contact with relatives. Individuals are enabled to visit family and friends. One person is taken to visit his grandmother each week and the other is supported to visit his mother, who lives some distance away, every month. Other relatives regularly visit the home and both individuals enjoy time at their family home. Activities such as, college attendance, drama classes and visiting a local café, all give opportunities for social interaction. The organisation provides guidance for staff regarding how best to support relationships. Written protocols are in place regarding how best to support people during meals. These promote independence and allow for individual preferences, for example, where people like to eat. The staff member on duty during tea explained the reasoning behind this guidance and the mealtime observed 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 12 appeared calm and relaxed. Staff explained that they support people to eat a healthy diet and the menus reflected this, as well as individual food preferences. Records show a gradual reduction, towards a healthier weight for one person at the home. This individual used to have such an interest in food that meal preparation and waiting for food to be prepared often lead to anxiety and challenging behaviour. With a consistent and sensitive approach he now appears calmer around food, accepting of the healthier meals provided and enjoys shopping for food and helping to prepare meals. 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 Medication is administered and stored appropriately. EVIDENCE: Medication is safely stored in a locked cabinet in a locked cupboard. The medication file contains the written policy and guidance for staff to follow, plus drug information sheets. There are individual protocols to be followed when administering medication to the two people at the home and guidance regarding emergency medication prescribed for one person with an allergy. Records of administration are accurately maintained. A daily handover sheet identifies which staff member is responsible for administering medication. During the inspection the member of staff administered medication according to the agreed guidance and also confirmed that they had undertaken training regarding administering medication. 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of the above standards were assessed at this inspection. EVIDENCE: 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 28 and 30 The home is comfortable, clean and well maintained, providing an attractive and homely environment for those living there. The excellent range of living space means that people can choose to spend time separately and that there is plenty of room for individual hobbies and interests to be followed. EVIDENCE: Since the last inspection the kitchen, office and one of the bedrooms have been redecorated, plus the final touches made to the refurbishment of the main living rooms. The past year has seen a great improvement in the decoration and furnishing of the home, making this an attractive and homely place to live. Regular maintenance checks take place, with records kept. There is good access to local amenities and leisure facilities. The range of living space is excellent, with a large dining kitchen, two lounges, a conservatory and a small living room off the kitchen. One person particularly likes to use this small room, to eat his meals and keep personal possessions and display his photos. The lounges are attractively decorated, with good televisions and music systems, particularly enjoyed by the other person at the home. This person has specific sensory needs and staff need to be able to control levels of stimulation such as having no net curtains and monitoring the 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 16 volume of music. The different living rooms allow for these individual needs to be met. All areas of the home were clean. Although the people living at the home are encouraged and supported to take part in household cleaning, the good standards are mainly due to the hard work of the support staff. There are written guidelines and cleaning schedules, which act as a reminder for staff. The potential health risks of having to take washing through the kitchen to the laundry area are addressed. All staff have read and signed this risk management guidance. 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 and 36 Staff are NVQ qualified, enthusiastic, highly motivated, effective and consistent in their approach. The qualities of the staff team promote the well being and personal development of those living at the home. EVIDENCE: The team consists of four main workers, all of whom know the two people at the home extremely well. The team manager is working towards gaining the registered managers award and the other three support staff are all qualified at NVQ level 2 or 3. Rotas show that there are usually two staff on duty during the day and one during the evening, allowing both individuals to have one to one time with staff. Regular staff meetings take place. The team have been able to apply a consistent approach, resulting in improvements in well being for the people at the home. Notes from a college review for one individual report; excellent progress, improved behaviour and better concentration. Notes from a care plan review for the other person at the home record signs of contentment. Incidents of challenging behaviour have also reduced. In order to maintain this consistency, staff regularly work long shifts and a high number of extra hours. During discussion with the three staff on duty, all appeared very enthusiastic and highly motivated, confirmed that they are happy with this arrangement and want to continue with this 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 18 consistent approach. Two staff working elsewhere in the organisation do provide some cover for staff holidays and both know the people living at the home. However, the registered manager is advised to monitor this situation and to consider adding to the staff team in order that staff do not become overstretched and consistency can still be maintained during times of staff illness or holidays. An ideal time to introduce new staff is during times of contentment and stability, which is the current state. Each person living at the home has an individual communication profile drawn up and staff show good communication skills and a good understanding of the different communication needs of the two people at the home. Staff demonstrated these skills when supporting communication with the inspector. The team manager has individual supervision meetings with staff approximately every month. Records show topics for discussion include work performance, training, NVQ progress and professional development. An example of professional development being a staff member supported to carry out risk assessments and develop risk management guidelines for one individual at the home. Regular staff meetings also take place. The registered manager should make sure that the team manager also receives formal supervision at least six times a year. 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The health and safety of people living and working at the home is promoted. EVIDENCE: There are well established procedures, policies and working practices in place, which promote the health and safety of people living and working at the home. There is a schedule of daily, weekly, monthly and quarterly, health and safety monitoring. Checks include fridge/freezer temperatures, water temperatures, fire alarm system, medication checks, vehicle checks, checks of first aid supplies and a very useful monthly hazard inspection of the home. Good records are kept of all these checks. Water temperatures are thermostatically regulated and the temperatures taken during the inspection were at a safe level. Appropriate policies and guidance are available for staff. Health and safety training such as food hygiene and first aid is included in the staff induction process, with a rolling programme of update training arranged via the organisations area office. Staff confirmed the relevance and availability of this training. The daily handover file contains emergency procedures, which all staff have read and signed. 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 20 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x 4 x 3 Standard No 11 12 13 14 15 16 17 x x x x 3 x 3 Standard No 31 32 33 34 35 36 Score x 4 3 x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 15 Osborne Road Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 22 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 17 (2) Schedule 4 Requirement A copy of the Statement of Purpose and Service User Guide must be kept at the home. Timescale for action immediate and ongoing. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 6 Good Practice Recommendations Care plans should be reviewed at least every six months. 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Unit 1, Tustin Court Portway Preston PR2 2YQ National Enquiry Line: 0845 015 0120 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 15 Osborne Road F57 F09 S10025 Osborne Rd V183964 080905 Stage 4.doc Version 1.40 Page 24 - 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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