Inspection on 21/02/06 for 167 Church Road

This inspection was carried out on 21st February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

167 Church Road 25/05/06

167 Church Road 16/10/05

167 Church Road 14/02/05

167 Church Road 06/07/04

167 Church Road 04/03/04

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 18-65 167 Church Road 167 Church Road St Annes Lancashire FY8 3TG Lead Inspector Lesley Plant Unannounced Inspection 21 February 2006 3:30 st 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 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 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 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. 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 167 Church Road Address 167 Church Road St Annes Lancashire FY8 3TG 01253 712547 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) None United Response Mr Stephen Turner Care Home 3 Category(ies) of Learning disability (2) registration, with number of places 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th October 2005 Brief Description of the Service: 167 Church 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. Individuals 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. 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced, started at 3.30 pm and took place over two and a half hours. The inspector spent time with and spoke to, the two people living at the home and the member of staff on duty. Care, medication and administration records were viewed. The inspector also visited the home the following evening and spent an hour with the registered manager, checking records and clarifying information. Key standards not assessed at this inspection will have been addressed at the previous inspection on the 26th October 2005. What the service does well: What has improved since the last inspection? What they could do better: Care planning must be improved. The person centred method of care planning would ensure that people living at the home have support to achieve longerterm goals and dreams, and would also provide an opportunity for all supporters to work together. 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 Page 6 The inconsistent following of procedures and unsafe storage of medication could pose risks for those people living at the home. This must be addressed. There are continual difficulties in maintaining the home to a good standard. One of the bedroom doors is off, compromising privacy and this should be attended to. There are still some gaps in the staff documentation required to be kept at the home. The registered manager must address this. It is important that the registered manager maintains a proactive role in the management of the home, continues to supervise staff and monitors progress with NVQ training. 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. 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 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 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 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 the following standard(s): 2 A thorough assessment process is in place, meaning that new people would only be admitted to the home, if their needs could be met. EVIDENCE: There have been no recent admissions to the home, the current individuals having lived at Church Road for many years. However, United Response has good systems and procedures in place regarding the assessment and introduction of new people. A comprehensive assessment format is used, as confirmed during inspections of other care homes within the organisation. The registered manager explained that although there were no plans to introduce a third person to the home, copies of the revised Statement of Purpose and Service User Guide are now kept on the premises, as required by regulation. 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 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 the following standard(s): 6 Care plans are not reviewed frequently enough to ensure that changing needs are addressed. EVIDENCE: Records show that both individuals had their support plan reviewed in early 2005. One person has a six monthly review by the funding authority and for the other this takes place annually. Minutes of these meetings were viewed. Although communication profiles, medical profiles and risk assessments are reviewed periodically, there is no system of regular/continuous person centred planning in place. There have been significant life changes for one individual, who has lost his employment and is also indicating that he may want to move to another area. The staff team have had informal meetings regarding these changes and the individual has been meeting weekly with the registered manager to discuss his wishes. Some future planning is evident, in that both people are looking forward to planned holidays, with an agreed savings plan in place for one individual. The registered manager explained that there has been some staff training regarding person centred planning and that there are plans to address this area at Church Road. Progress is slow, the lack of care planning and regular reviews, being highlighted at previous inspections. The registered manager of the home must address this. The person centred 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 Page 10 method of care planning 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 to work together. 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 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 the following standard(s): 12, 13 and 16 People are supported to take part in appropriate activities, inside and outside of the home, which promotes independence. EVIDENCE: The two people living at the home can both display challenging behaviour, which can impact upon involvement in community based activities, college attendance and employment. One individual has lost employment due to these difficulties, but is supported by staff to continue his other work, cleaning cars. This person confirmed his enjoyment of the job and the importance of receiving payment. Staff know the people at the home very well and continue to provide support regarding appropriate and achievable activities. Improvements in person centred planning would give more direction in this area. Each file contains a weekly plan of regular activities, however these are outdated, do not reflect the current situation and require updating. Individuals access a range of local community facilities, although the challenging behaviour of one person has resulted in access to certain shops being limited. One person has a car through the motability scheme. Public transport is also used, with a risk assessment covering this activity. Regular 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 Page 12 activities include meals out, swimming and shopping. On the day of the inspection, both people stated/indicated that they had enjoyed their trips out that day. Good staffing levels allow for the people at the home to pursue individual activities. People are encouraged to take part in household tasks such as shopping and cooking. At present individuals are being supported to take more responsibility for the cleaning of the home, with a chart of various tasks, such as vacuuming, being kept. There are regular meetings within the home, with one person saying that he liked to join in and “get stuff off my chest”. Daily routines are flexible, with one person saying that he enjoyed having a lie in at the weekend. The excellent range of communal living areas means that people can spend time alone if they choose. One person at the home particularly enjoys the space that the home provides. During the inspection it was evident that staff spend time talking to and listening to those living at the home and previous inspections have also seen this high level of interaction. 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 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 the following standard(s): 20 The inconsistent following of procedures and unsafe storage of medication could pose risks for those people living at the home. EVIDENCE: One person living at the home receives prescribed mediation and there is written guidance in place. The inspector observed medication being administered in line with this guidance. A system of blister packs is used and the member of staff on duty confirmed that there is a good relationship with the pharmacist. The record of weekly stock checking was viewed. Although good written procedures are in place, medication was not being safely stored. The medication cabinet was unlocked and there was no door to the under stairs storage area where the cabinet is sited. The member of staff on duty immediately locked the cabinet and explained that one of the people living at the home had damaged the under stairs door. Medication administration records showed errors, in that medication administered earlier that day had not been signed for. 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 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 the following standard(s): 22 and 23 There are opportunities to raise concerns, with policies and good practice promoting the protection of those living at the home. EVIDENCE: No complaints have been received since the last inspection. A complaints procedure is in place, with a guide using pictures and symbols, to aid the understanding of those living at the home. One person explained that he could talk to staff about any concerns and regularly joins in staff meetings. The other individual is currently meeting weekly with the registered manager to discuss how things are going for him and confirmed that he finds these sessions helpful. The member of staff on duty confirmed that he had attended training on abuse, which is part of the core training for all staff. Staff also receive specialist training regarding physical and verbal aggression and responding to challenging behaviour. Records of all such incidents are maintained. The organisation has developed good policies regarding protection and a copy of the ‘No Secrets’ in Lancashire document is also available for staff. United Response is an umbrella organisation for Criminal Records Bureau checks and all staff receive clearance at enhanced level. Both people living at the home require support with finances. The records for one person were viewed. These clearly show all income and expenditure and incorporate an agreed savings plan. The other individual explained how staff look after his money for him and that he was happy with this arrangement. 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 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 the following standard(s): 24 and 30 The home is not maintained to an acceptable standard, meaning that privacy is compromised. EVIDENCE: There are continual difficulties in maintaining the home to a good standard. The two people living at the home can display challenging behaviour, resulting in damage to the home. There has been slow progress with remedial work and this must be addressed. Since the last inspection the bathroom door has been replaced but one of the bedroom doors is still off and there is no door on the under stairs storage area. The garden gate also still needs attention. Although support staff carry out the main cleaning duties, the people living at the home are being encouraged to take more responsibility in this area. A chart of the regular cleaning requirements is kept and completed by whoever has done each task. The staff member on duty showed a good awareness of hygiene and infection control issues. In order to maintain reasonable levels of cleanliness and hygiene, the cleaning of the home should be monitored and laundry baskets should be used to carry dirty clothes to the machine. 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 The staff training opportunities promote a skilled workforce and the people living at the home appear happy with the support provided. EVIDENCE: The people living at the home appeared happy and relaxed with the member of staff on duty and there was a high level of interaction within the group. One person living at the home talked about his preference for certain members of the staff team, but understood that everyone was there to help him. Feedback regarding staff was positive, from both people living at the home. The staff team consists of the registered manager, team manager, three senior support workers and two relief staff, who work regular hours as part of the staff team. The registered manager has completed the Registered Managers Award and is working towards NVQ level 4 in care. The team manager is undertaking the Registered Managers Award. Some progress has been made with NVQ training for the support staff, two having achieved level 2 or 3. The remaining team members are working towards level 2 or 3. United Response operates a thorough recruitment process. There have been no recent appointments, the staff team having remained stable for some years. The inspector met with the registered manager to view and discuss the staff records, which must be kept at the home. Some progress has been made in collating this information, however there are still some gaps in the 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 Page 17 documentation required. The registered manager must continue to address this. Training records and certificates were viewed. There is good programme of core training and regular updates take place. This core programme includes; first aid, health and safety, food hygiene, moving and handling and abuse. Relief staff are included in training plans and take part in the core-training programme. There have been no new staff at the home, however the organisation does have an organised induction programme in place. Learning workbooks are used, which incorporate the Learning Disability Award Framework units and progress is monitored. Regular staff meetings take place. The team manager has responsibility for the formal supervision of support staff. The staff member on duty confirmed that he has regular discussions with the team manager and that a recent supervision meeting had taken place. Much of the day-to-day supervision of staff takes place informally during the natural course of duties. The inspector met with the registered manager of the home to discuss supervision and in particular the formal supervision given by himself, to the team manager. Records show that this has greatly improved, with four meetings taking place during the past six months. It is vital that this level of support continue, as the staff team have to deal with difficult situations and often work alone. 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Policies, good practice and staff training promote the health and safety of everyone at the home. EVIDENCE: The registered manager has many years experience, has recently completed the Registered Managers Award and is working towards gaining the NVQ level 4 in Care. Under the current arrangements the registered manager is responsible for four United Response care homes in St Annes. Although the team manager carries out much of the day-to-day management duties, it is vital that the registered manager maintains a proactive role in the management of the home. The registered manager has opportunities to update his knowledge and has recently attended training regarding person centred planning, which will greatly benefit the individuals living at Church Road. The staff member on duty explained that feedback from relatives is gained during phone contact and that the close working arrangements mean that there are natural day-to-day opportunities to gain feedback from those living at the home. One person stated that he particularly enjoyed joining in with 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 Page 19 staff meetings. The provider organisation has achieved the Investors in People Award and an annual service plan is produced which includes goals for the future. A formal monthly quality-monitoring visit by a manager within the organisation takes place, with reports being sent to CSCI. Quality monitoring will be improved when person centred planning becomes established at Church Road. Staff duties include a schedule of daily, weekly, monthly and quarterly, health and safety monitoring, with good records being kept. These include fire drills, equipment checks, water temperature checks, vehicle checks and a monthly hazard inspection. One of the people living at the home likes to help with some of the monitoring, such as checking fridge temperatures. The core-training programme addresses key areas of health and safety, including medication, first aid and food hygiene. 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 Page 20 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 X 2 3 3 X 4 X 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 1 33 X 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 2 X 2 X 3 X X 3 X 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 Page 21 YES 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 YA6 Regulation 15 (2) (b) Requirement The registered manager must keep the service users plan under review. (Previous timescale has not been met) Medication must be safely stored and administered. Staff documents required by regulation must be kept at the home. (Previous timescale has not been met) Timescale for action 30/04/06 2 3. YA20 YA34 13 (2) Schedule 2 and 4 21/02/06 30/04/06 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. 2. 3. Refer to Standard YA24 YA32 YA37 Good Practice Recommendations All areas of the home should be well maintained. Progress with NVQ training should be monitored. The registered manager should achieve NVQ level 4 in management and care. 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 Page 22 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way 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 167 Church Road DS0000010060.V259807.R01.S.doc Version 5.1 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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