Inspection on 12/12/06 for Apple Blossom Court

This inspection was carried out on 12th December 2006.

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 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Apple Blossom Court 17/07/08

Apple Blossom Court 26/09/07

Apple Blossom Court 08/06/06

Apple Blossom Court 14/03/06

Apple Blossom Court 21/11/05

Apple Blossom Court 15/03/05

Apple Blossom Court 26/07/04

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 Apple Blossom Court 1 Falkland Road Wallasey Wirral CH44 8EN Lead Inspector June Beaver Unannounced Inspection 12th December 2006 09:30 Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Apple Blossom Court Address 1 Falkland Road Wallasey Wirral CH44 8EN 0151 637 0988 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) Apple Blossom Lodge Limited Claire Halilogullari Care Home 17 Category(ies) of Learning disability (17) registration, with number of places Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Ms Halilogullari is to successfully complete the NVQ Level 4 Care/Registered Managers Award by 2005. 8th June 2006 Date of last inspection Brief Description of the Service: Apple Blossom Court is a large detached house in a residential area of Wallasey, close to local shops, community facilities and bus routes. Bedrooms are on three floors and are all single rooms there is a separate dining room, a large communal lounge and an activity room on the ground floor. To the rear of the home there is an enclosed patio/garden area that is accessed through patio doors in the main lounge or through the kitchen door. Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced site visit to the premises which lasted approximately 5 hours and was part of a key inspection. During the visit some of the service users were spoken to as well as members of staff. The Manager from the sister home Apple Blossom Court was present throughout the visit and had helped complete a pre-inspection questionnaire. The information it contained was verified on the day by looking at the records and documentation available at the home. The manager of the home was on leave and has yet to register with the Commission for Social Care Inspection, this has been made a requirement at the end of this report. There were also some requirements and recommendations made in respect of medication and basic food hygiene practices. What the service does well: What has improved since the last inspection? What they could do better: The owners of the home must make sure a person who has been registered with The Commission for Social Care Inspection is managing the home. The staff must ensure they wear appropriate protective aprons and gloves in the Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 6 kitchen and advice was given regarding a second person witnessing hand written entries on medication records. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 and 5. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and Service User guide contains enough information to enable service users and their families to make an informed choice regarding the suitability of the service. EVIDENCE: There has been no change to the Statement of Purpose and Service User guide since the last inspection visit. All potential new service users can access both documents and there is also a brochure available to take away with a summary of the home’s facilities. New admissions are usually given time to settle in and have trial visits beforehand. A local multi-disciplinary team is responsible for liaising with the home about possible stays and there is a twelve week trial period when either party can decide whether the placement is suitable or not. Social Service and the Primary Care Trust regularly review the placement. Each service user has a contract of terms and conditions which outlines the conditions of stay, what is covered in the fees and what has to be paid for separately. Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 9 Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There is a clear care planning system in place to provide staff with the information they need to meet service users needs. EVIDENCE: Three service users care files were case tracked and found to contain a good deal of information on service users mental, physical and personal care needs which will help the staff meet the needs as and when they arise. All service users have an individual care plans which are drawn up on admission to the home and reviewed regularly at meetings which are convenient for the service user, their families or advocates and involve social workers, the primary care trust and community nurses. The multi-disciplinary approach to care ensures that the most appropriate person reviews service users individual care and social needs. Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 11 Care plans indicated that some of the service users have specific needs and training records provided evidence that specialist training had been sought to enable the staff team to support individuals with these needs. This helps protect both the service user and others who live and work at the home from any harm. Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 and 17. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home provides service users with support and encourages them to take part in the local community and to pursue age appropriate leisure facilities Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: None of the current service users are in employment however some service users do attend local day services and the home are pursuing possible attendance at local community colleges. On the day of the inspection 12 service users were at home and 5 were out at different services. Staff support service users to be part of the local community and evidence of this practice was demonstrated on the day of inspection by observing the interaction between both parties. Each service users file contains an activity chart that indicated that the service users access a variety of community based activities such as local shops and churches, libraries and places to eat out. The daily Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 13 records indicate that service users go out regularly accompanied by members of staff or members of their family which can help service users feel integrated and part of the community. There was evidence in the care files that most of the service users go on holiday for short periods of time to places such as London, the Lake District or Chester. There have also been holidays abroad to Euro Disney. This gives service users the opportunity to broaden their life experiences. A record is kept of all holidays, day trips and activities so that an audit and evaluation of the events can be done and improvements made if needed. At lunch the service users ate a variety of meals, individually chosen by the service user, most were hot meals. The meal was served the dining room with staff sitting with service users to assist as necessary. Service users are encouraged to help out in the kitchen preparing meals with staff support. This helps develops some lifestyle skills and can improve independence. On the day of the visit the staff preparing meals did not wear any aprons or gloves when preparing and serving meals as necessary as part of basic kitchen hygiene. The person in charge was advised to ensure all staff follow these basic rules to help prevent food contamination. Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home supports service users mental and physical health care needs in an appropriate way and will seek advice from other professionals when needed. EVIDENCE: Through discussion with staff it was evident that service users wishes were taken into consideration as far as possible when planning day to day events. Staff appeared to be aware of service users likes and dislikes and how they prefer to spend the day. The home keeps a record of all activities on file and there is a notice board in the activities area of the routines each service user likes to follow. This is used as a quick reference point for staff to know where service users are at any one time. Evidence that staff ensure that the service users health care needs were met was provided in the care files. Each visit from a member of the multidisciplinary team such as G.P. social worker or a community psychiatric nurse was recorded with an outcome. This ensures all staff are able to keep up to Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 15 date with current health care needs and provides an audit trail for any visiting health care professionals. All service users are given the opportunity to use the well person clinics provided by the community and all are encouraged to follow a healthy eating plan. None of the current service users smoke. There are health promotion leaflets available in the home to encourage service users to follow healthy lifestyles. None of the current service users would be able to manage their own medicines. The manager from the other home explained that they had sought advice from a pharmacist regarding recording and administering medication. However, revised medication policies now mean all hand written entries on medication administration sheets must be witnessed by a second person. This has been made a recommendation in this report. Discussion took place with the Manager from the other home regarding death and dying as the home has had recent experience of handling bereavement. Staff and the local church supported Service users and the Manager from the other home said the loss was handled very sensitively. Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There is a satisfactory complaints procedure in operation, which ensures that service users and their families’ complaints, or concerns are listened to and acted on. The home provides staff with training in adult protection procedures to make sure service users are not put at risk of harm or abuse. EVIDENCE: The home has a complaints policy and procedure which is satisfactory and provides staff with sufficient information should they receive a concern or complaint. There is an Adult Protection policy that including a whistle blowing procedure. There is also a copy of the “No Secrets” policy. The staff have received training regarding Protection of Vulnerable Adults. During discussion with some of the staff it was evident that they were able to demonstrate a clear understanding of their role as alerter to incidents or allegations of abuse. Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the décor and furnishing within the home creates a homely, comfortable clean and well-maintained environment for the service users living at the home. EVIDENCE: On the day of the visit the home was clean and tidy. There were no offensive odours. The home has a good allocation of housekeeping time and staff work hard to maintain the environment to a good standard of cleanliness. A tour of the building included looking at some bedrooms; these were decorated with individuals’ personal belongings. There is a large kitchen, which the service users can access; on the first floor there is another kitchen area, where service users can engage in daily living skills. There is one dining room with several tables service users also use this area to engage with tabletop activities. There is a large lounge with a television this Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 18 leads to a patio/garden area, that the service users can access, which is secure. There is an area with a pool table which the staff said was very popular with some of the service users and there are sufficient bathrooms and showers to ensure all service users can bath or shower whenever they want. Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 35 and 36. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The recruitment and selection policies and procedures protect residents’ from the risk of abuse or poor practice. EVIDENCE: An inspection of the rota indicated that there is a steady stable workforce with no vacancies. The present staffing levels ensure service user needs are met and that their lifestyles and social activities are promoted. Through reviewing the staff files it was evident that there is a good recruitment procedure operating at the home. Staff files contained the information required to make sure service users are looked after by appropriately vetted staff. The recruitment process includes criminal record bureau and protection of vulnerable adult checks. The home provides staff with a wide range of appropriate training which includes NVQ training (National Vocational Qualification) to level 2 & 3. All staff have taken a first aid course to enable them to assist in an emergency and all Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 20 staff have taken a basic food hygiene course. . Staff are given regularly one to one supervision and a record kept of each session. Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home does not have a Manager registered with CSCI. The home has a good staff team who promote the health and welfare of the service users. EVIDENCE: The home does not have a manager that has registered with the Commission for Social Care Inspection. The person recently appointed as Manager of the home is being supported by the Manager from the sister home and is intending to complete her registration application early in the New Year. This has been made a requirement at the last two inspections. The newly appointed manager was on leave on the day of the visit. A random check on the finances held on behalf of service users done and the balances were all correct. Each service user has their own cash tin and Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 22 cashbook which is kept safely by staff however there money is very easily accessed when the service users want it. Information contained in the pre-inspection questionnaire provided evidence of recent policy and procedure reviews and evidence that the amenities such as gas and electricity have recently been checked. Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 3 27 3 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 x 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 x x x x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 x 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 x 3 x x 3 x Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 24 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 YA37 Regulation 8 Requirement The registered persons must ensure a completed application form to register a manager is forwarded to the Commission within the stated timescale. (This requirement remains outstanding From 14/03/06 and 11/8/06). Timescale for action 31/01/07 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. Refer to Standard YA20 YA17 Good Practice Recommendations It is recommended that all hand written entries on medication records are witnessed by a second person to help ensure their accuracy. It is recommended that staff ensure they are appropriately covered when serving and handling food in the kitchen with aprons and gloves. Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Apple Blossom Court DS0000018860.V319076.R01.S.doc Version 5.2 Page 26 - 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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