Inspection on 21/11/05 for Apple Blossom Court

This inspection was carried out on 21st November 2005.

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 18 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 12/12/06

Apple Blossom Court 08/06/06

Apple Blossom Court 14/03/06

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 Helen Carton Unannounced Inspection 21 November 2005 10:00 Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 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.V264578.R01.S.doc Version 5.0 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.V264578.R01.S.doc Version 5.0 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.V264578.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Ms Halilogullari is to successfully complete the NVQ Level 4 Care/Registered Managers Award by 2005. 15th March 2005 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.V264578.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. There were 15 residents’, living at Apple Blossom Court at the time of the visit. The inspection was unannounced and took approximately four and a half hours. Two inspectors’ visited the home and spent time with most of the residents’ as well as speaking with the manager and members of the staff team. What the service does well: What has improved since the last inspection? All members of the staff team have started NVQ level 3 training with specialist training in supporting adults with a learning disability included. The home has also arranged for a specialist nurse to come to the home to discuss the care needs of adults with a leaning disability who may be developing Alzheimer’s disease. Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 Page 6 What they could do better: 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. Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 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.V264578.R01.S.doc Version 5.0 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): 1&5 The home’s Statement of Purpose and Service User Guide provides good information for residents, prospective residents and their representatives about the home. However more detailed information is required with regard to the ethos and care practices within the home. EVIDENCE: The home has produced a detailed statement of purpose and service user guide to assist prospective residents’ and their relatives and representatives to decide if Apple Blossom Lodge is the right home for them. The inspector would advise the manager and owners’ to review these documents so that they provide greater detail about the people they support and how they go about doing this. This will provide very clear information to all parties about the type of people and support Apple Blossom Lodge is able to provide. Residents contracts provide detailed information however the inspector would advise the manager and owners to include a copy of the resident’s care plan and risk assessments to ensure the resident, their representatives and the placing authority are fully aware of the care and support to be provided. This should include detailed information about any restrictions placed on residents’ lifestyles. Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 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): 6,7,8 7 9 The care planning system on the whole is good and provides the staff team with the information they need to satisfactorily meet residents’ needs. However gaps in information were found which could have a detrimental impact on residents well being. The home is unable to clearly demonstrate they actively seek the views of residents’ in decision making about their personal lives and how the home is run. EVIDENCE: On the whole the care plans provide the staff team with good information and guidance as to the most appropriate care and support to be provided to residents. However the inspectors discussed with a manager from the company concerns about a resident needing to follow a separate diet as discussions with members’ of the staff team showed the diet was not being followed. It was also discussed that risk assessments and management plans are not as detailed and do not provide sufficient information about the type and level of restraint that may need to be used to keep individual residents safe should the need arise. Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 Page 10 The staff team have received specialist restraint training carried out by an accredited trainer with the British Institute of Learning Disabilities (BILD). The inspectors’ asked members of the staff team to demonstrate the techniques they had been taught. These appeared to be safe and used minimal force to restrain. All members of the staff team told the inspectors they would only use restraint if all other methods of support had failed such as diverting techniques. The inspectors’ discussed with the manager the need for the home to show they have actively seek the involvement of residents’ their families, other professionals and representatives of the placing authority. When decisions are being made that restrict residents’ freedom of choice and independence in the community. The manager told the inspectors’ she invites all parties to formal reviews, which are attended by a small number of professionals. The inspectors’ advised the manager to send copies of the reviewed care plan and risk assessments to all professionals responsible for supporting and monitoring the placement and to invite their comments. By doing this, the home is showing they are being open, honest and seeking others views about the care, support and supervision being provided by the home. The manager told the inspectors’ she had contacted MENCAP for advice and support on the best way to set up a residents’ group to enable them to fully participate in decision-making. They told her they would be happy to facilitate these meetings until the group is established. Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 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): 11, 12, 13,14 & 16 Links with the community are good and support residents’ social opportunities. There is a lack of educational activities available for residents’ to access. Consultation with service users is limited with little documentary evidence that their views are acted upon. Some of the support offered in the home is not offered in such a way as to promote and protect residents’ privacy, dignity and independence. EVIDENCE: The home offers residents’ the opportunity to take part in a limited range of community activities at a local leisure centre. Residents are able to attend a range of evening clubs run by members of MENCAP. Residents’ are able to attend numeracy and literacy sessions at the home twice a week. Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 Page 12 The manager told the inspectors’ residents’ will access community events as and when they happen. The inspectors’ discussed with the manager the lack of outside activities undertaken by residents’ particularly those who the home is working to promote life skills and independence. The manager told the inspectors’ activities were offered but residents lost interest quickly. The manager was advised to document the activities offered and the work carried out to try and encourage residents’ to maintain the activity. The inspectors’ advised the manager to make sure residents’ risk assessments accurately reflect all risk factors that may occur while residents are out in the community. Also those members of the staff supporting residents’ out in the community should have access to a mobile phone to call for assistance if needed. One of the two inspectors’ who visited the home spent time with the residents’ who appeared at ease in the home and looked to the staff team for positive reinforcement. The inspectors’ discussed with the manager the lack of educational opportunities for residents’. The manager told the inspectors’ the residents had received the Wirral three-year passport allowing them free access to specialist educational courses. However they have now run out and cannot be renewed. During the visit the inspectors’ saw a resident coming to the seniors’ office for sweets that had been left for them by family members’. Talking to members of the staff team showed this practice had developed and was not detailed in the resident’s care plan or risk assessments. The inspectors’ advised the manager to document why the home is holding the resident’s sweets as it could be viewed as a punitive measure. The inspectors’ saw a member of the staff team move a resident away from an office door towards the main lounge in an inappropriate way. The inspectors’ discussed this with the manager who told the inspectors’ she would discuss this with the individual member of staff. Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 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): 19 & 20 The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure residents’ medication needs are being met. Not all the residents’ health care needs are met with the involvement of multi disciplinary working being fragmented. EVIDENCE: One of the inspectors’ checked a sample of residents’ medication and looked at the home’s medication policy and procedure. The medication was well maintained and all necessary information is recorded. The inspectors’ looked at residents’ records and found that the home weighs residents’ regularly. However the residents’ ideal weight is not documented and there is no documentary evidence the home has sought advice from health care professionals. The manager told the inspectors’ the home weighs residents’ at Boots Chemist and takes the ideal weight from the weighing machine. The manager was advised to seek advice from relevant health care professionals to ensure residents’ ideal weights are specific to their overall health care needs. Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 Page 14 After the inspection visit the manager contacted the inspector to say she had contacted one resident’s GP for advice. It was stated by the manager that the GP had not been happy to weigh the resident at a normal appointment. The inspector advised the manager to ensure residents’ ideal weight targets are discussed and decided with input from other health care professionals such as dieticians, practice nurses and GPs’ and to fully document this input. Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 Page 15 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 & 23 The staff team have a basic understanding of Adult Protection issues. However lacked insight into some of the care practices that could be viewed as punitive or rough. The home has a satisfactory complaints system with some evidence that residents’ concerns are listened to and acted upon. EVIDENCE: The manager has carried out a piece of work to produce the Younger Adults National Minimum Standards in a user-friendly format for residents’. The manager has also produced a complaints procedure in a similar format and intends to add photographs of the management team and owners’ to enable residents to know who to talk to if they are worried about anything. As detailed earlier in the report concerns about withholding sweets from a resident and the way in which a member of the staff team moved a resident from one area to another were discussed with the manager. The manager informed the inspectors’ she has booked specialist training dealing with the protection of vulnerable adults and indicators of abuse. This training is to take place on the 29th and 30th November 05 and will include the Wirral social services protection of vulnerable adults protocols. The whole staff team including the owners are attending this training. Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 Page 16 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): 24,26 & 30 The standard of the environment within the home is of an acceptable standard. EVIDENCE: The home has a maintenance programme and employs a handyman to carryout repairs to the home. Many of the residents have purchased bedroom furniture for themselves, which is detailed in their property log. All areas of the home viewed during this visit were clean and tidy. Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 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 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): 31,32,34,35 & 36 The staff morale is high with them demonstrating a clear understanding of their roles. The owners, manager and staff team demonstrate a commitment to continuing professional development through the training being undertaken. The standard of vetting and recruitment practices are good with appropriate checks being carried out to protect residents’ from potential abuse. EVIDENCE: Since the last inspection visit all members of the staff team have started NVQ level 3 training with specialist units in supporting adults with a learning disability being included. The home has also arranged for a community psychiatric nurse to talk to the staff team about Alzheimer’s disease and the impact it has on adults with a learning disability. Members of the staff team told the inspectors’ they were well supported by the manager and the manager from the company’s other home and were very clear on what their roles are within the home. They told the inspectors’ at the beginning of each shift they are given information about each resident so they know how to approach and support residents’. Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 Page 18 A sample of staff members files, were looked at and they were well maintained with all the appropriate having been carried out. Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 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 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 & 42 The manager is supported well by the senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. EVIDENCE: The home does not currently have a registered manager with the acting manager being responsible for the day-to-day management of the home under the close supervision of the registered manager of the company’s other home. Issues about the detail in some of the records held by the home such as the care plans and risk assessments are documented in this report. The inspectors’ acknowledge on the whole the standard of record keeping in the home is good. The inspectors’ discussed with the manager the need to demonstrate and document work carried out with residents’ that shows their involvement in decision making about their lifestyles and living at the home. The manager reacted positively to this discussion and has involved members of MENCAP to be part of this process. Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 Page 20 Issues of health and safety such as the recording of residents’ ideal weights and the following of specialist diets were discussed with the manager. Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 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 2 X X X 2 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 2 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X 2 X X X 3 LIFESTYLES Standard No Score 11 2 12 2 13 3 14 3 15 X 16 2 17 Standard No 31 32 33 34 35 36 Score 3 2 X 2 2 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Apple Blossom Court Score X 2 3 X Standard No 37 38 39 40 41 42 43 Score 2 X 2 X X 2 X DS0000018860.V264578.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? yes 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 YA1 Regulation 4 Requirement The registered persons must ensure the Statement of Purpose provides detailed information regarding the range and complexity of needs they can provide for. The registered persons must ensure the Statement of Purpose provides detailed information regarding the range and complexity of needs they can provide for. The registered persons must ensure residents care plans accurately reflect all their care needs including dietary and health care needs. The registered persons must ensure when items are Timescale for action 30/01/05 2 YA5 5 30/01/06 3 YA6YA19 15 30/01/06 4 YA7 12 30/12/05 Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 Page 23 withheld from residents such as sweets. The reason why they are being withheld and who has been involved in the decision-making is fully documented. 5 YA7YA8YA16YA39 12 The registered 30/01/06 persons must ensure residents’ views are actively sought with regard to their individual lives and in the running of the home. These interactions and discussions must be recorded. 30/01/06 The registered persons must ensure residents’ risk assessments and management plans provide detailed information regarding action to be taken to diffuse difficult situations and if necessary the restraint techniques to be used as a last resort. The registered persons must ensure a review of activities offered to residents’ is undertaken to ensure educational opportunities external to the home are explored. The registered persons must ensure 20/02/06 6 YA9 13 7 YA11YA12 16 8 YA23YA26YA32YA35YA42 13 30/01/06 Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 Page 24 9 YA37 8 all issues of possibly abusive practice are fully discussed with the staff team with particular regard to the inappropriate moving of residents. The registered 30/12/05 person must ensure an application form is forwarded to CSCI with regard to the registering of a manager within the stated timescale. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Apple Blossom Court DS0000018860.V264578.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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