Inspection on 06/06/05 for Apsley House

This inspection was carried out on 6th June 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

Apsley House 12/07/06

Apsley House 22/11/05

Apsley House 13/12/04

Apsley House 06/07/04

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 Apsley House, 103 Queens Park Road, Heywood, Rochdale, OL10 4JR. Lead Inspector Jenny Andrew Unannounced 6th June 2005 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. Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Apsley House, Address 103 Queens Park Road, Heywood, Rochdale, OL10 4JR. 01706 360309 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) Mrs Linda Bell and Mrs Janet Kinsella Mrs Alexandra Bowling Care Home 4 Category(ies) of Learning Disability 4 registration, with number of places Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 4 service users, to include;up to 4 service users in the category of LD (Learning Disability) 2. The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. Date of last inspection 13th December 2004 Brief Description of the Service: Apsley House is a privately owned, small care home accommodating 4 younger adults with learning disabilities who need support to lead independent lives. The home is a spacious end of terraced house near to the centre of Heywood with good access to a range of community facilities and public transport links. A park is situated close by. All 4 bedrooms have en-suite facilities and are situated on the first and second floor levels of the home. As there is no lift, the home is unsuitable for anyone with mobility difficulties. This is published in the statement of purpose. Car parking space is available at the side of the house and there is a small garden area to the rear. Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over 7 hours, half of which was spent talking to service users. Two of the 3 service users were spoken to. The third person did not wish to speak to the Inspector and one service user was away for the week. The staff were having a training day but 5 of them were spoken to during their lunch break as well as at the end of the day. What the service does well: What has improved since the last inspection? What they could do better: The home needed to make sure that a care plan was in place for each service user so that staff were working in the same way towards helping them to meet their goals. Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 Page 6 Whilst staff listened to what service users said and valued their ideas, there was no quality plan in place showing service users how their opinions and ideas affected the way the home was run. 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. Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 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 Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 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) 2 A comprehensive needs assessment, involving service users, was undertaken prior to admission, ensuring they knew what to expect from the service and that their identified goals could be met. EVIDENCE: Both files inspected contained detailed assessment documentation. One contained a level 4 assessment which had been undertaken by a care manager together with the home’s own assessment tool. The other contained the home’s needs assessment tool and a partially completed level 4 assessment. For any future admissions, the home should ensure, that for service users referred through care management, a fully completed assessment is undertaken prior to admission. Some sections of the assessments, had been done during the visits the service users had made to the home prior to admission, but some sections had been completed later, when staff had been able to spend more time with the individuals. The home’s assessment tool was a comprehensive document and was added to over the first six months and utilised as the care plan during this time. Discussion with 4 visiting relatives indicated they were very much involved in the assessment process. Neither of the service users had a clear recollection about the assessment process but said they could remember being asked some questions by the staff. They did however, state that their individual Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 Page 9 needs and goals were regularly discussed and agreed with them and both felt their needs were being well met at Apsley House. Good joint working practices were identified with the home and the Social Services Department, which impacted positively on the service user group. During the visit, the Inspector was invited to sit in on a team meeting, focusing on risk assessment and management strategies for each of the service users. It was clear that the manager and support workers had the skills, knowledge and expertise required to ensure the needs of the present service user group were being well met. Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 & 9 The care planning system was inconsistent, although the assessment documentation in place provided staff with the information they needed to meet the service users individual needs. Service users were empowered to exercise choice in their lives within an agreed risk taking context, which made them feel valued and increased their self esteem. EVIDENCE: Care plans were said to be generated from the assessments after a six month period. It was however, identified that in one instance, where a service user had been admitted in August 2004, a plan of care had not been formulated. This must be addressed. Both service users said they had a copy of their assessment/care plan in their rooms but that they had not signed it. The assessment tool included goal setting although some goals with a review date of February 2005 had not been reviewed. This was also identified in some of the other care plans seen. In order to ensure service users are progressing towards meeting goals, regular reviews should be undertaken. Discussion with both service users did however, confirm they were clear about the goals they were working towards and felt they were making good progress. Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 Page 11 Clearly the good working practice being undertaken by the staff team is not reflected in the care planning documentation. Service users described examples of practical staff support and encouragement, which had resulted in their independence skills and selfconfidence increasing. Both felt they could make decisions and choices in their daily lives and that staff respected their rights to do so, provided the risk element was not too high. Examples included, budgeting, using public transport unsupported, choice of activities and preferred daily routines. Decision-making, affecting the house, was reflected in the minutes of service user meetings. Both felt that a recently introduced “student of the week” award, had really motivated them to achieve their goals and the Inspector observed the presentation of the award for the previous week. On the day of inspection, the staff team were holding a training day, the outcome of which would be to formulate new risk assessments and management strategies for each service user. Existing risk assessments were in place but they had not always been signed and dated. When the new assessments and strategies are written, they should be signed, dated and reviewed as necessary. Challenging behaviour was monitored and recorded in order that staff could establish whether there were any triggers or particular patterns leading up to behavioural issues. A training workshop for staff had previously been convened where risk management and behaviour strategies had been formulated for one service user. Eight staff had attended which had resulted in a consistent approach being taken when dealing with behavioural issues. The session had been facilitated by social workers from the Social Services Learning Disability team. Evidence of physical intervention and other related training was seen on the staff training files. Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 15 & 16 Links with the community were good, supporting and enriching service users social and educational opportunities. Staff valued the role, which relatives and friends could continue to play in the lives of service users, and encouraged and enabled such contact. Rules and regulations were kept to a minimum, thus ensuring that service users had control over their lifestyles. EVIDENCE: Community activities enjoyed by the service users included use of colleges, sport, leisure and entertainment facilities, pubs and shops. Staff were supporting one person to secure a voluntary job in a local charity shop. Since the last inspection, it was clear that one service user in particular had become far more motivated and settled at the home. One service user felt she had been well supported by the staff with regard to becoming independent in travelling on public transport to college. Staff support is provided on a flexible basis, in order to ensure that individual’s needs may be met. All 4 service users were registered on the electoral role and had been asked if they wanted to vote at the recent election. They had chosen not to do so. Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 Page 13 Relatives of one service user were spoken with during the inspection. They expressed their satisfaction with the service, stating the person they were visiting had settled in well, was developing more independent living skills, that the staff were “very approachable” and kept them fully advised as to any issues. Both service users said they were aware of the rules of the house which they felt were reasonable and were geared towards respecting each other and the staff. A fair system was in place in relation to household chores, with a rota having been written covering daily tasks. In addition service users said they helped with the cleaning, kept their own rooms tidy, made drinks and snacks and also assisted with the supermarket shopping. Individual rights were promoted with service users being given their mail unopened, having front door and bedroom door keys and staff respecting individual’s wishes with regard to spending time on their own. There was a smoking lounge for service users as well as a non smoking lounge. Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 20 The health needs of service users were well met with evidence of close working links with a variety of health care professionals. The systems for the administration of medication were good with clear procedures in place to ensure the safety of service users. EVIDENCE: Each service user had a file, which included details of medication including side effects, correspondence and appointments with health care professionals and other relevant information. Records showed that service users were supported to attend regular dental check ups and other health care visits. The visitors spoken to also confirmed that the person they were visiting had been supported on optician appointments as well as hospital appointments. From discussions with service users, relatives and staff, it was evident that service users health care needs were closely monitored with referrals being made to appropriate professionals as necessary. Medication procedures were being followed and subject to a satisfactory risk assessment, service users could self medicate. Medication was securely stored and there was no over-stocking of drugs. Since the last inspection, the manager or deputy were undertaking weekly audit checks to ensure that medication administration records were being appropriately signed by the staff. All staff responsible for the administration of medication had received training. Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 Page 15 The manager was in the process of arranging for a local pharmacist to undertake audit visits to the home. Health care professionals regularly reviewed medication and one service user said she was really pleased that she no longer had to take any medication. Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 An effective system was in place to respond to complaints, with evidence that service users felt their views were listened to and acted upon. Policies/procedures ensured the protection of service users from potential abuse. EVIDENCE: Both service users spoken to felt that the support workers were always available when they needed to speak to them about anything that was worrying or of concern to them. They also felt that problems were addressed quickly. The service user guide contained a copy complaints procedure and both service users said they had been given a copy but could not remember where they had put it. A complaints file was in place but since the last inspection, no formal complaints had been received by the home. Appropriate policies/procedures were in place in relation to whistle blowing and adult protection. Since the last inspection, the staff team had received inhouse training in relation to dealing with any suspicions of abuse. Feedback indicated they felt this had been useful and that they now felt more equipped should they need to deal with such an allegation. One of the owners and a support worker were due to attend vulnerable adult training, facilitated by Rochdale Social Services training department, the day following the inspection. Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 30 The home provided a safe, comfortable and clean environment for the people living there. EVIDENCE: A good standard of cleanliness was apparent throughout the home. Service users assisted with household tasks and were responsible for cleaning their own rooms. The Inspector was invited to view their rooms and it was clear they were proud of their achievements in this area. Satisfactory arrangements were in place in relation to infection control and policies/procedures were in place. Following a recommendation made at the last inspection, the communal bathroom, which was also used by staff, now had the provision of paper towels. The laundry could be accessed externally, without going through the kitchen and soiled linen was carried in a lidded basket. Disposable gloves and aprons were available as needed. Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 Page 18 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) 34 & 35 Good recruitment and selection procedures were in place providing the necessary protection for service users. Staff had received appropriate training ensuring they could meet the needs of the current resident group. EVIDENCE: Discussion with the staff identified they felt valued and supported by the management team and very much enjoyed working at Apsley House. They felt their training needs had been identified and that the training offered was appropriate to the client group they were supporting. They also commented upon the good teamwork and the willingness of everyone to work flexibly. Two staff files were checked and seen to be well formatted and in good order. The recruitment process followed the home’s procedure with an application form being completed with full employment history, two satisfactory references, completed health care declarations, contracts and Criminal Record Bureau checks being obtained prior to staff commencing work. Files also contained copies of training certificates and training profiles outlining the training each person had received. Signed declarations were in place stating they had received a copy of The General Social Care Council’s “Code of Conduct. Staff training was being undertaken both in-house and externally. This had included health and safety topics, physical intervention techniques, managing Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 Page 19 challenging behaviour, and infection control. One support worker had completed NVQ Level 3 training, 2 were in the process of doing the training and another worker was due to start shortly. All new staff were expected to undertake the Learning Disability Award Framework (LDAF) training although one support worker who had been working nights, but had recently transferred to days, had not yet commenced. From the files inspected, it was evident that staff had received at least 5 days training over the last 12 months. Since the last inspection, the new manager, who had transferred from Wellesley House, had commenced working at Apsley House. She had recently completed her Registered Managers Award and was continuing to attend other training courses in order to continue to update her knowledge and skills. Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 Page 20 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) 39 The manager and staff were committed to seeking service users’ views in order to improve life in the home, but an annual development plan had not yet been formulated. EVIDENCE: The management and staff team were committed to improving practice and to this end, regular management and full team meetings took place, staff received supervision, service user meetings were held, a key worker system was in place and service users were regularly consulted about their daily routines. This good practice should now be formulated into a development plan, which underpins this practice. Results of service user surveys should also be published and made available to service users. The service users had recently completed questionnaires, and the staff were in the process of taking action to address the feedback. In addition care management questionnaires had been circulated and feedback was very positive. The relatives spoken to during the inspection said that staff regularly consulted them and that communication with the staff team was excellent. The home were also committed to addressing any requirements and recommendations made in inspection reports, within the agreed timescales. Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 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 x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 Standard No 11 12 13 14 15 16 17 x x 3 x 3 3 x Standard No 31 32 33 34 35 36 Score x x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Apsley House, Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x x x F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 Page 22 Are there any outstanding requirements from the last inspection? No 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 6 Regulation 15 Requirement A service user plan must be in place for each person which should be reviewed and updated on at least a 6 monthly basis. Timescale for action 31.07.05 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. 4. 5. Refer to Standard 2 6 6 39 39 Good Practice Recommendations Where service users are admitted via care management, a detailed level 4 assessment document should be obtained prior to admission. Service users aims/goals should be reviewed and updated. Risk assments and management strategies should be dated and signed. A quality development plan should be written and made available to service users, CSCI and other interested parties. Results of service user surveys should be published. Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Turton Suite, Paragon Business Park, Chorley New Road, Horwich, Bolton, BL6 6HG. 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 Apsley House, F56 F06 S58327 Apsley House V230434 06.06.05 Stage 4.doc Version 1.30 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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