Inspection on 23/01/07 for Barnhill Road (11)

This inspection was carried out on 23rd January 2007.

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

Other inspections for this house

Barnhill Road (11) 09/07/07

Barnhill Road (11) 13/02/06

Barnhill Road (11) 04/11/05

Barnhill Road (11) 15/10/04

Barnhill Road (11) 19/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Barnhill Road (11) 11 Barnhill Road Wavertree Liverpool Merseyside L15 5BE Lead Inspector Manidipa Choudhury Unannounced Inspection 23 January 2007 09:30 Barnhill Road (11) DS0000025220.V321313.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 Barnhill Road (11) DS0000025220.V321313.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. Barnhill Road (11) DS0000025220.V321313.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barnhill Road (11) Address 11 Barnhill Road Wavertree Liverpool Merseyside L15 5BE 0151733 7646 9999 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) www.c-i-c.co.uk. Community Integrated Care Linda Sinclair Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Barnhill Road (11) DS0000025220.V321313.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Mrs Sloane starts adequate and recognized training in relation to the needs of the client group by 31st August 2005. 13th February 2006 Date of last inspection Brief Description of the Service: 11 Barnhill Road is registered with the CSCI to provide care for three adults under the category of learning disability (LD). The home is part of and is managed by Community Integrated Care. The home is situated in the Wavertree area of Liverpool. The home benefits from being part of a small residential area and is close to local amenities, bus and rail routes. The building is a bungalow and has been adapted over the years to meet the needs of the service users. Service users occupy single rooms and share communal bathroom, kitchen and lounge/dining room facilities. The home is accessible to wheelchair users; the accommodation provided is spacious and the home is well maintained and furnished to a high standard. Barnhill Road (11) DS0000025220.V321313.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This statutory unannounced inspection took place on 23rd January 2007 and lasted almost five and half hours. A full tour of the premises took place. A range of records such as care plans, Essential Lifestyle Plans, staff personnel files, policies & procedures and medication charts were examined. The Senior Support Worker and a support worker were on duty. Another staff member arrived for an afternoon shift. The inspector spoke to two staff members on duty, and the three service users were closely observed during the course of this inspection. The inspector also spoke to a family member of a service user. What the service does well: What has improved since the last inspection? The new Manager Linda Sinclair has been in post since July 2006. Two new staff members have attended the 5 day corporate induction course since the last inspection. Some staff members have attended a training course on Food Hygiene. At present the home is not using any agency or bank staff. If and when required, the home uses CIC bank staff. One such staff member was on duty on the day of the inspection. Barnhill Road (11) DS0000025220.V321313.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Barnhill Road (11) DS0000025220.V321313.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 Barnhill Road (11) DS0000025220.V321313.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): 1,2,3,4,5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The homes Statement of Purpose and Service Users Guide are well written and comprehensive providing service users and/or their representatives and any potential service users with details of the services the home provides enabling an informed decision to be made about admission to the home. EVIDENCE: All three service users currently living at the home has been resident there for a number of years. Each service user has an Essential Lifestyle Plan (E. L. P), which is reviewed and updated annually. This document is intended to cover every aspect of a service users life and includes their preferences, choices, hobbies and interests and provides a detailed insight into the person being cared for and the lifestyle they wish to have. This plan is especially useful as the services users have severe communication difficulties. The Statement of Purpose and the Service User Guide needs to be reviewed and updated. The documents still mention the name of the last Manager. The name of the new Manager in post should be included instead. Barnhill Road (11) DS0000025220.V321313.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The individualised care plans of each service user evidence how the service users needs and goals are met on a daily basis. EVIDENCE: The inspector case- tracked two service users. All service users in the home have a comprehensive and detailed individual care plan. The care plans are generally reviewed once in three months. However, there was evidence that in some cases, certain parts of the care plan were not getting regularly reviewed. A certain aspect of a service user’s care plan had been last reviewed in March 2006. At present a review entails a date and an initial to suggest that the review has been undertaken. This is insufficient. Following a review the Key Worker or whoever is undertaking the review should evidence that they have looked at all aspects of the care plan, document any changes or significant Barnhill Road (11) DS0000025220.V321313.R01.S.doc Version 5.2 Page 10 developments during the period and how it affects the service user, include comments on the service user’s general well being during the period and any changes are recorded and actioned. Daily health records are documented on each shift for each service user, and this includes any critical incidences plus any visits from GPs, specialists, etc. Care plans are comprehensive and contain detailed information regarding the individual needs of the service users. Each service user has an Essential Lifestyle Plan (E.L.P) which records service users individual choices and preferences, interests and hobbies, social history, daily routines and documents what is important to the individual service user. However, there were no dates on either Essential Lifestyle Plan documents. There was no evidence detailing how often the Essential lifestyle plans are updated. There was also no evidence suggesting that they are reviewed on a regular basis. The Essential Lifestyle Plans show that service users and /or their relatives are involved in the care planning process. Personal and environmental risk assessments are completed for each service user. The more functional risks are reviewed twice a month. There are other risk assessments in place with regard to more long-term risks like constipation, deterioration of eyesight, deterioration of skin due to incontinence etc. The staff were not sure how often these are reviewed. The Inspector suggested that they be reviewed every 3 to 6 months, unless there is a problem requiring that they be looked at immediately. Full involvement of NHS and other healthcare professional agencies was clearly evident on all service user care plans examined. Barnhill Road (11) DS0000025220.V321313.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Evidence suggests that the service users participate in a limited range of activities. Staff members support residents to participate in certain age appropriate activities. EVIDENCE: All three-service users have an Essential Lifestyle Plan, which details their individual interests hobbies and aspirations. All three service users require the support of staff to participate in any social or leisure activities. During the winter months limited activities have taken place, although staff said that the service users were still being taken to the “Light Room “ each Friday and shopping trips to the supermarket have continued. Barnhill Road (11) DS0000025220.V321313.R01.S.doc Version 5.2 Page 12 Staff members explained that they sometimes take the service users out for a meal, or a walk near Otters Pool. They try to do this on a monthly basis, but it is somewhat problematic due to staffing difficulties. They need 3 staff members on duty to be able to do this activity. Only one staff member can drive, and this too limits them. This particular staff member is going to leave soon, which will further restrict them. The family of two service users visit regularly. On the day of the inspection the family of one particular service user dropped in, and the inspector spoke to him. He expressed his satisfaction with the service, and explained that he does not visit on a regular basis. The inspector looked at the daily diary sheets of the individual service users and also the Home Diary. There was very limited evidence of activities or outings. The senior care worker explained that appropriate records have not been maintained. Some activities have taken place, but records have not been kept. Apparently, one service user visited the theatre with the key worker around Christmas, but there was no record of it in the home diary. Activities engaged in by the service users need to be recorded systematically, either in the individual daily diary sheets or in an Activities Diary. Due to the complex nature of their disabilities, the service users cannot participate in a huge range of activities. Therefore, it becomes imperative that suitable and specific activities appropriate to them are carefully planned and executed. The service user’s views, likes and dislikes and individual abilities need to be taken into consideration. Where appropriate family members and other significant persons in their lives should also be able to contribute to this discussion. On the day of the inspection the three service users had Tuna sandwiches for lunch. A staff member was in the process of preparing the evening meal. She was making steak, chips and vegetables. All three-service users require staff support and assistance at mealtimes. None of the service users are on a pureed diet. The food needs to be cut into small pieces. Due to the complex nature of their disabilities and the lack of communication, none of the service users can participate in drawing up a menu plan. The staff members explained that some of the staff who have been at the home for a long time can pick up specific signs which tells them which meals a service user enjoys. The home has a menu plan, but they don’t always follow it. They tend to note down what the service users had for their main meal in the Home Diary, but the recordings are erratic. Systematic and daily records should be kept, as they don’t necessarily follow a menu plan. Ideally they should also note down what the service users had for lunch, as this is the only record of the service user’s daily food intake. On the day of the inspection the fridge and the kitchen cupboards were very inadequately stocked. There was no fresh fruit and vegetables available, except a few bananas. The staff were planning to use frozen vegetables for the evening steak meal. Barnhill Road (11) DS0000025220.V321313.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Medications are managed in accordance with the National Minimum Standards, although a few problems were identified. The permanent staff have a good understanding of the service users’ support needs. This is evident from the positive relationships, which have been formed between the staff and service users. EVIDENCE: No current service user in the home self medicates, medications for service users are administered by the care workers in the home. At present, only one service user is on medication. The inspector found that the home had a far larger stock of a particular medication than detailed in the MAR sheet. It seems that a large stock of this medication was carried forward, but this was not appropriately recorded in the individual MAR sheet. It is suggested that the Barnhill Road (11) DS0000025220.V321313.R01.S.doc Version 5.2 Page 14 home discusses this issue with the pharmacist. It is not advisable to keep a large stock of medication. The inspector checked the medication returns sheets. Although the sheets record the name of the medicine, the service user’s name, the number of medicines returned and a staff member signs they also need to get the Pharmacist to sign these records. The pre-inspection questionnaire sent to the inspector mentions that the home has a medication policy. However, this could not be found on the day of the inspection. It is recommended that a copy of the medication policy should be kept in the general medication file of the service users. It is a basic reference document for all staff administering medication. On the day of the inspection there was no evidence that the staff members who are administering medication have the requisite training to do so. All staff members administering medication need to have appropriate accredited training. One service user is given rectal diazepam. Two staff members (including a night staff) have been trained for this procedure, and they administer the procedure. All three service users at the care home require the intervention of staff for all their personal support and health care needs. Staff spoken to during the inspection were fully aware of the personal support needs of the service users and how important it was that those needs should be met in a way that is sensitive to the service users preferences. On the day of the inspection the inspector observed a care worker feeding the service users with sensitivity and with appropriate consideration given to their dignity. Two of the service users are currently using bed rails. Bumpers are used. A risk assessment regarding this matter was found. The Manager of the home did it. There is no evidence to suggest that she is “competent “to undertake this assessment. There is no evidence that it is regularly reviewed. The staff have had no training on the use of bed rails. There was evidence in the care plans that a number of health care professionals are regularly consulted regarding the care of the service users. Service users regular visit the GP, dentist, optician and other healthcare professionals. Details of all planned visits are recorded. Information and advice given by healthcare professionals is also recorded. Barnhill Road (11) DS0000025220.V321313.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Barnhill has a comprehensive complaints system and appropriate checks are made on all staff to ensure the protection of service users. EVIDENCE: A clear complaints policy and procedure is available for both service users and their representatives. Included in this are contact details of the local CSCI. Office. The three service users are unable to communicate verbally but staff said that they were able to use non-verbal communication if they were unhappy. Family members of two service users also visit regularly, and they can be the advocates for the service users. No complaints have been received by the home since the last inspection. CSCI have also not received any complaints for the home. However, on the day of the inspection the complaints book could not be found. The home needs to ensure that the complaints policy is clearly displayed where all can view it, and the complaints book or forms are kept at an easily accessible place. All staff at the home have had the appropriate C.R.B. checks to ensure that the service users are protected. Barnhill Road (11) DS0000025220.V321313.R01.S.doc Version 5.2 Page 16 Since the last inspection there has been no progress made in accessing P.O.V.A training for all staff. This has been an outstanding issue since the last three inspections, and needs to be addressed on an urgent basis. Barnhill Road (11) DS0000025220.V321313.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): 24,25,26,27,28,29,30 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 environment within Barnhill Road is good, providing service users with an attractive and homely place to live. EVIDENCE: The home is situated in the Wavertree area of Liverpool and is close to shops and other amenities. The home is a three bedroom bungalow leased from Maritime Housing Association. The home is warm, comfortable and homely and on the day of the inspection odour free. Barnhill Road (11) DS0000025220.V321313.R01.S.doc Version 5.2 Page 18 Each service users bedroom is individualised to reflect their personal taste and preferences, all three service users bedrooms have tracking equipment with individual slings to assist safe moving and handling. The home has an ongoing problem with regard to the trees at the side of the house overhanging the rear garden. This could prove to be a hazard if they were to break and snap off and are a potential health and safety risk. They need to be pruned to reduce this risk. This particular tree belongs to the garden next door. The inspector was informed that the home is planning to have a walk-in shower installed. Barnhill Road (11) DS0000025220.V321313.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): 31,32,33,34,35,36 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Staff members are committed towards providing quality care for the service users. However there are a number of outstanding issues pertaining to staff training. EVIDENCE: A random selection of 4 staff personnel files were viewed. In 3 cases copies of contracts were not found on the individual files. In the case of 1 newly employed staff member, evidence of induction to the home, service users and necessary procedures was not found. In the case of 1 staff member the references could not be found. All the staff members have appropriate CRB checks. At present no agency staff are being used. If and when required the home uses CIC Bank staff. A CIC Bank staff member was on duty on the day of the inspection. The home has a stable staff team, and some of the carers have been working at the home for a number of years. The staff have a good understanding of the Barnhill Road (11) DS0000025220.V321313.R01.S.doc Version 5.2 Page 20 service users’ support needs. This is evident from the positive relationships, which have been formed between the staff and service users. This is particularly vital, as the service users residing at this home have complex disabilities. They are particularly vulnerable as none of them are able to communicate in any way. Thus they rely heavily on staff members who are able to discern their tiniest mannerisms as indicators of specific needs, likes and dislikes. The inspector was informed that a staff member who had been working at the home for a number of years has recently left. Another staff member has also handed in her notice. This may have an impact on the care of the service users, who need consistency, and staff who “know” them play a vital role. The home maintains individual staff training records in separate files. The inspector checked the staff training records of the same 4 staff members. The newly employed staff member has done the 5 day organisational induction. The other staff have done very limited training. Most of them have only had training in basic food hygiene and Overhead tracking (as this has been installed at the home).There has been no updating of mandatory or specialist training identified during the last two inspections. The home needs to take urgent action to ensure that on every shift there is at least one staff member with an up to date first aid training certificate. This includes the night shift. It is recommended that the personal training profiles of each staff member is accompanied by a training record data sheet, which shows at a glance the training courses attended by that particular staff member, and when the mandatory training needs to be updated. In the case of 1 staff member the training certificates were not found on her file. The manager needs to ensure that either the original training certificates or copies are kept on individual staff training files. The manager has recently started doing staff supervision and appraisals. At present only one staff member has a NVQ level 2, which does not meet the requirement laid out in standard 32. 50 of care staff in the home should have achieved a care level of NVQ 2. Barnhill Road (11) DS0000025220.V321313.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): 37,38,39,40,41,42,43 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Management of the home has deteriorated in some ways. This results in some practices that do not promote the health, safety and welfare of service users and staff. EVIDENCE: All records are kept in accordance with the Data Protection Act 1998, in a safe, limited access facility. The Accident book was checked. There have been no recorded accidents in 2006. Fire records were found to be satisfactory. Detailed fire risk assessments have been done. Fire equipment has been appropriately serviced. However the Barnhill Road (11) DS0000025220.V321313.R01.S.doc Version 5.2 Page 22 staff have had no fire training in 2006. Fire drills are held 3 to 4 times a month for the day staff, but there is no evidence that the night staff have attended any fire drills in the past year. On the day of the inspection the gas and electricity certificates could not be found. They were later faxed to the inspector. The fire systems servicing records were not filed systematically in chronological order. It is recommended that these vital records are systematically filed and kept in an orderly manner. Some of the other safety certificates were seen by the inspector. COSHH assessments and product information sheets were found to be appropriate. The water temperature records were found to be satisfactory. With regard to Quality Assurance, a Health and Safety checklist has been introduced recently. It is done twice a month. The list goes through all the health and safety checks (e.g. COSHH, first aid, wheelchairs, water temperature etc ) to record whether it is satisfactory. A monthly core standards review/audit is also undertaken. It looks at areas like staff recruitment, staff supervision, training, etc. The last one done on 12/01/07 was incomplete. On the day of the inspection the inspector was not able to find any evidence of quality assurance surveys done to seek the opinion of service users, their relatives, staff and other professionals involved with the home regarding their service delivery. Staff team meetings are generally held on a bi-monthly basis. The inspector felt that the staff morale was low. There are internal organisational and day to day management issues contributing to this. Barnhill Road (11) DS0000025220.V321313.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 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 2 13 2 14 2 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 x 3 2 2 3 2 2 3 Barnhill Road (11) DS0000025220.V321313.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 YA35 Regulation 18 Requirement The registered person shall ensure that persons working at the care home receive training appropriate to the work they are to perform. A staff training audit identifying individual mandatory and specialist training needs to be completed and the relevant training made available. This is an out standing requirement from the last two inspections. The registered person shall ensure that all staff members, including night staff attend fire drills at regular intervals and that this is systematically documented. The registered person shall ensure that the service user care plans are systematically reviewed at regular intervals and updated to reflect the changing needs of the service user. The registered person shall ensure that arrangements are DS0000025220.V321313.R01.S.doc Timescale for action 01/04/07 2. YA42 23 30/03/07 3. YA6 15 15/03/07 4. YA13 YA14 16 25/03/07 Barnhill Road (11) Version 5.2 Page 25 made to enable service users to participate in appropriate local, social and community activities. Facilities should be provided for recreation having regards to the needs of the service users, and they should be appropriately documented. 5. YA17 16 & 17 The registered person needs to ensure that the service users are offered a nutritious, varied and balanced diet. Their individual choices and preferences should be respected. The registered person shall ensure that appropriate records of the food provided for service users are kept in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise. The registered person shall make appropriate arrangements for the recording handling, safekeeping, safe administration and disposal of medicines received into the care home. 7 YA20 13 The registered person should make appropriate arrangements to ensure that all medicines, including controlled drugs, are administered by designated and appropriately trained staff. The training for care staff must be accredited and must include: (a) basic knowledge of how medicines are used and how to recognise and deal with problems in use (b) the principles behind all aspects of the home’s DS0000025220.V321313.R01.S.doc 15/03/07 6. YA20 13 10/03/07 30/05/07 Barnhill Road (11) Version 5.2 Page 26 policy on medicines handling and records. 8 YA42 13 (c) The registered person needs to ensure that when bed rails are in use, an appropriate risk assessment is undertaken by a “competent” person. This is kept under constant monitoring and review. All staff members handling it have the necessary training. 01/04/07 9 YA23 13 The registered person shall make 30/04/07 appropriate arrangements to train staff to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. The registered person needs to ensure that staff receive training on first aid, and that all shifts, including night shifts, are covered by a qualified first aider The registered person needs to ensure that two written references are obtained before making an appointment and any gaps in the employment record explored. 30/04/07 10 YA42 13 11 YA34 17 15/03/07 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. Refer to Standard YA32 Good Practice Recommendations It is recommended that the registered person makes adequate arrangements so that at least 50 of all care staff in the home achieve a care award of NVQ 2 The registered person needs to ensure that the Statement DS0000025220.V321313.R01.S.doc Version 5.2 Page 27 2. YA1 Barnhill Road (11) Of Purpose and the Service User Guide is reviewed to include the most up-to-date information regarding the home. 3 YA9 The registered person should make adequate arrangements to ensure that the service user risk assessments are reviewed and updated at regular intervals, and this is clearly documented. It is recommended that the personal training profiles of each staff member is accompanied by a training record data sheet, which shows at a glance the training courses attended by that particular staff member, and when the mandatory training needs to be updated. It is recommended that either the original training certificates or appropriate copies are kept on individual staff training files. It is recommended that all staff members receive appropriate structured induction training and this is systematically documented It is recommended that all staff members receive a formal contract stating their terms and conditions of employment, and a copy of this document is retained in each staff personnel file. The trees at the side of the rear garden are overhanging and require pruning to limit the threat to the service users health safety and welfare. It is recommended that the registered person negotiates with the owner of the property, where the tree is located, to resolve the problem. It is recommended that effective quality assurance and quality monitoring systems, based on seeking the views of service users, are in place to measure success in achieving the aims, objectives and statement of purpose of the home. The views of family, friends and advocates and of stakeholders in the community are sought on how the home is achieving goals for the service users It is recommended that efforts be made to ensure that individual records and home records are maintained in an organised and systematic manner. 4 YA35 5 6 7 YA35 YA35 YA34 8 YA24 9 YA39 10 YA41 Barnhill Road (11) DS0000025220.V321313.R01.S.doc Version 5.2 Page 28 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. 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