Inspection on 19/01/06 for Bedford Road, 153

This inspection was carried out on 19th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bedford Road, 153 30/01/08

Bedford Road, 153 23/11/06

Bedford Road, 153 21/09/05

Bedford Road, 153 13/01/05

Bedford Road, 153 22/04/04

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 Bedford Road, 153 153 Bedford Road Bootle Liverpool Merseyside L20 2DR Lead Inspector Mrs Janet Marshall Unannounced Inspection 19th January 2006 09:00 Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Bedford Road, 153 Address 153 Bedford Road Bootle Liverpool Merseyside L20 2DR 0151 933 5397 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) bedford@autisminitiatives.org www.peterhouseschool.org Autism Initiatives Mrs Elizabeth Murtagh Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 3 LD Date of last inspection Brief Description of the Service: 153 Bedford Road is a four bedroom terraced house situated in a residential area of Bootle, it is indistinguishable from other properties in the area. The property is registered as a small care home for three people who have learning disabilities. There are currently three young men in residence. The house both externally and internally is well maintained and clean throughout. The home is operated by Autism Initiatives an organisation that provide support for people with autism and other associated difficulties. The home provides staff 24 hours a day to provide care and support for the residents who live there, the overall philosophy being to maximise ordinary living and to promote independence of the residents in all aspects of their daily life both at home and in the community. Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection to be held this inspection year (April 2005 to March 2006) and took place during over four hours. The manager was not on duty on the day of the inspection so it was carried out with the help of the deputy manager the residents who were home throughout the inspection and staff that were on duty. The requirements from the last inspection report were examined with the deputy manager. One of those requirements has not been fully met so has been raised as a requirement as part of this inspection report. There were no other requirements given as part of this visit. However the two other requirements given as part of this inspection report are requirements previously given that could not be examined because the evidence to show that they have been met was not available on the day. (Due to the absence of the manager). The areas assessed during this inspection related to standards that are applicable to care homes providing care and support to younger adults. The inspection involved a tour of the premises and discussions with one resident, the deputy manager and staff who were on duty. The nature of the disability of other residents is such that it was not always possible to obtain direct views about their experiences, however, non-verbal communication with those residents, general observations and compliance with standards provided evidence for a conclusion about the service to be made. What the service does well: There was a warm and friendly atmosphere at the home. The service is good at providing information about all aspects of resident’s lives including cooking, personal care, and socialising, communicating, leisure interests and residents disability. The service is good at striving to enable greater decision making for residents this was apparent through the steps being made to enable greater independence for one resident who has difficulties communicating. Some residents have little or no verbal communication. In this situation its important to observe and monitor closely, looking at body language, responses, gestures to get an idea of residents moods and feelings The service is good at doing this. It places residents at the centre of what they do and this is obvious in observations made during this & previous inspections. The staff team know each resident very well, in terms of their strengths, needs and their likes/dislikes. This is of great importance where an individual cannot verbally say what they want or if they are unhappy/in pain. The service is good at ensuring the health and safety of residents and staff through checks to fire detection systems, the control of substances hazardous to health, the checking of water temperatures, the testing of portable appliances and the use of general risk assessments. Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. There was a good standard of assessments enabling the home to be sure of meeting residents care needs prior to admission. EVIDENCE: Care records seen contained assessment details gained prior to admission completed by the home and Care Management teams. Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 & 9. Key standards 6 and 7 were assessed at the last inspection. Standard 7 was met. Standard 6 was not fully met so was reassesses at this inspection. Care plans are not updated to reflect the current and changing needs of residents. Residents are encouraged to take risks as part of an independent lifestyle. EVIDENCE: A requirement was raised as part of the last inspection report for care plans to be reviewed and updated to reflect current and changing needs of residents. This is because care plans viewed at the last inspection showed that they had not been updated since January 2005. Examination of care files showed that this has not yet been done. Care files contained a lot of good information about all aspects of residents lives including cooking, personal care, socialising, communicating, leisure interests and residents disability. However there is a risk that needs are not being met because they have not been reviewed and updated at regular intervals. Discussion with the deputy manager and examination of care files showed that the company are introducing ‘Support Plans’ a new format for care planning documentation. When completed it is intended that this tool will provide information gained at assessment and Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 10 reviews which will then be transferred into an action plan for staff to follow. Staff are receiving training in how to implement this the new documentation in a staged process with all the staff to undertake the training and responsibility for the care plans. Part of the new style care plan has been completed for one resident. It is expected that all care plans will soon be reviewed and updated using the new documentation. Risk assessments have been carried out for each person, which showed that they are supported to take responsible risks as part of an independent lifestyle. They show the level of risk associated with an activity and what action/support staff need to take to minimise the risk identified. Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15, 16 & 17. Key standards 12 & 13 were assessed at the last inspection and were met. The service enables residents to be involved in every day experiences and opportunities. Their rights and responsibilities are recognised and promoted. Relationships are recognised as very important and encouraged. Residents are encouraged to eat and prepare food that they enjoy and is healthy. EVIDENCE: All the residents were at home throughout the inspection but had plans to go out later on that day. Weekly timetables and daily records that were viewed for all residents, showed activities and opportunities which included meals out, shopping, pubs, theatre, cinema, weekends/holidays away, visiting friends/family, music and TV in addition to day services provided by other organisations. Staff accompanied residents on a holiday to Wales in September 2005. Discussion with staff and residents and photographs of the holiday showed that they all had a good time. All residents attend day services for part of the week. One resident who has a work placement one day a week said that he really enjoys it. He also Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 12 said that he enjoys day care where he takes part in activities such as gardening and outwood bounds (part of a walking group). Residents have made links and friends and it was obvious that they like, and feel part of the groups that they attend. The assessment of resident’s rights status was assessed through observation and by the level of support given, as the residents cannot always verbally comment upon this. Staff spoken to demonstrated high standards and a deep commitment to good practices such as promoting resident’s rights on a day-today basis. They were observed interacting positively & respectfully with residents during the inspection. A resident who has difficulties with verbal communication is given opportunities to maintain and develop skills using communication skills that he prefers and understands. Staff are consistent in using pictures and sign language as a way encouraging the resident to make decisions and choices as part of an independent lifestyle. For example, what food to eat where to go and how he is feeling. Care Plans, daily records & the wide range of activities promoted showed that staff had a very good knowledge of residents as individuals and were committed to upholding and promoting their rights. One resident said that he has contact with his family on a regular basis. Staff confirmed that contact is maintained by telephone and regular visits to his parents home. Other residents also have regular contact with their family and friends. Menus at the home were discussed with staff. This and food stocks showed a wide range of healthy meals available. Staff were observed providing meals to suit residents in terms of choice and times. Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Residents personal and healthcare needs are understood, however some records need reviewing and updating to ensure that these needs are fully met. EVIDENCE: Care records and assessments of one resident case tracked showed detailed support that they need for health and personal care. This included clear hygiene & health routines and the person’s preferences when being supported. Because this information is an essential part of the care plan it must be reviewed and updated at regular intervals, which has not been done as described earlier on in this report. Therefore there is a risk that residents personal and health care needs are not being met. The deputy manager said that the new care planning documentation, which is being implemented, would ensure that this is done. Staff help residents with medical observation on a day-to-day basis as they cannot always verbally communicate pain/discomfort, and staff attend all health appointments with them. Detailed records were seen outlining all health visits/appointments, their outcome and treatment planned. Treatment received was also well recorded. Medication and records were examined they were well kept and up to date. Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 14 Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 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): These standards were not fully assessed during this inspection. Key standards 22 & 23 were assessed at the last inspection EVIDENCE: The deputy manager said that the manager is supporting residents to open bank accounts in their own name and address so that they have better financial independence. Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 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 & 30. Key standard 24 was assessed at the last inspection but was not met so was reassessed at this inspection. All parts of the home were clean, tidy and maintained to a good standard providing a comfortable and safe environment for the people who live there. EVIDENCE: A tour of the home was carried out. This showed the following improvements have been made to the home in response to requirements raised at the last inspection: • One residents bedroom, which was being decorated at the last inspection, is now completed. The resident provided a tour of his room. It was decorated and furnished to a high standard with colour schemes and furniture that he chose. • A lampshade has been fitted to the ceiling light in another residents bedroom ensuring his safety and dignity. • Carpets in the hall and landing and on the stairs that were heavily stained have been cleaned. The carpet, which was stained in the dining room, has been replaced with laminate floor covering. These and other improvements have made the home more comfortable for residents. Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 17 All areas of the home were clean and tidy on the day of the inspection. Since the last inspection the outside of the house has been painted making it look more attractive. Cleaning routines were in place. Staff said that residents are encouraged and supported to help with cleaning and general house hold tasks for example, vacuuming, making their own beds and washing dishes. Residents were seen washing dishes following their mid day meal. Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35. Key standards 34 & 35 were assessed at the last inspection but were not met so were reassessed at this inspection. Records for staff show that training and development is linked to the aims of the service and residents needs. Staff recruitment records are better maintained to provide necessary safeguards and protection for people living in the home. Skilled and competent staff support the service, and the residents. EVIDENCE: Records showed that the manager has provided training and development plans for each member of staff, they showed a structured plan that includes a programme of training that meets the aims of the home and the needs of the residents. At the last inspection records showed that staff references did not match the details given by the applicant on their original application form. The manager was advised that if references obtained are different from those given on the original application form the reason for this and details of the new referee must be recorded on the staff file. This is to ensure that the person is of good character. The information required has been supplied. Staff demonstrated throughout this & previous inspections that they are skilled, competent and committed to the welfare of residents. Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 19 This was evident through observations of staff and residents care records. Staff evidently respect residents and strive to get the best quality of life for them, through opportunities, activities and care. Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 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 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): 38, 39 & 42. Key standards 37, 39 & 42 were assessed at the last inspection. Standard 37 was met. Standards 39 was not met so has been reassessed at this inspection. Residents appear to benefit from a management team that are approachable and effective. The health and safety of residents is promoted. EVIDENCE: The current arrangements for managing the home appear to be effective. This was evident through discussion with staff and by outcomes measured during this and the last inspection. Staff spoken with said that they were happy with the way the home is managed. Comments made about the management included, “they are both very good”, and “I know if there was a problem it would get sorted”. Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 21 The company must continue to review the current management arrangement on an ongoing basis to ensure that it meets the aims and objectives of the home and the number and needs of the residents. Records showed that the required health and safety checks on the environment are being carried out at the required intervals. Those examined were well kept up to date. An annual development plan for the home was not available for inspection. Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X X 3 2 X X 3 X Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 23 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 2 3 Standard YA6 YA23 YA39 Regulation 15(2)(b) Requirement Timescale for action 31/03/06 30/04/06 31/03/06 Residents care plans and other care records must be reviewed and updated regularly. 17(2) Residents must have a bank Schedule 4 account in their own name and address. 24(1)(a)(b) An Annual Development Plan for the home must be provided. 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 Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Bedford Road, 153 DS0000005236.V279958.R01.S.doc Version 5.1 Page 25 - 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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