Inspection on 20/07/06 for Booker Avenue (98)

This inspection was carried out on 20th July 2006.

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 no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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 Booker Avenue (98) 98 Booker Avenue Allerton Road Liverpool Merseyside L18 9SD Lead Inspector Debbie Corcoran Unannounced Inspection 20th July 2006 10:00 Booker Avenue (98) DS0000067108.V296435.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 Booker Avenue (98) DS0000067108.V296435.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. Booker Avenue (98) DS0000067108.V296435.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Booker Avenue (98) Address 98 Booker Avenue Allerton Road Liverpool Merseyside L18 9SD 0151 524 3606 0151 524 3602 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) North West Community Services (Merseyside) Limited Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Booker Avenue (98) DS0000067108.V296435.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th March 2006 Brief Description of the Service: 98 Booker Avenue provides care and accommodation for three adults with a learning disability. The home is situated in the Allerton area of Liverpool and is close to local amenities, bus and rail routes. The care home is a dormer bungalow and the facilities for the residents are situated on the ground floor. The home is accessible for wheelchair users; the accommodation provided is spacious and the home appears well maintained both internally and externally. Since the 1st November 2005 North West Community Services have taken over the management of the home. Booker Avenue (98) DS0000067108.V296435.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit to the home was carried out on an unannounced basis. During the visit all 3 of the service users were met. Two members of the staff team and a service manager were spoken with. Service user plans, staff training records, health and safety records and other relevant records were examined in some detail. A tour of the home was carried out which included all areas. What the service does well: The overall findings of the inspection were good. 98 Booker Avenue is a small home which works on the principles of ordinary community living. Each of the service users has an appropriately detailed care plan. The care plans include information on the service users likes, dislikes, strengths and needs. The service users are supported to remain healthy and staff have a good level of information on the service user’s health needs and are supporting the service users to attend health appointments on a regular basis. Members of the staff team appear to know the service users well and have formed good relationships with them. The staffing levels are good in that at all times during the day there are two staff to support three service users. This means that each of the service users can have a good level of one to one support. Service users are supported to use local shops, pubs and public transport on a regular basis. There is a clear emphasis on the service users using and developing their daily living skills. The home is well presented, well maintained and presented as clean and hygienic. The home is fitted with aids and adaptations to meet the needs of the service users. The home appears to be well organised and staff reported feeling well supported by the manager. Booker Avenue (98) DS0000067108.V296435.R01.S.doc Version 5.2 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. Booker Avenue (98) DS0000067108.V296435.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 Booker Avenue (98) DS0000067108.V296435.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Not assessed. EVIDENCE: Standard 2 is a key standard. There have been no new service users to the home and the three people living at the home have done so for many years. This standard could not therefore be assessed. Booker Avenue (98) DS0000067108.V296435.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9, 10 Each service user has a plan of care which clearly reflects their needs and choices. Where a service user is thought to be at risk of harm a risk assessment is carried out and plans are put in place in order to best manage the risk. Service user’s confidentiality is not being protected by the current arrangements for storing information. EVIDENCE: Each of the service users has a care plan or Essential Lifestyle Plan (ELP). The service user’s plans are clear, informative and easy to follow. The plans include information on the service user’s skills and needs, daily routines, likes and dislikes, health, weekly activities, communication skills and needs. When appropriate the plans include detailed guidelines as to how to support the service users with aspects of their personal support and health. The service user’s essential lifestyle plans include a good level of detail to describe their choices and preferences. During discussions with staff they were able to give examples of how they promote the service users to make as many choices as possible and how they understand the service users communication skills. Booker Avenue (98) DS0000067108.V296435.R01.S.doc Version 5.2 Page 10 Where a service user is involved in activities which pose a risk to their safety then a risk assessment is carried out. The risk assessments cover different aspects of the persons support. The risk assessments include a good level of information on what the potential risk is and what steps need to be taken to prevent the risk from occurring. One area of potential risk to one of the service users was discussed with staff, a requirement has been given for the registered person to seek professional advice for this matter. The details of this have been discussed with the manager outside of the inspection. Risk assessments are reviewed however these reviews should be carried out more frequently. Some risk assessment information is not signed or dated. A number of records relating to the service users are being kept in an unlocked cupboard in a communal area of the home. The manager must arrange for these records to be maintained securely in order to protect the service user’s confidentiality. Booker Avenue (98) DS0000067108.V296435.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Service users are supported to use their daily living skills and to be involved in appropriate activities within their local community. Service users are offered a good choice of healthy food and staff are aware of the service needs and choices with their diet and eating. EVIDENCE: Each of the service users has an essential lifestyle plan and these include information on the activities which the person likes to be involved in. A record of the activities that each of the service users are supported with is kept and this shows the service users are supported to be involved in a variety of activities on a regular basis. During discussions with staff they gave numerous examples of the activities which the service users are supported to be involved in. Two of the service users were going to a pop concert on the evening of this visit. There were also plans for an excursion a few days later. The people living at the home are supported to maintain relationships. Service users and care staff maintain regular contact with members of the service user’s family where this is appropriate. Booker Avenue (98) DS0000067108.V296435.R01.S.doc Version 5.2 Page 12 Service user’s essential lifestyle plans include a good level of information on the person’s independent living skills and thus staff are clear as to how to promote and encourage these. One of the people living at the home is supported to maintain a work placement and is enrolling to attend college course in the near future. In assessing the diet and meals available to service users menu records were examined, lunch was observed, staff feedback was sought and the storage and availability of food at the home was checked. Information on the service user’s likes, dislikes, strengths and needs food and eating are recorded in the service user’s essential lifestyle plan. The home has a domestic sized kitchen and this was found to be well stocked with food, snacks and refreshments. Staff were observed to be sensitive and respectful to the service users needs during lunch and staff are clearly well aware of the residents routines in this area. Booker Avenue (98) DS0000067108.V296435.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Service users are well supported with their personal and health care needs. Medication appears to be managed appropriately. However many staff are administering medication without having been provided with training in this. EVIDENCE: Each of the people living at the home has a care plan / essential lifestyle plan which includes a good level of information on how to meet the person’s personal and health care needs. Each service user has a ‘personal health record’ booklet and these include information on the person’s health appointments and the outcomes of these. This showed that the people living at the home are supported to attend health appointments on a regular basis. Where one of the people living at the home requires support with personal care their plans include detailed information on the person’s needs, skills, choices and routines with this. Polices and procedure used for the receipt, storage, and documentation of medications within the home are in place. Medication storage and records were checked. These were found to be appropriate with the exception of one medication administration record which should have been signed and dated as to when a medication was discontinued. Information on medication and on the side effects of medication is maintained. Booker Avenue (98) DS0000067108.V296435.R01.S.doc Version 5.2 Page 14 Staff are administering medication without having been provided with medication training. It was reported that medication training has been booked for staff. Booker Avenue (98) DS0000067108.V296435.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Policies, procedures and practices are in place for dealing with complaints and which aim to protect service users against abuse or neglect and systems are in place for dealing with allegations of abuse. EVIDENCE: The home has a complaints procedure which is time scaled appropriately. Information on how to make a complaint is provided in the service user’s guide to the home. Complaints information is written in plain language and includes the use of pictures and a form for lodging a complaint. The home has an adult protection policy and information on the protection of vulnerable adults. The home also has a copy of the Local Authority adult protection procedures and the home’s procedures link in to this. During staff discussions staff were aware of their responsibilities for ensuring the service users are protected and for reporting allegations of abuse. A small number of staff have had training in adult protection. This should be extended to include all care staff. A record of key events is maintained for example incident reports and accident reports. These records were checked and found to be appropriate. Booker Avenue (98) DS0000067108.V296435.R01.S.doc Version 5.2 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, 25, 26, 30 The home is well presented and appears safe and clean. Each service user has their own room and these are well presented and personalised. Health and safety precautions are taken to protect service users and staff. EVIDENCE: The home is an ordinary domestic property. The home feels spacious and there are nice gardens areas both at the front and rear. There is one lounge area, a dinning area and a chill out room which is a light and sound room. Each of the people living at the home has their own room and these were found to be nicely presented and personalised with the service users own belongings. The home has aids, adaptations and equipment to meet the needs of the service users. The home has health and safety practices and procedures which are aimed at ensuring the home is safe and clean and free from hazards to the health and safety of service users and staff. Booker Avenue (98) DS0000067108.V296435.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36 Staff have clear roles and responsibilities and are appropriately supported to do their job. Staff appear to know the needs of the service users and their likes and dislikes well and staffing levels are good and allow for a good level of one to one support for service users. The level of staff training in meeting the needs of the service users is variable as some staff are well trained to meet the needs of the service users effectively and others have minimal training. EVIDENCE: Staff are aware of their roles and responsibilities across the organisation and within the home. The majority of the staff team are relatively new to the service as the home has had a change of service provider in November of last year and most of the original staff team have left the home. Staff rotas confirmed that 2 members of staff work at the home throughout the day and when activities are planned for the people who live at the home then additional staffing is provided. Staff training records were examined. These showed that staff have been provided with training in topics such as health and safety, food hygiene, protection of vulnerable adults, first aid, moving and handling, supporting people with specific health needs. Records show that some staff have more extensive training than others and there was no record of training for one Booker Avenue (98) DS0000067108.V296435.R01.S.doc Version 5.2 Page 18 member of staff. The manager should demonstrate that an analysis of staff training has been carried out and subsequent planning is in place to meet the identified training needs of staff and to ensure that staff are provided with mandatory skills and in topics relating specifically to the needs of the service users. Staff training records indicate that the home is not attaining the standard for 50 of care staff to have attained a relevant qualification. It is recommended that this is addressed by the registered person. Staff recruitment and selection practices were not fully assessed on this occasion as the inspector did not have access to staff files. During discussions with staff they confirmed that they were required to complete an application form, provide 2 written references and provide a criminal records bureau disclosure prior to the commencement of their employment. Staff reported that they have a good induction to the home which has included a period of shadowing members of staff before being put on rota to provide care. There were no records to confirm that staff have been provided with an induction. Observation of staff and discussions with them indicate that the staff know the needs of the service users well, know their likes and dislikes, are respectful in their manner and are attentive in meeting the needs of the service users. Discussions with staff indicated that they are supporting the aims and objectives of the home in encouraging service users to make choices, develop their independent living skills and have opportunities for community access. Staff reported feeling well supported by the manager of the home and reported that they have regular and recorded supervision with the manager. This could not be confirmed as there was no access to staff records during the visit. Staff reported that they have regular team meetings. This was confirmed as the minutes of some of these meetings were available. Booker Avenue (98) DS0000067108.V296435.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 The home does not have a manager who is registered with the Commission. Monthly unannounced visits are not being carried out at the home as part of the quality assurance process. Health and safety practices and checks are carried out. EVIDENCE: The home has a designated manager. This person has recently made an application to the Commission for registration. In line with quality assurance processes the registered person should ensure that the home is visited on an unannounced basis at least once per month and provide a report on the findings of the visit to the Commission in line with Regulation 26 of the Care Home Regulations 2001. These visits should form part of the quality assurance process and should involve seeking the views of service users (and their representatives as appropriate) and staff in order to form an opinion on the standard of care provided. Booker Avenue (98) DS0000067108.V296435.R01.S.doc Version 5.2 Page 20 The home has numerous policies and procedures in relation to the health and safety of service users and staff. Staff are provided with training in some core health and safety related skills, the manager should review staff training needs in this area. Fire safety and health and safety practices are adopted. Records of fire and health and safety checks were checked and found to be up to date with the exception of the fire alarm which should be tested more frequently. Booker Avenue (98) DS0000067108.V296435.R01.S.doc Version 5.2 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 Standard No Score 1 x 2 x 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 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 2 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 2 x 2 x x 2 x Booker Avenue (98) DS0000067108.V296435.R01.S.doc Version 5.2 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 YA10 Regulation 17 Requirement Timescale for action 21/08/06 2. YA39 3. 4. 5. YA23 YA42 YA35 6. YA20 The registered person shall ensure that all personal and confidential information is stored appropriately and securely. 26 (5) The registered person shall ensure that the home is visited at least once per month on an unannounced basis and shall supply a copy of the report following the visit to the Commission. 13 (6) The registered person shall ensure that staff are provided with training in adult protection. 23 (4)(c) Fire alarm tests must be carried (v) out at appropriate intervals. 18 (1) (c ) The registered person shall (i) ensure that a staff training analysis is carried out and planning is put in place to ensure that all staff are provided with training as appropriate to their role. 18 (c) (1) The registered person shall ensure that staff who are responsible for the administration of medication are provided with medication training. 21/09/06 21/11/06 21/08/06 21/09/06 21/11/06 Booker Avenue (98) DS0000067108.V296435.R01.S.doc Version 5.2 Page 23 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. Refer to Standard YA9 YA9 YA32 Good Practice Recommendations Relevant information should be signed and dated. Risk assessments should be reviewed on a regular basis. The home should aim to achieve for 50 of care staff to have attained a relevant qualification. Booker Avenue (98) DS0000067108.V296435.R01.S.doc Version 5.2 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 Booker Avenue (98) DS0000067108.V296435.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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