Inspection on 09/12/05 for Burden Road (43)

This inspection was carried out on 9th December 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Burden Road (43) 05/06/08

Burden Road (43) 17/07/07

Burden Road (43) 28/09/06

Burden Road (43) 31/05/05

Burden Road (43) 06/01/05

Burden Road (43) 16/06/04

Burden Road (43) 31/01/04

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 Burden Road (43) 43 Burden Road Moreton Wirral CH46 6BG Lead Inspector Inger Moynihan Unannounced Inspection 9 December 2005 09:00 Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Burden Road (43) Address 43 Burden Road Moreton Wirral CH46 6BG 0151 678 9962 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) Community Integrated Care Limited Mrs June Mary Bell Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st May 2005 Brief Description of the Service: 43 Burden is a residential care home providing 24 hour personal care and accommodation to three service users with a learning disability. This service is owned and managed by Community Integrated Care. The home is located in a residential area close to Moreton town centre which has a large selection of shops, pubs, a post office and other town amenities. The home is a two story detached house with bedroom accommodation on both floors; all bedrooms are single occupancy. Toilets are located on both floors with a bath and shower on the ground floor. The communal facilities comprise of a lounge, dining room and kitchen. Smoking is not permitted in the home. The home has its own transport allowing service users to access community facilities easily. Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over five hours and was the statutory announced inspection for 2005/2006. A tour of the premises took place and staff and service users records were inspected. Four staff were spoken to during this inspection and observations were made on the service user group. What the service does well: A care plan outlining service users care needs is recorded and provides staff with information on how to look after the service users properly. Service users have an opportunity to develop their social and communication skills. A range of social activities are provided to ensure service users interest and stimulation. The routines within the home are flexible which promotes service users independence and choice. A varied and nutritious diet is provided to ensure service users interest and good health. Service users are provided with the personal care they require and have access to a range of health care professionals to ensure their good health. Thorough medication administration procedures are in place to ensure service users good health and well being. Systems are in place to ensure service users are safeguarded from abuse and harm. The deployment and number of staff available are sufficient to meet service users needs. There are clear lines of management and accountability within the home which is run for service users best interest. Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 6 The health, safety and welfare of the service users throughout the home. is well promoted What has improved since the last inspection? What they could do better: The home has a complaints procedure to ensure staff views are listened to and acted upon. A more user-friendly complaint procedure must be provided for the service users to ensure their concerns are always taken into account and acted upon appropriately. The communal living space has been reduced as the dining-room is now being used as a bedroom. This issue has been ongoing for nearly two years and has still not been resolved. This issue is being dealt with outside of the inspection process. Further training needs to be provided on the specific learning disabilities the service users experience. As a result of the requirements made during the last inspection, improvements have been made to the way in which 43 Burton Road is managed. Systems have improved and further management input has been provided. However, one of the managers who visits is actually a registered manager from another service. This issue was discussed during inspection and it was confirmed that she spent approximately two days per week at the home. While her input has certainly had a positive impact on the home, other arrangements must be made to support the staff as this person is not fulfilling her own responsibilities with regard to the service she is registered for. Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 7 43 Burton Road has not had a registered manager now of 18 months. In the light of this, the registered person must write to the CSCI to update the inspector of the progress being made with this situation. 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. Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 8 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 Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 9 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 Service users care needs have been assessed which enables the staff team to look after the service users in accordance with their particular needs. EVIDENCE: Documentation demonstrated that a comprehensive assessment of service users’ care needs is in place. All of this information has recently been reviewed to ensure it is an accurate reflection of service users care needs. Staff spoken to during the inspection confirmed they had access to this information when necessary. Risk assessments have been carried out in relation to the different aspects of the service users lives. Carrying out such risk assessments ensures service users are encouraged to take risks as part of an independent lifestyle, but at the same time ensures their safety and welfare. At the last inspection the dining room was also being used as a bedroom for one of the service users whose care needs had changed and they were unable to access their bedroom by the stairs. Last year the CSCI agreed this situation could continue for a period of assessment for as long as the responsible individual took action to find appropriate accommodation for this service user. This living arrangement effectively reduces the communal living space for other service users. Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 10 More recently arrangements have been made for the service users to have their meals in the kitchen which at least ensures this particular service user has his own bedroom, also more bedroom furniture is being purchased. While this situation is acceptable for the interim, and staff have not identified any particular problems with regard to service users having their meals in the kitchen, further discussions need to take place before a decision is made on whether this arrangement is suitable in the long-term. This matter will continue to be addressed with the responsible individual outside of this inspection. In the meantime, the registered provider is required to write to the CSCI to confirm the inspector of the action is being taken with regard to addressing this issue. Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 11 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 A care plan outlining service users care needs has been recorded and provides staff with information on how to look after the service users properly. EVIDENCE: Service users health, personal and social care needs are set out in an individual plan of care. This is in line with good practice and ensures staff know how to care for the service users in accordance with their particular needs. This information covers a range of relevant issues and includes the use of various assessment tools which are used to monitor service users health care on an ongoing basis. Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 14, 16 and 17 Service users have opportunity to develop their social and communication skills. A range of social activities are provided to ensure service users interest and stimulation. The routines in the home are flexible which promotes service users independence and choice. A varied and nutritious diet good health. EVIDENCE: Service users have opportunity to develop their social and communication skills to ensure their personal development. Service users are provided with a range of leisure facilities and make use of the local pubs, cinema and shops etc. Leisure activities are provided on an Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 13 is provided to ensure service users interest and individual basis or within small groups with appropriate staff support being provided at all times. The routines within the home are flexible which promotes service users independence and choice. Mealtimes are flexible and service users dietary requirements are met. A varied and balanced diet is provided to ensure service users interest and good health. Service users medical needs are incorporated into the menu planning. Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Service users are provided with the personal care they require and have access to a range of health care professionals to ensure their good health. Thorough medication administration procedures are in place to ensure service users good health and well being. EVIDENCE: Each of the service users requires some degree of help with their personal care. Through discussion with staff, the inspector established that service users’ healthcare is monitored on a regular basis with a record of any specific issues being made. This monitoring and recording ensures service users enjoy a good quality of life and maintain good health. Regular contact is maintained with a range of health care professionals who give advice and support as required. A record of service users general welfare is in place along with the outcome of any health care appointments. Staff have completed appropriate training in relation to specific aspects of service user care needs and policies, procedures and guidelines are in place to support the staff in these areas of care. All of this is in line with good practice and ensures service users physical and mental health is monitored and maintained. All of these factors contribute to providing a safe environment for service users to live. Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 15 The systems in place for the administration of medication are good with all the required documentation being in place. Appropriate training has been provided for those staff who take responsibility for administering service users medication. Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The home has a complaint procedure to ensure staff views are listened to and acted upon. A more user-friendly complaint procedure must be provided for the service users to enable them to express any concerns they may have. Systems are in place to ensure service users and harm. EVIDENCE: Neither the CSCI or the staff at the home have received any complaints about the standard of care provided. The complaint procedure is clearly displayed for staff. The CIC organisation are currently looking to put this procedure into a more user-friendly version to ensure service users can make a complaint if they are unhappy about any aspect of the care provided. All staff have completed training on the protection of vulnerable adults within the last two years. It was agreed with the acting manager that staff now require an update in this area of training. The acting manager stated this will be completed by the next inspection in approximately six months. Information relating to the Wirral adult protection procedures was given to the acting manager. The registered person is required to ensure a full copy of this procedure is available for staff reference to ensure any allegations of abuse are acted upon in line with recognised local practice. are safeguarded from abuse Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 The standard of furnishing within the home is now improved and contributes to providing a much more homely environment for service users to live. The communal living space has been reduced as the dining-room is now being used as a bedroom. EVIDENCE: The premises are in keeping with the local community and are comfortable and free from offensive smells. Service users have their own bedrooms which have been personalised with their own belongings. The lounge has sufficient furniture for the number of service users living at the home, although staff did explain they needed another armchair as this was the preferred seating for two service users; at present there is only one armchair provided. To ensure service users comfort, the registered person is required to ensure another armchair is provided in the lounge. Arrangements are being made for the whole house to be redecorated with new carpets being fitted throughout. At present the dining room has been converted into a bedroom for one of the service users which significantly reduces the amount of communal living space Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 18 available for the service user group. This issue is being addressed with the registered provider outside this inspection. The standard of hygiene throughout the building is good. The staff spoken to during the inspection confirmed they had completed appropriate training and confirmed sufficient equipment and materials were provided to enable them to carry out their work and ensure the prevention of cross infection. All of this contributes to a safe and comfortable environment for the service users to live. Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32 and 35 Staff are clear on their role and responsibility with regard to the care of the service users. The CIC organisation provides staff with a range of appropriate training to ensure they know how to look after the service users in accordance with their particular needs. The deployment and number of staff available is sufficient to meet the service users needs. EVIDENCE: Staff spoken to during inspection demonstrated they were aware of their responsibilities with regard to the care and protection of the service users and demonstrated good values in relation to their care. Through discussion the staff demonstrated a positive attitude towards their work which contributes to providing a supportive and caring environment to service users who often experience very complex needs. Staff comments included I enjoy my work and love working with the service users. Documentation demonstrated staff had undertaken a range of training relevant to the care of the service users and a programme of training was available for the forthcoming year. Training was provided by way of external training Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 20 courses, National Vocational Qualification and training provided by the CIC organisation. During discussion it was identified that training in relation to the specific learning disabilities the service users experience was needed to support the staff in their role. In the light of this, the registered person is required to ensure all staff are provided with training in relation to this aspect of care. The staff rota indicated staff are evenly deployed across the week and the required staffing levels, as agreed by the Registering Authority are provided. The staff spoken to during the inspection said there are sufficient staff on duty to enable them to carry out their work and care for the service users in accordance with good practice. The acting manager spoke highly of staff team stating they were reliable, hardworking and caring towards the service users. Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 There are clear lines of management and accountability within the home which is run for service users best interest. Improved quality assurance systems have now been introduced to ensure a high standard care is maintained. The health, safety and welfare of the service users is well promoted throughout the home. EVIDENCE: There is currently no registered manager at 43 Burden Road. Ms Susan Oldrid has agreed to act as manager of the home until this post can be filled. The post of registered manager has been vacant now for 18 months although this post is currently being advertised. The registered person is required to write to the CSCI to update the inspector of the progress being made with regard to this situation. This issue will also be addressed outside of this inspection. Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 22 As a result of the requirements made during the last inspection, improvements have now been made to the way in which 43 Burton Road is managed. Systems have improved and further management input has been provided. All of the staff spoken to during inspection commented they now felt well supported and confirmed clear line of communication have now been established. One of the managers who visit 43 Burden Rd to support the staff team is actually a registered manager from another service within the CIC organisation. This issue was discussed during inspection and it was confirmed she spent approximately two days per week at the home. While her input has certainly had a positive impact on the home, other arrangements must be made to support the staff as this person is not a fulfilling her own responsibilities with regard to the service she is registered for. In the light of this, the registered person is required to write to the CSCI and inform the inspector of the action being taken to address this situation. It is clear that Ms Oldrid is clearly working very hard to ensure the home is well managed and the service users are cared for in accordance with good practice. The staff spoke highly of Ms Oldrid saying she was very supportive of the staff team and very caring towards the service users. They stated she was a hands-on manager who worked very hard to ensure the service users were cared for properly. Service users health and safety is well promoted with safe working practices being implemented throughout the home. Staff are provided with appropriate training around this issue and regular fire safety checks and checks on all equipment are carried out. All of this ensure a safe environment is provided for the service users to live. The member of staff who took responsibility for the overall health and safety of the building stated they required additional fire safety training. The registered person is required to address this issue to further promote service user and staff safety. To further promote service users health and safety, the registered provider is advised to keep up to date with the information provided on the Health and Safety Executive website. Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 x x x Standard No 22 23 Score 2 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x x x x Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x x x x 3 LIFESTYLES Standard No Score 11 3 12 x 13 x 14 3 15 x 16 3 17 Standard No 31 32 33 34 35 36 Score 3 2 x x 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Burden Road (43) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 1 x 2 x x 3 x DS0000018971.V261986.R01.S.doc Version 5.0 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 YA2 Regulation 12 Requirement The registered person is required to write to the CSCI to update the inspector of the action being taken to find appropriate accommodation for the service user who is currently sleeping in the dining room. The registered person is required to ensure a more user-friendly version of the complaints procedure is available to service users. The registered person is required to ensure another armchair is provided in the lounge. The registered person is required to ensure staff are provided with training around the specific learning disabilities the service users experience. The registered person is required to write to the CSCI to inform the inspector of the action being taken to propose a manager for this service. The registered person is required to write to the CSCI to inform the inspector of the action being taken to ensure a manager from another service is not being used DS0000018971.V261986.R01.S.doc Timescale for action 13/01/06 2 YA22 22 13/01/06 3 4 YA24 YA32 23 18 13/02/06 31/03/06 5 YA37 8 13/01/06 6 YA39 12 12/01/06 Burden Road (43) Version 5.0 Page 25 to support the staff at 43 Burden Road. 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 YA42 Good Practice Recommendations It is recommended that the registered person keeps up to date with the information provided on the Health and Safety Executive Website. Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Burden Road (43) DS0000018971.V261986.R01.S.doc Version 5.0 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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