Inspection on 13/02/06 for Cambridge

This inspection was carried out on 13th February 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 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cambridge 18/09/07

Cambridge 21/08/06

Cambridge 22/11/05

Cambridge 08/02/05

Cambridge 21/07/04

Cambridge 29/03/04

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 Cambridge Road 43/45 Cambridge Road Bootle Liverpool Merseyside L20 9LF Lead Inspector Mrs Julie Garrity Unannounced Inspection 13th February 2006 10:30 Cambridge Road DS0000005259.V282614.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 Cambridge Road DS0000005259.V282614.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. Cambridge Road DS0000005259.V282614.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Cambridge Road Address 43/45 Cambridge Road Bootle Liverpool Merseyside L20 9LF 0151 284 5007 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.peterhouseschool.org Autism Initiatives Simon Michael Thomas Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Cambridge Road DS0000005259.V282614.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users to Include up to 4 (LD) The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection Brief Description of the Service: Cambridge Road is a Care Home for the personal care and support of service users with a Learning Disability. In total the home provides care for 4 service users under retirement age. The home is owned by Autism Initiatives, which also owns a variety of services and is a voluntary organisation that operates throughout the North West of England. The Home is situated in a residential street in Bootle. The Strand shopping centre is a short bus ride away and there are main bus routes and train services within a short walk from the home. Parking is available in the street and there are no separate parking facilities. There is residential parking only in the adjacent streets. There are two separate houses each one is accommodation for a service user and a building that accommodates two service users, all of these areas are linked by a central courtyard. The separate houses contain a kitchen and dinning area, a lounge and a bedroom. The second house has an additional bedroom, which is used by staff of a night when they undertake their sleeping duty. The main building has two bedrooms and a bathroom on the ground floor, a lounge and an office on the 1st floor and a Mezzanine come 2nd floor that contains a kitchen area. Cambridge Road DS0000005259.V282614.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced inspection undertaken by on inspector over a day. The total duration of the inspection was 5 hours. CSCI inspects “core” standards over 2 inspections. The core standards not covered in this report were covered in the previous report undertaken on 22/11/05. The inspector undertook this inspection by reviewing on-site records such as individual plans, medications, daily records, staffing rotas, staff training and staff recruitment records. Other records reviewed were previous reports and CSCI records such as notifiable incidents and provider visit reports. Discussions were held with 4 residents and 3 staff. The inspection was undertaken with the support of the manager and all areas were discussed with the manager as they occurred. Full feedback was given to the manager at the end of the inspection. All but three requirements from the previous reports were addressed were made in this report. What the service does well: What has improved since the last inspection? Some areas of redecoration and refurbishment have been addressed and new flooring is being reviewed for one service user. The service user has been involved in the final decision and helped choose the type of flooring available. Staff files have been updated both for training and recruitment and reflect better the training and skills that staff have undergone. Continued review of the cumbersome paperwork is still in place and a number of methods to make these more suitable for the service users to access have been looked at. Cambridge Road DS0000005259.V282614.R01.S.doc Version 5.1 Page 6 Staff receive on-going supervision and support designed to increase the quality of the service that they provide to the service users and further develop individual skills. 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. Cambridge Road DS0000005259.V282614.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 Cambridge Road DS0000005259.V282614.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 The home is able to identify individual needs and aspirations before service users move into the home. EVIDENCE: Cambridge Road has not admitted any new service users for nearly 2 years. An examination of a selection of case files found in each a full care needs assessment undertaken prior to admission. In addition, Cambridge Road also does a detailed assessment of residents’ needs. Staff have a good understanding of residents’ needs and, when asked, staff could explain the care for each resident with their individual programme of care. One of the residents spoken with said that “staff are truly excellent, they are family” and other said, “staff are very good, they know what I need and how to help when needed”. Cambridge Road DS0000005259.V282614.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): None of the standards were fully reviewed at this inspection. EVIDENCE: Individual Plans and risk assessments remain very complicated. The service users are not aware of what the plans cover. The manager is exploring a different communication method for individual plans that will simplify the plans and make them accessible to the service users. This would of great benefit to the service users. Cambridge Road DS0000005259.V282614.R01.S.doc Version 5.1 Page 10 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, 17 The home has a programme of activities, which attempts to keep residents active and involved with families and the community. Service users are supported to have a good diet. The home needs to further support to make sure that they can accommodate special diets fully. EVIDENCE: Service users spoken with discussed their family’s involvement in their lives. This varied greatly depending on service users choices and needs. It was clear that the service users choices were paramount in maintain family contacts and the home supported both service users and families to maintain contact. Service users are supported to visit families independently, with a member of staff or families visit the home. One service user said, “its what suits me that’s mostly happening”. An outstanding issue remains regarding a service user who needs daily district nurse in put this has severally restricted her choices. The PCT has been contacted for advice and guidance and this need will hopefully fully accommodated in the future. All the service users spoken with enjoy the food. 2 of the service users undertake their own shopping and cooking and the other residents are Cambridge Road DS0000005259.V282614.R01.S.doc Version 5.1 Page 11 supported by staff to be as independent as possible. There are records maintained around the food that residents eat. Discussions with staff and a resident detailed that there was a little understanding of a special diet needed for one resident and a differing point of view amongst staff and the service user. Cambridge Road DS0000005259.V282614.R01.S.doc Version 5.1 Page 12 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): None of the standards in this area were fully reviewed at this inspection. EVIDENCE: Medications continue to be well managed and documented. Further support is needed in managing the medical needs of one service user that limits their life style choices. Advice and guidance has been provided to the home from local organisations since this inspection in order to resolve this situation. Cambridge Road DS0000005259.V282614.R01.S.doc Version 5.1 Page 13 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 Service users views influence all aspects of their daily lives. They are sought by staff and acted on. EVIDENCE: All service users concerns are noted and acted on. One service user has concerns regarding their future and staff are actively seeking to support them appropriately. Staff are aware of the service users needs and are able to explain in detail the needs of the service users. Service users support this point of view. One said, “if I’m worried about anything, or something isn’t right I tell the staff and they sort it out, something’s take longer than others but it’s always fixed”. The home keeps records around service users concerns and general complaints. There is a policy and information leaflet that informs service users of how to raise complaints. At present this is not in formats suitable to the service users needs Cambridge Road DS0000005259.V282614.R01.S.doc Version 5.1 Page 14 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): None of the standards in this area were fully reviewed at this inspection. EVIDENCE: There are a number of araes within the home that have been redecorated and replaced. The bathroom has been repainted and the settee in the main building has been repaired. There are a number of maintenance areas that need to be done. There are: 1. 2. 4. 5. 6. The tumble dryer is not in usage as it frequently “blows” the electrical fuses in the building. (this is outstanding from the previous inspection) The carpet in the ground floor bedroom nearest the bathroom is damaged and has an offensive odour coming from it. (this outstanding from the previous report) The bathroom door has peeling paint. (this outstanding from the previous report) The bed in the bedroom nearest the bathroom is not suitable to the needs of the residents and has an offensive odour. (this outstanding from the previous report) The settee and chairs in one of the houses is torn and stained and in need of replacing. DS0000005259.V282614.R01.S.doc Version 5.1 Page 15 Cambridge Road 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): None of the standards in this area were fully reviewed at this inspection. EVIDENCE: Staffing levels have been reviewed and risk assessments for those service users are unattended in the home are in place. Staffing records are up to date. However the manager is not always given the full information about staff checks undertaken before staff start in the home and is never shown a copy of staff Protection of Vulnerable Adults or Police checks. Staff training is on going and regularly updated. Staff are in need of training regarding a special diet and a medical activity that they undertake on a daily basis. Cambridge Road DS0000005259.V282614.R01.S.doc Version 5.1 Page 16 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): 39 Service users views are used to influence the running of the home. EVIDENCE: The home’s monthly audits from Autism Initiatives was examined. They looked at all aspects of the home and service. The residents spoken didn’t want to read these but understood that where residents do not like something, they can change it. One said staff were “very happy to fix” any concerns the residents had. Key worker reviews detailed that staff encouraged independence and taking responsibility from the service users. There was a definite feeling from service users and staff during the visit that everyone has an equal part to play in the home. Cambridge Road DS0000005259.V282614.R01.S.doc Version 5.1 Page 17 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 3 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X X X 3 X X X X Cambridge Road DS0000005259.V282614.R01.S.doc Version 5.1 Page 18 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 YA6 Regulation 15 (a) (b) (c) (d) Requirement Care plans must be developed that are accessible to service users and written to the guidelines detailed in standard 5 of Care Homes for younger adults. (Outstanding from 3 previous reports) The maintenance points identified within this report must be actioned. (Some areas of this are outstanding from a previous report) Timescale for action 13/04/06 2. YA24 23 (2) (b) 13/04/06 3. YA34 19 (1) (b)1 - 6 All staffing files must be 13/04/06 available within the home that contain 2 written references, proof of identity, proof of qualifications, Criminal Records Bureau check and health declaration as a minimum. (This is an outstanding requirement on 3 previous reports.) Cambridge Road DS0000005259.V282614.R01.S.doc Version 5.1 Page 19 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 YA19 Good Practice Recommendations The manager should review the current arrangements in place regarding the administration if insulin to one service and the restriction that this places on their choices and lifestyle. Staff and service users within Cambridge Road should be included in the recruitment of new staff and in the development of areas that affect them such as relevant policies and procedures. All relevant policies and procedures should be available to service users in suitable formats to meet their needs. 2. YA34 Cambridge Road DS0000005259.V282614.R01.S.doc Version 5.1 Page 20 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 Cambridge Road DS0000005259.V282614.R01.S.doc Version 5.1 Page 21 - 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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