Inspection on 28/06/07 for Chelwood Avenue (7)

This inspection was carried out on 28th June 2007.

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

Other inspections for this house

Chelwood Avenue (7) 22/07/09

Chelwood Avenue (7) 24/07/08

Chelwood Avenue (7) 16/11/06

Chelwood Avenue (7) 20/02/06

Chelwood Avenue (7) 09/06/05

Chelwood Avenue (7) 29/10/04

Chelwood Avenue (7) 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 Chelwood Avenue (7) 7 Chelwood Avenue Childwall Liverpool Merseyside L16 3NN Lead Inspector Helen Carton Unannounced Inspection 28th June 2007 17:30 Chelwood Avenue (7) DS0000025236.V331982.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 Chelwood Avenue (7) DS0000025236.V331982.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. Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chelwood Avenue (7) Address 7 Chelwood Avenue Childwall Liverpool Merseyside L16 3NN 0151 722 2854 0151 722 6502 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.c-i-c.co.uk Community Integrated Care Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 2007 Brief Description of the Service: Chelwood Avenue is registered to care and offer support to two adults with a learning disability and is run by Community Integrated Care, a major local notfor profit organisation. 7 Chelwood Avenue is a semi-detached house in a quiet suburb of Liverpool, close to a small parade of shops, the M62 and bus routes to Liverpool city centre. Downstairs there is a large lounge, dining room and a kitchen. Upstairs there are two spacious single bedrooms, a bathroom and a small room that is currently used as a staff sleep-in room. The former garage has been converted to an office and utility room There is a large garden to the rear and side of the house. Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A site visit to the home as part of the key inspection the inspector spent approximately 3 hours in the home. Time was spent sitting and talking with residents and observing the day-to-day routines of the home including the support offered by members of the staff team. The inspector looked around the building to check if it provided a comfortable, safe and homely environment for residents to live in. A selection of records kept where looked at and the inspector also checked that the requirements made at the last inspection had been completed. The main focus of the inspection process was to understand how the home was meeting the needs of residents including how well the staff team were themselves being supported by the manager. This is to make sure they have the skills, training and support to meet the individual needs of residents. What the service does well: Residents are supported to take part in activities in the community including day services, shopping cafes and leisure facilities. Residents’ are supported to make positive choices and decisions in their lives. The manager and CIC offer the staff team support and training opportunities, which enables them to offer appropriate, safe and sensitive support to residents. Members of the staff team were observed supporting residents’ in a sensitive and supportive manner. Chelwood Avenue (7) DS0000025236.V331982.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. The summary of this inspection report can be made available in other formats on request. Chelwood Avenue (7) DS0000025236.V331982.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 Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed pre admission assessments ensure the service offers placements to people they are confident they can meet their needs and offer the support they want. Resulting in people living in the home receiving an individualised approach to their care and support. EVIDENCE: There have been no new admissions to the home since the last site visit. However examination of records show before admissions to the home take place the manager and members of the staff team carryout as detailed assessment of prospective residents needs. Care plans and risk assessments show the manager and the staff team support residents to live the lives of their choosing within a safe and supportive environment. Residents have a written contract, which gives them the terms and conditions with the home and provides good information about what service and facilities are included or not in the accommodation fees charged by the owners of the service. Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 &9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall the care planning and risk management strategies adopted by the home support residents holistic needs. Ensuring their needs and wishes are central to the delivery of the service at 7 Chelwood Avenue. EVIDENCE: Care plans provide good information about the physical, emotional, mental and social care needs of residents. The records detailed information enables the staff team to support residents sensitively and safely. Daily routines are recorded as well as likes/dislikes and non-negotiable activities and routines. This ensures the staff team, work to supporting residents to live their daily lives in a way that promotes a sense of wellbeing and limits the impact of negative or challenging behaviour. Daily records show residents are supported to take part in community activities and access further education opportunities. Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 10 Risk assessments do not reflect the current situation at the service. The senior member of staff on duty said these documents were currently being reviewed as risks had reduced significantly in recent months. Accident/incident records indicate a wooden gate placed at the top of the stairs to safeguard residents during the night is in fact causing a significant risk to residents. A risk assessment has not been carried out as to the full reason why the gate has been fitted, the impact this has on residents ability to access all part of the home and the risks of the actual gate and their health and safety. Members of the staff team were observed supporting clients in a supportive respectful and affectionate way. Issues of challenging behaviour were dealt with sensitively and safely. Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are proactively supported to engage in local community activities and to maintain positive relationships in their lives to promote a sense of wellbeing. EVIDENCE: The manager and the staff team support residents to access activities they enjoy within a routine that makes them feel safe and comfortable. Residents attend day centres through the week with members of the staff team supporting them to maintain routines to ensure they attend. Discussion with members of the staff team indicate they are aware of activities and routines the residents enjoy and those which make them anxious or unhappy. The staff team demonstrated a good understanding of residents complex care needs and social and emotional needs. Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 12 Records held by the home indicate residents are supported to maintain positive relationships and encouraged to visit family members at their homes. Observations made during the site visit indicate members of the staff team have built up positive relationships with residents and respect them as individuals. Care plans indicate residents’ likes and dislikes with regard to food and meals provided. Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents holistic needs including their healthcare and emotional wellbeing are well met. Resulting in them receiving a person centred service, which reacts to their changing needs. EVIDENCE: The care plans and risk assessments provide the staff team with detailed information about the most appropriate and safe way to support residents with their personal care needs. This guidance involves practical help for the staff team regarding how clients like their hair washed and were assistance is needed and when prompting is required. The plans also provide detailed and individualised information about what makes residents happy, sad, frightened and angry. The plans build a picture of the important things to residents including those things that are non negotiable in their daily lives. This enables the staff team to provide appropriate emotional support and mental stimulation to ensure residents feel safe and content in their daily lives. Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 14 A sample of medication prescribed to residents was examined with the accompanying Medication Administration Records (MAR) sheets. Resident are supported to take their medication at the stated intervals and any difficulties are reported to the prescribing GP. The home safely administers, stores and records residents’ medications. Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints or concerns are dealt with in a professional and sensitive manner. Resulting in residents their relatives and supporters feeling valued and listened to. Care practices within the service promote residents wellbeing and offers protection to them from abuse, neglect and incidents of self-harm. EVIDENCE: Residents their relatives and supporters receive information about how to complain and raise concerns about the service they are receiving in the Statement of Purpose and the Service User Guide. The home has a record of complaints/concerns which details the action carried out to resolve these issues. There are also detailed policies and procedures for the staff team to refer to if they witness or are told about incidents of abuse. This also includes a whistle blowing policy. Staff members spoken to demonstrate a good understanding of their responsibilities with regard to safeguarding the people they support. The company’s induction process involves attending safeguarding vulnerable adults training. Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 16 Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,27,28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall residents benefit from living in a well-maintained, pleasant and homely environment. EVIDENCE: A tour of the building provided the following information: Communal areas in the home are pleasantly decorated and furnished providing a pleasant and comfortable environment for residents to live in. Bedrooms are pleasantly decorated, furnished and have been personalised to reflect the interests of residents. In the bathroom there is a bare plastered wall, which has been like that for several months. This area does not provide a pleasant environment for residents to spend time in. Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 18 The wooden gate fixed to the top stair appears to be a health and safety risk to residents accessing the first floor and has resulted in injuries. A risk assessment must be carried out to look at the positive and negative outcomes for the use of the gate. The stairs and landing carpet is badly worn and stained resulting in a possible slip hazard to residents and the staff team. The home was clean and tidy and overall provides a pleasant, comfortable and homely environment for residents to live in. Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The company supports the manager and the staff team to undertake training to enable them to offer residents safe and appropriate support and to encourage an individualised approach to their care. Recruitment processes appear to protect residents from possible harm and abuse. EVIDENCE: Information provided by the manager following the site visit indicates the company is committed supporting the staff team to undertake training such as NVQ, mental capacity awareness, moving and handling and communication skills. The manager and the staff team seek the advice and support of other professionals involved in residents care. This has resulted in clear written guidance on how to best support and supervise residents who present with challenging behaviours. The manager was not on duty at the time of the site visit resulting staff records not be examined. Information gained from previous inspection reports Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 20 indicates recruitment and selection handled by the company’s human resource department with all required checks and references being sought. There have been no new staff appointments since the last site visit. Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There have been significant improvements in the management structures within the home resulting in residents receiving a more individualised care service. EVIDENCE: The manager has been in post since the beginning of the year and it is the intention of the company to apply to CSCI for him to become the registered manager of the service. There are policies, procedures and routines in place to support residents to maintain their daily routines whilst allowing the staff team to be clear about their roles and responsibilities. Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 22 Members of the staff team spoken to spoke positively about the manager and the structure he has brought to the service. Examination of documentation and discussion with members of the staff team indicates they work hard to develop good relationships with residents’ families and other professionals supporting them. This is to assist them in determining whether the service they are providing is meeting residents care needs and aspirations. This approach offers residents with complex needs and limited verbal and cognitive abilities protection against receiving a generalised care service that does recognise their individualised needs. Overall the manager proactively deals with health and safety issues that arise at the home. Regular safety and maintenance checks are carried out at the required intervals. Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 3 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 2 28 3 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 X X X 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 2 3 X X 2 X Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 24 No 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 YA9 Regulation 13 Requirement A risk assessment must be carried out to ensure the gate fitted on the stairs is safe and the outcomes for service users are positive. The worn and stained carpet on the stairs and landing is slip hazard and must be replaced. The bare plasterwork in the bathroom is to be decorated to provide a pleasant comfortable place for residents to spend time in. A completed application to register a manager in respect of the home must be received by CSCI by the required timescale. This is to ensure residents receive consistent and safe support to enable them to live their lives as they wish. Timescale for action 30/09/07 2. YA24 16 30/09/07 3. YA27 23 30/09/07 4. YA38 8 30/10/07 Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 25 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 Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Merseyside Area Office 2nd Floor South Wing Burlington House Crosby Road North Waterloo, Liverpool L22 OLG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Chelwood Avenue (7) DS0000025236.V331982.R01.S.doc Version 5.2 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!