Inspection on 31/10/05 for Cherriton

This inspection was carried out on 31st October 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cherriton 15/06/06

Cherriton 04/05/05

Cherriton 02/09/04

Cherriton 07/04/04

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 Cherriton 1 Bedford Road Rock Ferry Bebington Wirral CH42 6RT Lead Inspector Beate Roth Unannounced Inspection 31st October 2005 10:00 Cherriton DS0000018874.V262418.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 Cherriton DS0000018874.V262418.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. Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cherriton Address 1 Bedford Road Rock Ferry Bebington Wirral CH42 6RT 0151 643 8145 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) MacIntyre Care Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Only adults (aged 18-64 years) with a learning disability may be accommodated. 4th May 2005 Date of last inspection Brief Description of the Service: Cherriton is registered to accommodate 6 adults with a learning disability. Cherriton is a two storey, detached property located in a residential area. Service users have single bedrooms. Bedrooms are located on the ground and first floor. On the ground floor there is a lounge, dining room, kitchen, bathroom and a separate toilet. On the first floor there is a shower room and a bathroom. Bathing aids are provided in both bathrooms. The home has a large garden which has seating areas. There is wheelchair access via a ramp from the lounge. Parking is available on the main road. There is access for the homes vehicle on the driveway. Cherriton is located in a central position close to Birkenhead and Prenton. There are local shops within walking distance and there is access to public transport. Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over four hours. During the inspection time was spent in the office examining records and policies and procedures. Staff were spoken with and were observed delivering care to service users. A tour of the home was undertaken. Following the inspection, a discussion took place with the acting manager. What the service does well: What has improved since the last inspection? What they could do better: Improvements need to be made to the recording of risk assessments in order to ensure these fully support service users. It was not clear if some risk assessments had been recently reviewed as they were not dated. Service users would benefit from 50 of staff having undertaken a formal training qualification in care of adults with a learning disability. The practice of locking the windows when service users are in their bedrooms, rather that having an alternative method of securing the window that allows the service user to have the choice of whether to have the window open, is to be reviewed. It is strongly recommended that window restrictors are fitted in accordance with the guidelines from the Health and Safety Executive. Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 Page 6 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. Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 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 Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 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, 4 and 5 A full assessment would take place to ensure that a service user’s needs could be met before they move to the home. The contracts/terms and conditions support the interests of service users. EVIDENCE: Since the last inspection a new service user has come to live at the home. The records indicated that an appropriate assessment had taken place that involved the service user, their family and relevant professionals and provided information that would form the basis for developing a care plan. The records and a discussion with staff indicated that the new service user and their relatives had made several introductory visits to the home to meet the current service users and staff. A sample of service user contracts/statement of terms and conditions were seen and provide the information that is needed. At the last inspection it was recommended that an appropriate advocate, who is independent of MacIntyre Care, should be involved in supporting service users when drawing up the contract/statement of terms and conditions, especially as this document makes reference to each service users circle of support agreeing the contents. At this inspection there was evidence of the involvement of an advocate in the drawing up of the contracts/statement of terms and conditions. Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 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 and 9 Care planning reflects the assessed and changing needs of service users. Improvements need to be made to the recording of risk assessments in order to ensure these fully support service users. EVIDENCE: A sample of service user care plans were seen. These provide a lot of detailed information on the needs of the service users and there was evidence that these had been reviewed since the last inspection. The staff spoken to were aware of the needs of the service users and how to meet them. The records and a discussion with staff indicated that service users are assisted to make decisions about their lives in accordance with their abilities. Communication dictionaries assist in this process. Records of service users likes and dislikes and preferences around daily living, such as what time they like to get up and the activities they enjoy also ensures service users choices are respected. A sample of risk assessments indicated that in general, service users’ needs are assessed and their need for independence is balanced with any risks to Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 Page 10 their wellbeing. It was not clear if some risk assessments had been updated in the last 12 months, as they were not dated. These related to service users going out into the community. A risk assessment relating to the provision of medication in food had not been updated. Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15, 16 and 17 The daily routines and opportunities to develop and maintain relationships ensure that the emotional and social needs of service users and their preferences are provided for. EVIDENCE: Service users are provided with opportunities to establish friendships. Family contact is promoted with records indicating the family history of service users and how contact is maintained. Discussions with the staff and observations confirmed that the home’s routines are flexible as much as possible. The records inspected indicated the support service users need in their daily lives in order to make choices and encourage independence. An examination of the menu records indicated that varied meals are provided. Care plans indicate service users’ dietary requirements and any assistance with eating that they may require. Advice is obtained from a dietician if this is required. Staff encourage the service users to eat a balanced diet and monitor diet and appetite in order to ensure their well being. Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 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): 18 and 20 The personal support needs of service users are well met. Service users are supported by the home’s practices around the handling of medication. EVIDENCE: There is clear information available for staff on service users personal care routines that indicate service users preferences. The records seen provide information on the morning and evening routines of each service user. Observations indicated that staff promote the dignity of service users. Staff interviewed were aware of the support needs of service users. The medication procedure gives clear guidance to staff. The medication records and corresponding medication were examined and found to be in order. Medication is stored securely. Members of staff interviewed reported that they have been trained in the administration of medication. Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 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): 23 The practices at the home provide protection for service users. EVIDENCE: A copy of Wirral Borough Council’s adult protection procedure was available at the home. A shorter and more accessible version of the adult protection procedure has been made available by Wirral Borough Council and was at the home for staff to refer to. Staff spoken with confirmed they have received training in the adult protection procedures. None of the service users manage their own benefits. The director of MacIntyre Care is the appointee for the service users living at the home. The records in relation to this are held at the MacIntyre Care head office. The home manages the personal allowances for all service users. From discussion with members of staff and from an examination of the financial records, the home’s policies and practices with regards to service users’ money and financial affairs safeguard service users. It continues to be recommended that advocates be used to oversee the management of service users monies for the service users who have limited family contact. Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 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): 24 and 30 The home is clean and generally well presented and provides a comfortable and pleasant environment for service users. A safe environment is in general maintained. EVIDENCE: A tour of the home and grounds showed that in general the home is well maintained. There are some minor decorative works in the communal areas that need attention. In the shower room the decorative border is peeling off in areas and there are cracks to the plaster. The downstairs bathroom is showing signs of wear and tear. There are several marks to the wall covering and a small area of tiles missing following the refitting of the bath. Furniture and fittings are generally of a good quality. The dining room table is showing signs of wear. There are a number of markings to the tabletop. The acting manager is aware that these areas need attention, the progress in addressing these works will be looked at, at the next inspection. At the last inspection a requirement was made that a risk assessment take place of the windows that do not have window restrictors. This has taken place and staff are ensuring that the windows are locked when service users are in their bedrooms. This was confirmed by the staff interviewed. This Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 Page 15 practice limits the opportunities for service users to have their windows ajar when they are in their bedrooms and the risks presented are only reduced as long as staff remember to lock the windows. This practice is also not recommended by the fire service. The Health and Safety Executive (HSE) recommend that windows in care homes have restrictors that allow windows to be opened to a maximum of 10cm. The acting manager was advised to assess the current risk assessment around the windows not having restrictors in accordance with the guidance from the HSE. It is strongly recommended that window restrictors are put in place. A tour of the home showed that the home was clean. The home smelt fresh. It is clear the staff are working hard to ensure good standards of cleanliness are maintained throughout the home. There are procedures for staff to refer to about hygiene and infection control. Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 35 and 36 There are in general sufficient numbers of staff to meet the needs of service users. Service users benefit from staff having regular supervision and would further benefit from 50 of staff having undertaken a formal training qualification in care of adults with a learning disability. EVIDENCE: The staffing rota showed that there is a minimum of two staff on duty during the day and evening with a third member of staff available for some shifts. A member of staff said there are generally enough staff available to meet the needs of the service users, but that the needs of the service users are better met when there are three staff on duty during the day and evening. Following the inspection a discussion took place with the acting manager who agreed that three staff better meet the needs of service users. The acting manager reported that this has been discussed with the service manager and that a 19 hour support worker post is to be advertised to address this. Waking night staff are deployed. There is a domestic member of staff employed for 20 hours a week. Relief staff and the current staff team cover staff vacancies and absences. The rotas show and a member of staff said the same relief staff are employed who know the service users and how the home works. No new staff have been employed since the last inspection. Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 Page 17 Training records and staff indicated that training is provided to ensure service users are being cared for properly and that their needs are being met in accordance with current good practice. Four out of twelve staff hold an NVQ qualification. Work is taking place to make sure that further staff have the opportunity to obtain an NVQ in care of adults with learning disabilities. Records and a discussion with the acting manager and a member of staff indicated that since May 2005 supervision of staff has taken place on a two monthly basis. Supervision is now planned in advance to ensure that staff receive this support on a regular basis. The acting manager has had training around providing supervision. Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 Page 18 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, 38, and 39 The quality assurance systems and management approach ensure that the best interests of service users are supported. EVIDENCE: The acting manager has been in post for 7 months. An application to register the acting manager has been made to CSCI and is currently being assessed. The acting manager is experienced and is currently undertaking management qualifications. A discussion with the acting manager and records show that the acting manager has undertaken training to keep her skills and knowledge up to date and that the acting manager has had several years experience working as a manager. Discussion with staff indicated that they are able to present their views about the operation of the service to the acting manager. The acting manager was described as being open and supportive. Team meetings are held. A clear complaint procedure is available. An equal opportunities policy is also available. Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 Page 19 There are a number of quality assurance systems in place. An annual audit is carried out by Macintyre Care which looks at how service users are supported and how the home and staff meet their needs. Relatives are consulted as part of the audit. There is an annual development plan for the home. The service is subject to an Investors In People Review. Key workers elicit the views of service users in line with each service users’ ability. Regulation 26 visits by the registered provider are carried out. Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 Page 20 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 3 X 3 3 Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 X X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cherriton Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score 2 3 3 X X X X DS0000018874.V262418.R01.S.doc Version 5.0 Page 21 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 9 Regulation 13 Requirement Timescale for action 31/10/05 2 24 13 The registered person must ensure that all risk assessments are regularly reviewed so as to provide up to date information for staff on meeting the needs of service users. The registered person must take 31/10/05 appropriate action to address the risks presented by the windows not having window restrictors in place. 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 23 24 32 Good Practice Recommendations It is recommended that advocates be used to oversee the management of service users monies for service users who have limited family contact. It is strongly recommended that window restrictors are fitted in accordance with the guidelines from the Health and Safety Executive. 50 of staff should have an NVQ Level 2 qualification or equivalent. DS0000018874.V262418.R01.S.doc Version 5.0 Page 22 Cherriton 4 37 The manager should have an NVQ Level 4 qualification in management or equivalent. Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 Page 23 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 Cherriton DS0000018874.V262418.R01.S.doc Version 5.0 Page 24 - 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!