Inspection on 16/11/06 for Cherryvale

This inspection was carried out on 16th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cherryvale 19/12/08

Cherryvale 25/07/07

Cherryvale 24/02/06

Cherryvale 24/11/05

Cherryvale 15/12/04

Cherryvale 01/06/04

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 Cherryvale Cherryvale Acrefield Road Liverpool Merseyside L25 5JN Lead Inspector June Beaver Unannounced Inspection 16 November 2006 2pm th Cherryvale DS0000025237.V305328.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 Cherryvale DS0000025237.V305328.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. Cherryvale DS0000025237.V305328.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherryvale Address Cherryvale Acrefield Road Liverpool Merseyside L25 5JN 0151 428 4458 0151 428 4458 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 Vacant post Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Cherryvale DS0000025237.V305328.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th February 2006 Brief Description of the Service: The home is set in a residential area of Woolton and is accessible by a fairly regular bus service during daytime hours and a less frequent bus service by night. The nearest train station is a bus ride away and not within walking distance. There are a variety of small shops and large supermarkets within Woolton Village as well as banks, post office cafes, bars and restaurants. All of the rooms used by service users are on the ground floor; there is a first floor to the dormer bungalow property, which is used for office and laundry facilities only. There is a private enclosed garden to the rear and side of the house, which is well maintained and there is a patio/paved area leading off from the lounge. The service users have the benefit of a mini bus with designated drivers for trips out locally or into Cheshire and Wales. The fees per week are £338.00. Cherryvale DS0000025237.V305328.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced site visit to the premises which lasted approximately 5 hours and was part of a key inspection. During the visit the three service users were spoken to as well as four members of staff. The Manager prior to the visit completed a pre-inspection questionnaire and the information it contained was verified on the day by looking at the records and documentation available at the home. The Manager has since left the home and a new Manager has been recruited who is due to commence employment shortly. A senior member of staff who has worked for the company for a number of years has taken charge in the absence of a manager. There were some requirements and recommendations made which relate to documentation and training. What the service does well: What has improved since the last inspection? The requirements made at the last inspection have mostly been met. The staff make sure the service users wishes are adhered to wherever possible and act as advocates on their behalf. The activities diary is kept up to date and staff try to vary outings and in house activities taking into account all three service users different choices. The staff spoken to on the day of the site visit stressed their strength of feelings regarding discrimination against the disabled and discussion took place about how they would respond should they need to which emphasised their positive approach. Cherryvale DS0000025237.V305328.R01.S.doc Version 5.2 Page 6 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. Cherryvale DS0000025237.V305328.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 Cherryvale DS0000025237.V305328.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 Outcome in this area is adequate. This judgement has been made using all available evidence and by a site visit to this service. The Statement of Purpose and service user guide contained sufficient information to enable service users and their families to make an informed choice regarding the suitability of the service. There was no pre-admission documentation available to provide evidence that the procedure was carried out in full. EVIDENCE: The Statement of Purpose was updated as required on the last inspection with the Manager’s details. Unfortunately that Manager has now left therefore the Statement of Purpose and Service User guide are inaccurate and need updating. The last admission to the home was nearly three years ago, however there was no pre-admission assessment documentation to look at in the service user’s file. The staff on duty stated that the service user did visit the home on several occasions to determine whether it was a suitable placement. Cherryvale DS0000025237.V305328.R01.S.doc Version 5.2 Page 9 A written contract was available on all three files clearly stating the terms and conditions of the residency and outlining what the company will provide. Cherryvale DS0000025237.V305328.R01.S.doc Version 5.2 Page 10 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): Standards 6,7 and 9. Quality outcome in this area is adequate. This judgement has been made using all available evidence and by visiting this service. Care plans are developed following a person centred planning approach and service users and their families are involved in the production of care plans and essential life style plans. EVIDENCE: Service users have care files which contain an essential life plan, a care plan as well as risk assessments, copies of their contracts and personal details. The information contained is repetitive and makes the file difficult to read. The care plans need to be reviewed more regularly and updated when needs change. For example medication changes were made for all service users after consultation with their G.P. however this was not written in the care plans (it was entered on the medication administration records). The last care plan review date was July 2006. Cherryvale DS0000025237.V305328.R01.S.doc Version 5.2 Page 11 Evidence that service users can make choices about aspects of their lives was provided by documentation and discussion with staff. Service users families are also actively involved in decision making on their behalf. Where possible staff will consult service users or their families before making any important changes to lifestyles, appearance or major activities. None of the service users have any verbal communication skills, however they can make their needs know to staff who know them by body language, facial gestures and specific actions/gestures. Risk assessments are carried out for general day to day activities such as washing and dressing, bathing, going out in the mini bus as well as more specific activities such as using a hydro-pool at the day centre and the “ballpool” in the service. Concerns were discussed regarding using the hoist in the “ball-pool” room as some staff do not feel confident. The activity has been assessed by the company’s Occupational Therapist who have given instructions to staff on how to use the hoist safely, however this issue needs to be explored further from a health and safety point of view. All staff have been advised by senior management not to carry out functions they do not feel comfortable doing. Cherryvale DS0000025237.V305328.R01.S.doc Version 5.2 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): 12,13,14,15,16 and 17. Quality in this outcome area is good. This judgement has been made using all available evidence and by a site visit to the service. Service users are encouraged to make choices and decisions for themselves and are able to enjoy a stimulating lifestyle with a variety of activities. Service users are encouraged to use local amenities and services and are provided with the opportunity to engage in leisure activities outside the home. EVIDENCE: The home is close to both Woolton and Gateacre Village which have a variety of shops, banks, cafes libraries and spacious parks. Service users, accompanied by staff, use these services regularly throughout the week. There is a local cinema however due to the strobe lighting and some special effect flashing lighting in some of the films regular attendance is not always advisable due to the service users’ medical conditions. The service users use the local pubs for either lunch or early tea and have tried the local bowling Cherryvale DS0000025237.V305328.R01.S.doc Version 5.2 Page 13 alley without much success as staff state there was not much interest in the games. All three of the service users enjoy quality time at home either watching television or films, listening to music or having “pamper” times. Each of them enjoys going out in the mini bus and also going out for “fresh air” in the wheelchair to the local green space/parks with staff. Through discussion with staff it was evident that they will advocate and fight discrimination on the service users behalf if necessary for example one staff member gave an account of an incident involving one of the local libraries in the area when disabled access was very poor and entering the area was difficult. A letter was sent on behalf of wheelchair users to the service concerned. Other staff discussed the attitude of the public and how at times people tend to talk to the carer and not address the service user. When possible staff will discreetly point this out or steer people towards the service user if appropriate. A review of the week’s planned menu was done and discussion took place regarding the meals served. It was evident that staff are very aware of the likes and dislikes of the service users and they take this into account when cooking/planning meals. Fridge and freezer temperatures are recorded daily, the kitchen was clean and tidy. Service users accompany staff to the local supermarket when doing the weekly shopping to encourage them to help choice the week’s food. Cherryvale DS0000025237.V305328.R01.S.doc Version 5.2 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. Quality outcome in this area is adequate. This judgement has been made using all available evidence and by visiting the service on two occasions. The service users physical and mental health care needs are assessed and evaluated through review of the care plans, lifestyle plans and through discussion. Service users personal support preference is documented. Medication practice at the home needs to be more robust. EVIDENCE: Through discussion with staff it was evident that service users wishes were taken into consideration as far as possible when planning day to day events. Staff appeared to be aware of service users likes and dislikes and how they prefer to spend the day. The care files contain helpful and useful information for staff to refer to such as what certain facial expressions or gestures mean. This is particularly helpful for bank/agency staff. Evidence that staff ensure that the service users health care needs were met was provided in the care files. Each visit from a member of the multidisciplinary team such as G.P. or district nurse was recorded with an outcome. Cherryvale DS0000025237.V305328.R01.S.doc Version 5.2 Page 15 Medication practices at the home need reviewing. The service users tablets are kept locked in a kitchen cupboard and the person in charge of each shift is responsible for administering the tablets at set times. On this site visit a stock balance check of medication was carried out and some of the medication was missing. The staff on duty doubled checked the stock balance before notifying the Service Manager for the home. On the second visit to the service the following day, the Inspector was informed that the missing medication had been found and a check on the stock balance was then correct. The Service Manager was present at this visit and had implemented changes to try minimising the risk of this happening again. When repeat prescriptions are due the Pharmacy will collect the prescriptions from the service users G.P. and deliver the medication to the home. This can sometimes lead to overstocking as the staff do not see the repeat prescription. It is important that staff are aware of what is being asked for to prevent any build up or duplication of medication. The medication is mostly blister packed altogether in small segments, however there is no description on the blister pack as to what each tablet actually is. It would improve practice and help staff ensure safety if the home obtains a description of each tablet dispensed so that there would be no confusion should one of them be stopped for a medical reason. Cherryvale DS0000025237.V305328.R01.S.doc Version 5.2 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. Quality outcome in this area is good. This judgement has been made using all available evidence and during a site visit to this service. There is a robust complaints procedure in operation so that service users and their families can be satisfied that there complaints or concerns are listened to. The home provides staff with training in adult protection procedures to ensure service users are not put at risk of harm or abuse. EVIDENCE: Through discussion with staff and reviewing the pre-inspection questionnaire it was evident that there had not been any complaints since the last inspection. There is a comprehensive complaints procedure in operation at the home so that service users and their families can feel confident that there concerns will be listened to and staff will try and resolve matters. It is anticipated that all staff will have completed Adult Protection training by the end of the year, some staff have already had this training and further training is planned for December 2006. This training will help staff understand the importance of preventing and recognising different forms of abuse when assisting vulnerable adults. Cherryvale DS0000025237.V305328.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,29 and 30 Quality in this outcome area is good. This judgement has been made using all available evidence and by visiting this service. The service users live in comfortable clean surroundings. The home is modern and bright, accessible to local amenities and equipped with aid and adaptations to support each service users needs. EVIDENCE: The living room and bedrooms were clean, well maintained, odour free and decorated to a good standard, however there were one or two areas that need some attention such as the broken tiles in the bathroom and the shower chair seating that was cracked and torn. There was some discussion regarding the padding required on one of the beds to ensure safety. Steps have been taken to re-cover the padding which is presently covered with unsuitable towelling material. The hall floor covering has been replaced since the last inspection with carpet as the previous flooring was slippery when wet. Cherryvale DS0000025237.V305328.R01.S.doc Version 5.2 Page 18 There are private enclosed gardens to the rear and side of the premises which the service users like to use in the summer/warmer weather. There is some off road parking to the front of the property for a limited number of vehicles. Cherryvale DS0000025237.V305328.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 and 36. Quality in this outcome area is adequate. This judgement has been made using all available evidence and on a site visit to this service. The service has a satisfactory recruitment procedure and employs sufficient numbers of staff to ensure the service users health and welfare needs are met in a safe manner. Staff training in some areas needs updating. EVIDENCE: An inspection of the rota indicated that there is a steady stable workforce with one vacancy and the regular staff are presently covering these hours. There is usually two care staff on duty throughout the day and a waking member of staff at night. On occasions there are more staff on duty during the day to help support service users who are going out socially or keeping hospital appointments. The present staffing levels ensure service user needs are met and that their lifestyles and social activities are promoted. Through inspecting the staff files it would appear that there is a good recruitment procedure operating at the home. Staff files contained the information required by registration including CRB checks to ensure staff are suitable for the post. Some of the older files for staff who had worked for the organisation for longer than ten years were not as complete due to several Cherryvale DS0000025237.V305328.R01.S.doc Version 5.2 Page 20 office moves by Headquarters, however steps had been taken to replace the missing information (mainly references). The training records inspected were not up to date. There had been no fire awareness training and the moving and handling updates for most staff had not been done for several years. Fire drills were carried out however there was no record of who had attended the drills and how long it had taken. There were copies of applications to attend various courses however there was no supporting evidence of attendance. There was evidence on file that the Manager who left in the summer had carried out one to one supervision for all staff when they could raise issues relating to their own development and training needs. It is anticipated that the staff will have this opportunity again when the newly recruited manager takes up her post. Cherryvale DS0000025237.V305328.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37.38,39 and 42 Quality outcome in this area is adequate. This judgement has been made using all available evidence and by a site visit to the service. The service needs to provide a Manager who is suitably qualified and has experience of working with the client group. The health and safety of the service users is promoted by ensuring all equipment and appliances are serviced and monitored in accordance with manufacturers instructions. EVIDENCE: The Manager of the home has recently left the post to move to another CIC home in Scotland. Prior to leaving he had completed the pre-inspection questionnaire and a lot of the information he supplied has been used on this inspection. Cherryvale DS0000025237.V305328.R01.S.doc Version 5.2 Page 22 There is an Acting Manager in post who has been supported by the Service Manager for the area by extra visits and by being available on call. Regular monthly reports have been forwarded to the local CSCI office giving updates on the conduct of the home. The post of Manager has now been filled and it is hoped that she can commence employment before the end of the month. The service Manager stated that the new recruit has the skills and experience to manage this client group and has been registered with CSCI as a manager on a previous occasion. The certificates of worthiness for all major and smaller appliances were inspected and found to be in order. The gas fire in the lounge is old and dated and the gas engineer recommends that it be replaced although it did pass all the safety tests. There has been a new washing machine installed since the last inspection so that service users laundry is washed and dried on site without the need for outside agencies. Cherryvale DS0000025237.V305328.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 2 2 2 3 3 4 3 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 3 25 3 26 3 27 2 28 3 29 2 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 x 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 2 2 3 x x 3 x Cherryvale DS0000025237.V305328.R01.S.doc Version 5.2 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. YA1 Standard Regulation 4 Requirement The registered person must ensure that the Statement of Purpose is up to date with all the relevant details included. The registered person must ensure that pre-admission documentation is available on service users files for reference The registered person must ensure that care plans are reviewed and amended when service users treatment change. The registered person must ensure that the stock count for the medication is correct and unused medication is returned to the pharmacist. The registered person must ensure that the broken tiles in the bathroom are repaired and that the shower chair which is in poor condition is replaced. The registered person must ensure that staff training is updated to include all mandatory training such as fire awareness and moving and handling. DS0000025237.V305328.R01.S.doc Timescale for action 31/12/06 2. YA2 14 31/12/06 3. YA6 15 30/11/06 4. YA20 13 30/11/06 5. YA27 23 31/12/06 6. YA35 18 31/12/06 Cherryvale Version 5.2 Page 25 7. YA42 23 The registered person must ensure that staff receive regular fire drills and record attendance. 30/11/06 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 YA9 Good Practice Recommendations It is recommended that the risk associated with using the hoist in the ball pool room be explored as staff are unhappy with the present arrangement despite this being assessed by an Occupational Therapist who is health and safety trained. It is recommended that the lounge gas fire be replaced in accordance with the Gas Engineers recommendations. 2. YA24 Cherryvale DS0000025237.V305328.R01.S.doc Version 5.2 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 Cherryvale DS0000025237.V305328.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. 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