Inspection on 13/03/06 for Chestnut Street, 59

This inspection was carried out on 13th March 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chestnut Street, 59 12/06/07

Chestnut Street, 59 23/11/06

Chestnut Street, 59 24/11/05

Chestnut Street, 59 28/02/05

Chestnut Street, 59 13/12/04

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 Chestnut Street, 59 59 Chestnut Street Southport Merseyside PR8 6QP Lead Inspector Mr Paul Kenyon Unannounced Inspection 13 March 2006 17:30 th Chestnut Street, 59 DS0000005270.V283613.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 Chestnut Street, 59 DS0000005270.V283613.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. Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Chestnut Street, 59 Address 59 Chestnut Street Southport Merseyside PR8 6QP 01704 539505 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) Speciality Care (Rest Homes) Limited Mrs Greta Morphet Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 3 LD Date of last inspection 17th November 2005 Brief Description of the Service: 59 Chestnut Street is a registered care home offering support to three individuals with learning disabilities. The home provides term time accommodation for students who attend Arden College, a local educational resource that specialises in the provision of life skills to individuals with a learning disability with a view to promoting future independent living. Greta Morphet is the Manager of the service. Arden College is a subsidiary of Speciality Care, a private organisation. The home is located in a residential area of Southport, close to local amenities and transport links. The home is a semi-detached property that has not been specifically adapted for the purpose of the service. The home consists of a ground floor, which contains a kitchen, dining room and a lounge to the front. All bedrooms are located on the upper floors with two rooms on the first floor and a further one on the second floor. A bathroom is available with toilet as well as a staff sleep-in room/office on the top floor. The home is not suitable as accommodation for students with a physical disability at present. Students are able to access all parts of the home. As a result, no adaptations are required at present. Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection to be held this inspection year (April 2005 to March 2006) and took place during the evening. The Manager was given a few hours notice of the inspection to ensure that students and staff would be available. In total the visit lasted 2 and a half hours. The National Minimum Standards for Younger Adults were used to measure how well the service provided support to the individuals who live there. The service provides term time accommodation to three individuals who access Arden College on a daily basis. As a result, individuals using the service are referred to as students in this report. The Inspector involved discussions with the Unit Manager, examination of some records that are connected with the support that are provided to students and a tour of the premises. The inspection also included discussions with each of the students and their comments are included within this report. All three students had recently been to a service user involvement day run by the Local Office of the Commission For Social Care Inspection. Two commented on this and said it had been useful and that they had made suggestions. What the service does well: The service is good at enabling students to make decisions about their lives and enabling them to be as independent as possible. The service is good at ensuring that students maintain relationships with families and friends and to involve these individuals in reviews. The service is good at respecting the rights of students in their daily lives and enabling them to be as involved as possible in the running of the daily routines within the home. The service is good at involving students in shopping, planning menus and preparing meals with appropriate support. The service is good at enabling students to be as independent as possible in maintaining their own personal hygiene and appearance. The home is good at providing a comfortable, well-decorated and home-like environment for students. The service is well run and takes the views of students and their families into account. Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 Page 6 The staff team are good at interacting with students and providing advice. They are approachable to students and students in turn feel comfortable with the staff team. Comments from students included: ‘I am well’ ‘I have my finances dealt with by the organisation for the time being and I am happy with that’ ‘I manage my own money’ ‘I am fully involved with routines around the house’ ‘The house is comfortable enough’ ‘I can fit all my stuff in my room’ ‘I feel happy and safe’ ‘We have meetings and they ask you what you think’ ‘We take it in turns to cook and we get help with this’ What has improved since the last inspection? What they could do better: Some good practice recommendations are raised in this report. The staff team should receive learning disability awareness training to reinforce their care practice. The Unit Manager should be provided with copies of the monthly visit reports undertaken by the Registered Manager. Evidence should be provided that staff had had the opportunity to look through the learning materials obtained from the British Institute of Learning Disabilities. There are a number of issues that the service could do better with. Staff must be provided with infection control guidelines in relation to the washing machine being located in the kitchen. The organisation must identify a deadline date for the completion of NVQ Level 2 for one more member of staff so that the relevant standard on qualifications can be met. Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 Page 7 An external light must be installed to the rear of the building in order to promote the health and safety of students and staff alike. This was raised as a requirement following the inspection in November 2005. The service must provide infection control and manual handling training consistently to all its staff. This was raised as a requirement at the last inspection in November 2005. 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. Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No standards in this section were measured. Standard 2 was measured at the last inspection was met. EVIDENCE: Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 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): 7. Standards 6 and 9 were measured at the last inspection and were met. Students are given the opportunity to make decisions about their lives and feel comfortable about doing this. EVIDENCE: Evidence during the inspection confirmed that students are provided with the assistance to influence their own lives. The emphasis of the service is on enabling independent living. Interactions between staff and students involved staff providing informal advice and support about daily tasks and activities. All these led up to enabling students to make decisions. Two students are completely independent with their finances. Photographic evidence was available outlining the degree to which this independence occurs with a photograph of one student using a cash machine. Despite this independence, students are encouraged to budget their monies and finance sheets that had been completed by them evidenced this. One student relies on the organisation to keep his money for safekeeping yet stated that ‘I am happy with that for the time being’. The same student stated that he ‘is able to make decisions in life and I do’. One student is in their final year of college. The individual has been offered plans for his future and it is understood that an advocate from a local service is involved in this process. Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 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. Standards 12 and 13 were measured at the last inspection and were met. Students maintain relationships with their families who are involved in their support. The rights of students are respected. Students participate in the planning and preparation of meals with an emphasis on a healthy diet. EVIDENCE: One student was able to confirm that he had links with his family. Through general discussions the individual confirmed that his parent had attended a recent review and were happy with the support he was receiving. Other items of discussion confirmed that this person was able to receive mail and other correspondence from his family. Another student confirmed that he maintained contact with his family and was noted having the opportunity to speak to a family member on the telephone and in private. The home has a cordless telephone system in place that enables students to make calls in private. The individual also confirmed that he was able to use the Internet in the home to maintain contact. All students have accessed the college for more than one year. Another student accommodation is located next door and links to this continue. Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 Page 12 Access to the individual accommodation of students is respected by staff. The Unit Manager asked for permission to enter one bedroom and sought this permission from the student concerned. Others were able to access their bedrooms using their own key and the Inspector observed this on two occasions. Staff do not solely interact with each other. Throughout the inspection there was significant interactions between staff and students on a host of issues. These ranged from issues relating to their own support to general issues about their day at college or activities that they had planned. It was observed that all students have unrestricted access to all parts of the house with the exception of each other’s rooms. There is an expectation that students participate in household routines given that this is part of the emphasis on maintaining and encouraging the independence that the organisation subscribes to. One student confirmed that ‘we take it turns to do the cooking’. A rota is available which suggested that students are responsible for doing their own laundry with staff support where required. One student was observed assisting in cleaning the kitchen after the evening meal had been prepared. There is an expectation that students are involved in the planning of menus and the preparation of meals. When the Inspector arrived, one student with staff support was preparing the evening meal. The staff member was observed to be providing advice to the individual as much as possible to ensure that the activity was completed successfully. A menu is available. All lunches during the week are taken at college and therefore only breakfasts and evening meals are needed during weekdays with lunch provided during the weekend. One student confirmed that the main shopping day was Friday and that everyone was involved in this. Photographic evidence was on display demonstrating student involvement in cooking. The menu serves as a guide but is used flexibly. One student stated ‘we just get home and decide together what we want’. No student has any special dietary needs. One student stated that he had given up having sugar in hot drinks because ‘it is healthy’. Clearly the individual was proud of this. The kitchen is domestic in scale and is equipped accordingly. Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18. Standards 19 and 20 were measured at the last inspection and were met. Students are supported to maintain their own personal hygiene and appearance. EVIDENCE: The needs of students at present are such that there is no need for direct personal care to be provided by staff. Levels of personal care focus on prompting students if needed about their general appearance and personal care tasks. Evidence was available during the inspection, which reinforced the role of prompting individuals, rather than provide direct care. This emphasis on prompting is in line with the overall philosophy of the service to maintain and ensure the independence of individuals. Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 Page 14 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. Standard 23 was measured at the last inspection and was met. Students are aware of how to make complaint should the need arise as well as the role of the Commission for Social Care Inspection. EVIDENCE: A requirement at the last inspection highlighted the need for the complaints procedure to be reinforced to students. Discussions with students noted that they were aware of who to refer any complaints to and also understood the role of the Commission for Social Care Inspection in this process. One made reference to a document that he was aware of about complaints yet stated that he did not have any complaints at present. Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 Page 15 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 service provides a home like and comfortable environment, which is clean and hygienic. Residents do not completely benefit from practices that control infection. EVIDENCE: A tour of the house noted that all areas are well decorated and an overall home-like impression is achieved. Furnishings are comfortable. Two students stated that they were happy with the extent to which their rooms had been decorated and that they were able to ‘fit all our stuff in the room’. The address is in keeping with the neighbourhood and cannot be externally identified as a registered care home. The same tour of the house noted that all areas were clean and hygienic and that there were no offensive odours present. The home does not employ domestic staff given that there is a role for staff to assist students to be involved in this process with a view to enabling them to become as independent as possible. Laundry facilities are included within the kitchen in the form of a domestic appliance. This reflects the aims of the service to provide an ordinary domestic feel to the house. As a result, clothes that Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 Page 16 require laundering are brought into areas that are used for food preparation. There needs to be written guidance for staff to refer to taking infection control into account in this area. This is raised as a requirement in this report. Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 Page 17 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 and 35. Standard 34 was measured at the last inspection and was met. Students do not fully benefit from a fully qualified staff team. Students are supported by staff team who have the necessary qualities to assist them in daily living. Students do not benefit form a fully trained staff team. EVIDENCE: Throughout the inspection, staff interacted with students in a friendly and informal manner. Underlying these conversations, staff demonstrated that listened to students and provided them with the information they needed to make decisions. Clearly students felt comfortable in approaching staff. One student stated that ‘staff are really helpful’ and ‘I always speak with staff’. The staff team has the experience to support adults with a learning disability. A learning pack is available form the British Institute for learning disabilities offering information about the client group and an overview of their needs including dealing with challenging behaviours. The last point is not a feature of Chestnut Street at present. There was no evidence that staff had read these workbooks. It is recommended that they do. Only one member of staff out of the four deployed in the home have attained at least NVQ Level2. This person has NVQ Level 3. As a result only 25 of the staff team has achieved this. All other staff members have commenced this qualification. It is required that a deadline date for at least one other person to attain the qualification is Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 Page 18 achieved in order that 50 of staff are qualified and have met this National Minimum Standard. Training is limited to mandatory training. This has not been fully complied with and this is outlined in Standard 42 of this report. The presence of the British Institute for Learning Disability and ongoing NVQ work should extend training yet it is recommended in this report that more specific learning disability training is undertaken by staff to supplement this. Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. Students benefit from a well run home. The service measures the quality of the support it provides. The health and safety of students is not fully protected. EVIDENCE: The home’s management structure works in two ways. The Registered Manager is responsible for other registered student accommodation run by the same organisation. In addition to this the home has a Unit Manager who was present during the visit. The Registered Manager has been approved by the Commission for Social Care Inspection and is qualified to perform the role having the necessary experience in addition to this. The Unit Managers role is to deal with the day-to-day issues that students have as well as supervise the staff team. The organisation has recently issued a new quality assurance procedure and this goes into detail about the aspirations of the organisation to take the views of those who use the service and their families into account. The Unit Manager undertakes a daily and weekly audit of whether tasks are being achieved in the home and these were examined. One student stated that ‘staff ask us what Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 Page 20 they think of it here’. Another confirmed that his parents had received a questionnaire recently asking what they though of the support he received at Chestnut Street. The Registered Manager undertakes monthly visits to the service and reports on her findings. These are retained by the Registered Manager and sent to the Commission For Social Care Inspection. It is recommended that copies of these reports be sent to the Unit Manager so he is aware of any action that is needed. Two requirements at the last inspection highlighted the need for an external light to be fitted to the rear of the home to promote the safety of students and staff alike and that all staff receive manual handling and infection control training. Neither of these requirements have been addressed and are raised once more in this report. Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 Page 21 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 X 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 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 X 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X X X 3 X 3 X X 2 X Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 Page 22 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 YA30 Regulation 13 Requirement Timescale for action 31/03/06 2 YA32 18 3 YA42 23 4 YA42 13 Guidelines must be produced to outline infection control arrangements for the use of the laundry facilities within the kitchen A date for the completion of the 31/03/06 NVQ Level 2 qualification for remaining staff must be identified External lighting to the rear must 31/03/06 be provided to ensure the safety of students and staff during the hours of darkness All staff must receive infection 30/04/06 control and manual handling training 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 Refer to Standard YA32 YA32 Good Practice Recommendations Training in learning disability awareness should be provided to staff. Staff’s awareness of the British Institute of Learning DS0000005270.V283613.R01.S.doc Version 5.1 Page 23 Chestnut Street, 59 3 YA39 Disabilities learning material should be evidenced Reports relating to monthly visits should be made available to the Unit Manager Chestnut Street, 59 DS0000005270.V283613.R01.S.doc Version 5.1 Page 24 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. 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