Inspection on 27/06/05 for Childwall Brook

This inspection was carried out on 27th June 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Childwall Brook 01/08/06

Childwall Brook 09/11/05

Childwall Brook 17/12/04

Childwall Brook 20/07/04

Childwall Brook 03/02/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Childwall Brook 30 St Paschal Baylon Boulevard Childwall Liverpool L16 3NY Lead Inspector Les Hill Unannounced Monday, 27 June 2005 09.15 th 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 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 Stationary 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. Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Childwall Brook Address 30 St Paschal Baylon Boulevard, Childwall, Liverpool, L16 3NY Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0151 738 0353 Alternative Fututes Limited Lear Cave N Care Home with Nursing 20 Category(ies) of MD Mental Disorder 20 registration, with number of places Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents between ages of 16 - 64 years 2. To accommodate one named gentleman over 64 years old Date of last inspection 17th December 2004 Brief Description of the Service: Childwall Brook is a care home registered with the CSCI to provide 24 hour nursing care support for 20 younger adults with enduring mental illness. It is owned and managed by Alternative Futures, A registered charity, that offers a variety of facilities throughout the North West of England. The home is located in the Childwall area of Liverpool and has easy access to bus routes, shops, pubs and other amenities. Childwall Brook is a single storey, purpose built establishment that was opened in 1993. It is set in its own grounds and there are gardens to all apsects. The accommodation is made up of 18 single bedrooms and two self-contained bedsits. 10 of the bedrooms and the two bedsits have en-suite facilities. Communal space in the home consists of a rehabilitation kitchen, games room, activity room three conservatories and three lounge areas, one of which is designated as non-smoking. Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken on Monday 27th June 2005. It took place over 4 hours and involved the examination of records, a tour of the building and discussion with five of the residents. The inspection was part of the Commissions requirement to visit and report on each registered care home on two occasions each year. What the service does well: What has improved since the last inspection? What they could do better: Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 Page 6 The replacement floor coverings in bathrooms and WC’s required in the previous two inspections have not yet been provided. Formal professional supervision is in place but is not provided at least six times each year. The manager should ensure that audits of medicines held in the home are thorough. 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. Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 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 standard(s) 1, 2, 3,4 and 5 Childwall Brook has a Statement of Purpose that gives good information to prospective residents; thorough pre-admission assessments were being carried out and admission procedures were flexible to meet the needs of individual residents EVIDENCE: The home’s Statement of Purpose was well presented with good information for prospective residents. Comprehensive and thorough pre-admission assessments were in place on the two residents files examined during the inspection. Referrals are made through the PCT and the manager is invited to visit prospective residents in their current placement. If it is felt they could be supported at Childwall Brook, they are invited to visit. Pre-placement visits and stays are arranged to meet the needs and wishes of the prospective resident. Residents whose support is funded by Social Services have a contract in place provided by the local authority. All residents have a licence agreement with Alternative Futures that identifies the terms and conditions of their residency at the home. Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 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 standard(s) 6, 7, 8, 9 and 10 Comprehensive care plans were being produced in conjunction with residents that included appropriate risk assessments. EVIDENCE: Two residents files were sampled during the inspection. Both contained a comprehensive care plan that identified areas of need and evidence that the plans were being reviewed. There was also evidence in the files and from observation of the interaction between staff and residents, to confirm that wherever possible residents were involved in the development of their individual care plans. Care plans contained “trigger” information to alert staff when a residents mental health needs required closer observation. Childwall Brook is an “open” establishment where residents may come and go as they please. However staff have undertaken risk assessments where necessary about the safety of individual residents in the community and in agreement with them, expect to know where they are going and when they expect to return. Service user meetings are held in the home and matters affecting the day-today life at Childwall Brook are discussed. In addition Alternative Futures Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 Page 10 arranges Resident’s forums where representative residents can meet with residents from other homes and with senior managers to report on, and assist the development of the organisation. Employment contracts expect that staff will respect the confidentiality of information maintained in the home and this is supported through the organisations policies and procedures. Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 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 standard(s) 11, 12, 13, 14, 15 and 17 Individual residents were being supported to develop and maintain a lifestyle appropriate to their needs. EVIDENCE: Individual care plans took account of the social and personal development needs of residents in the home. The home is equipped with a rehabilitation kitchen, games and activity rooms and two bed-sitting rooms for residents who are able to move on from Childwall Brook. Residents are able to attend local colleges, a local authority day centre or the organisation’s Open Learning Centre to develop their skills. However, for many of them, the level of state benefits they receive is a disincentive to find work. The Rehabilitation Coordinator arranges activities in the home and trips out from the home but some residents independently arrange their own trips. Residents who choose to do so are taken out for meals and some residents access the local church social club. Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 Page 12 Staff accompany residents on holidays and at the time of this inspection, a group were preparing for a trip to Scotland. The home is equipped with snooker table, table tennis table, board games, music, television and video/DVD players. Outside space is plentiful and there was evidence of a recent barbeque. Residents are able to visit family and friends subject to any restrictions identified through care planning arrangements and family and friends are welcomed at the home. Residents have their own bedrooms that they are expected to keep clean and tidy, although there is support from the home’s domestic staff. They are expected/assisted to do their own laundry and timetables for the use of the machines are prepared to avoid confusion. The home has a four-week menu in place that assists the ordering of food but the cooks are able to prepare meals not listed if they or the residents want to do something different. A choice is available at every mealtime and a record is maintained of the foods chosen by individual residents to monitor dietary intake. Residents who spoke with the inspector were complimentary about the food prepared and served in the home. Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 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 standard(s) 18, 19 and 20. The health care needs of residents was given good priority but staff need to take more care when auditing the medicines. EVIDENCE: Most residents are able to manage their own personal care with guidance and prompting when necessary, although at the time of this inspection staff were providing high levels of personal/ health care to one resident who had a number of potentially debilitating medical conditions including a “peg” feed. Trained psychiatric nurses are available throughout the day and night time periods to manage the mental health care needs of residents at Childwall Brook. However, the inspector was told that they also receive good support from the Consultant Psychiatrist and from CPN’s. Residents are listed with GP’s at a local Health Centre and the home has experienced some difficulties particularly around the issuing of prescriptions. The manager was advised to discuss her concerns with the local PCT. The home has regular visits from a chiropodist and appointments are made with dentists and opticians as necessary. Records of health care interventions are maintained in resident’s files. Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 Page 14 Secure and appropriate facilities are provided for the storage of medicines. A sample check of medicines revealed one instance where the stock check record did not tally with the number of tablets available. Medicines kept at the home are managed by trained nurses employed by the organisation or those contracted through nursing agencies. The manager should ensure that nurses take more care when auditing medicines. Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Good complaints procedures were in place as were policies and procedures to protect residents form abuse. EVIDENCE: The home’s complaints procedure is displayed in the hallway to the home. The manager told the inspector that she and the staff deal with small matters on a day to day-to-day basis but that any more serious matters are logged as formal complaints. One complaint was logged since the inspection in December 2004. The matter was dealt with appropriately by staff and was reported to the police. Training is provided for all staff during their induction to the home. The organisation has also provided staff with a leaflet on adult protection and its own procedures for “Whistle Blowing”. None of the staff have been referred for inclusion on the POVA list. Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 Page 16 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 standard(s) 24, 25, 26, 27, 28 and 30. Childwall Brook is a purpose built home that provides good spacious accommodation for residents. Damage to floor coverings in WC’s and bathrooms at the home had been reported in the previous two inspections but had not yet been remedied. EVIDENCE: The home was purpose built in 1993 and provides good ground floor/single room accommodation. There are ample communal recreational areas and good outside space. Most of the residents smoke and some will unwittingly damage their surroundings with lighted cigarettes. The two previous inspection reports from CSCI have drawn particular attention to damage to WC and bathroom flooring and to the fittings in these rooms. The manager told the inspector that she had chosen a more appropriate floor tile for the bathroom areas but was waiting for the Housing Association staff to fit them. The Inspector recognises that the home has a maintenance/redecoration programme in place but because residents in Childwall Brook will more readily cause damage to the fabric of the building through the inappropriate management of cigarettes the schedule Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 Page 17 should reflect this and be flexible enough to maintain an appropriate living environment. Resident’s bedrooms were of a good size and were being maintained appropriately. Some had an en-suite facility and two were provided as a bedsit. Standards of personalisation varied according the needs and wishes of the resident. Communal areas were provided around the building thereby offering the opportunity for residents to have quiet sitting and group activity space. A pleasant dining room was sited at the entrance to the home. Furniture and fittings were of a good standard. Residents were able to have a key to their own bedroom and were provided with a lockable drawer to store any personal items. The home is fitted with an emergency call system but at the time of this inspection there was no need for specialist moving or handling equipment. There were no offensive odours present in any part of the home. Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 35 and 36 The organisation maintains agreed staffing levels and is committed to appropriate staff training and development. Standards for the regularity of individual professional supervision have yet to be achieved. EVIDENCE: The home employs Registered Mental Nurses (RMN) and care staff. There is always a RMN on duty at the home though sometimes they are provided from an employment agency. The home currently has a vacancy for an RMN and for a domestic assistant. RMN’s are encouraged to undertake continued professional development training. Twelve of the fifteen care staff have an award an NVQ level 3 and the three other staff are working towards an NVQ award appropriate to their role in the home. In addition to qualification and award training the organisation arranges its own training events relevant to the work being carried on in its homes that staff are expected and encouraged to attend. Staffing levels agreed with the former registering authority are being maintained. Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 Page 19 The manager informed the inspector that formal staff supervision is being undertaken at the home but they have not yet been able to ensure that all members of staff receive supervision at least six times each year. Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39 and 42 Childwall Brook appeared to be well managed with the needs and best interests of residents at the forefront of all activity. EVIDENCE: The manager of the home has been in post for some time. She is a qualified RMN and has completed the NVQ level 4 in management. She has a BSC Honours degree in Psychosocial Interventions. In conversation with the inspector she was clear about the role and function of the home and was fully aware of the needs of each resident. During the course of the inspection, staff on duty at the home were observed to carry on with their work without constant reference to the manager. The organisation undertakes monthly visits to the home. More recently this is being developed into a peer group audit with managers linked to report on Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 Page 21 each other’s homes. The organisation will need to ensure that copies of reports are forwarded to CSCI. The organisation has set up a number of working groups to develop and maintain standards of good practice across all of its homes, and as reported earlier, they also meet with service user representatives to get feedback on what it is like to live in the care homes. Policies and procedures are in place to maintain a safe working and living environment. The fire alarm system is checked regularly as is the temperature of hot water delivered to resident’s rooms and bathrooms. The temperature of fridges and freezers is recorded on a daily basis and fresh meat delivered to the home is temperature tested to ensure it has been transported appropriately. Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 Page 22 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Childwall Brook Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 3 x F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 Page 23 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 YA24 Regulation 23 Requirement Appropriate action must be taken to replace the damaged floor covering in the identified WCs. Care must be taken when auditing medicines to ensure that counts from the written records and of the stock held are the same. Timescale for action 31/07/05 2. YA20 13 27/06/05 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 YA36 Good Practice Recommendations The registered manager should ensure that all staff receive professional supervision at least six times in any 12 month period. Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Liverpool Area Office 3rd Floor, 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 Childwall Brook F52 F02 S25094 Childwall Brook V235089 270605 Stage 4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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