Inspection on 09/11/05 for Childwall Brook

This inspection was carried out on 9th November 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

Childwall Brook 01/08/06

Childwall Brook 27/06/05

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 Merseyside L16 3NY Lead Inspector Les Hill Announced Inspection 9th November 2005 09:30 Childwall Brook DS0000025094.V257045.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 Childwall Brook DS0000025094.V257045.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. Childwall Brook DS0000025094.V257045.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Childwall Brook Address 30 St Paschal Baylon Boulevard Childwall Liverpool Merseyside L16 3NY 0151 738 0353 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) Alternative Futures Limited Miss Lear Elizabeth Cave Care Home 20 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (20) of places Childwall Brook DS0000025094.V257045.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Residents between ages of 16 - 64 years To accommodate one named gentleman over 64 years old Date of last inspection 27th June 2005 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 range 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 aspects. The accommodation is made up of 18 single bedrooms and two self-contained bed sits. 10 of the bedrooms and the two bed-sits 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 DS0000025094.V257045.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection of Childwall Brook was undertaken on 9th November 2005 over a period of 3.5 hours. It involved the examination of some records, a tour of the building and meeting with residents. The inspection was part of the Commission’s responsibility 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? Flooring in the WC’s has been replaced. Medicines were well documented. Professional staff supervision had been introduced. Childwall Brook DS0000025094.V257045.R01.S.doc Version 5.0 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. Childwall Brook DS0000025094.V257045.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 Childwall Brook DS0000025094.V257045.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): 1, 2, 3, 4 and 5. EVIDENCE: The home’s Statement of Purpose is well presented and contains all matters identified in Schedule 1 of the National Minimum Standards, Care Homes for Younger Adults. Some minor amendments were to be made to the list of staff. Comprehensive and thorough pre-admission assessments were in place on the four resident’s care files examined during the inspection. Referrals are made through the Primary Care Trust (PCT) and the manager visits prospective residents in their current placement. If it is felt they can be supported at Childwall Brook they are invited to visit. Pre-placement visits and stays are arranged as appropriate. The manager told the inspector that discussions are being held to consider the placements in Childwall Brook of people originally from Liverpool who are funded in homes outside the area. In making any future placements the organisation must consider the registered status of the home and ensure that Childwall Brook is able to meet their needs. Licence agreements were in place on each of the four resident’s care files. Childwall Brook DS0000025094.V257045.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, 8, 9 and 10. Comprehensive care plans were in place that included appropriate risk assessments. EVIDENCE: Care plans evidenced on the four resident’s files examined were detailed and comprehensive and supported the needs identified in assessments. There was evidence that residents had been involved in the preparation of their care plans and had been invited to attend regular reviews. Some of the staff have undertaken training in Psycho-social Interventions (PSI) and one of the care files contained details of the work being undertaken with the resident. The work was extremely detailed and gave clear indications of the progress being made. Childwall Brook is an “open” establishment and residents may come and go as they please. However, risk assessments are in place to identify the safety of individual residents and staff expect them to discuss where they are going and what time they expect to return. Childwall Brook DS0000025094.V257045.R01.S.doc Version 5.0 Page 10 Risk assessments were in place to support residents and staff in a range of areas. The need for risk assessments was clearly identified through the care planning processes. Monthly resident’s meetings are held and minutes taken. In addition Alternative Futures hold resident’s forums where representatives from their residential homes can meet with senior managers to assist the development of the organisation. None of the residents from Childwall Brook have volunteered to attend at this point in time. The home has policies and procedures in place to support the need for confidentiality to be maintained at all times. Employment contracts also expect that staff will maintain the confidentiality of information kept in the home. Childwall Brook DS0000025094.V257045.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): 11, 12, 13, 14, 15, 16 and 17. Residents were being supported to develop and maintain their individual interests. EVIDENCE: Individual care plans took account of the resident’s personal and social development. The home is equipped with a rehabilitation kitchen, games and activity rooms and has two bed sitting rooms for residents who are able to move on. Alternative Futures has its own Open Learning Centre where residents from all of their homes can go to follow a course of training in a range of skills. One of the residents from Childwall Brook is currently attending a computer course. Others have been able to undertake an NVQ course in simple food preparation. For many of the residents, the levels of state benefits they receive are a disincentive to find work. A Rehabilitation Coordinator is in post although as the home is currently without a cook he is spending much of his time in the main kitchen. Other support staff will, however support residents with the development of personal Childwall Brook DS0000025094.V257045.R01.S.doc Version 5.0 Page 12 skills and arrange trips out from the home. Some residents choose to access the local church social club. Residents have benefited from holidays in Scotland, The Cotswolds, Wales and Blackpool. Small groups holidays are arranged to meet the needs and preferences of individual residents. The home is equipped with snooker table, table tennis table, board games, music, TV, video and DVD players. Outside space is plentiful. Residents are able to visit family and friends subject to any restrictions listed in the care plans. Family and friends are welcomed at the home. Residents are expected to keep their own bedrooms clean and tidy, though there is support from the home’s domestic staff if required. They are also expected to do their own laundry though again, help is provided when necessary. The home has a four-week menu in place that can be amended to take account of the availability of particular foods or the needs and wishes of residents. A choice is available at every mealtime and a record is maintained of each resident’s dietary intake. Residents who spoke with the inspector about the food were complimentary about its quality and presentation. Childwall Brook DS0000025094.V257045.R01.S.doc Version 5.0 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, 19 and 20. The personal and healthcare needs of residents was given appropriate priority. EVIDENCE: Most residents are able to manage their own personal care with guidance and prompting when necessary. However, at the time of this inspection staff were providing high levels of personal/health care to one resident who has a number of debilitating medical conditions and has a “PEG” feed. Trained psychiatric nurses are available throughout the day and night to manage the mental health care needs of residents. Additionally the home receives good support from the Consultant Psychiatrist and from visiting CPN’s. Residents are listed with GP’s at a local health centre and the home has made some progress in ensuring prescriptions are provided appropriately. Links have been made with Mersey Eye Care and with a local dentist. The home has visits from a private chiropodist for which a fee of £20 is charged. Records of health care interventions are maintained on resident’s files. Secure and appropriate facilities are provided for the receipt and storage of medicines. A sample check of the medicines held in the home confirmed that they were being managed well. Arrangements for the disposal of medicines and the destruction of Controlled Drugs have changed in line with practices Childwall Brook DS0000025094.V257045.R01.S.doc Version 5.0 Page 14 across the country. The home was experiencing some initial problems through a lack of specific advice from the company, contracted to remove the medicines. Childwall Brook DS0000025094.V257045.R01.S.doc Version 5.0 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 the following standard(s): 22 and 23 Good complaints procedures were in place as were policies and procedures to protect residents from abuse. EVIDENCE: The home’s complaints procedure is listed in the Statement of Purpose and is also available in the entrance hallway. Minor matters are dealt with on a dayto-day basis but more serious matters are logged and the process of investigation recorded. The manager had dealt with two complaints in the past twelve months both of which had been substantiated, but resolved within the time scales set. Training is provided on adult protection during induction and is updated from time to time. Staff are given leaflets to remind them of their responsibilities in protecting residents from abuse and to encourage “whistle blowing” should they have concerns about practice in the home. None of the staff have been referred for inclusion on the POVA list. Childwall Brook DS0000025094.V257045.R01.S.doc Version 5.0 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 the following standard(s): 24, 25, 26, 27, 28, 29 and 30. Residents live in a comfortable and safe environment. EVIDENCE: Childwall Brook was purpose built in 1993 and provides ground floor, single occupancy accommodation. There are ample communal/recreational areas and good outside space. Most of the residents’ smoke and some will unwittingly damage the environment through the careless management of cigarettes. Previous inspection reports have drawn attention to the damage to bathroom and WC flooring and fittings. The home has now replaced the floor covering with a more durable tiling. Resident’s bedrooms were of a good size and were being maintained appropriately. Some have an en-suite shower and there are two bed-sits. Standards of personalisation of the rooms varied according to the wishes of the resident. Communal areas around the building offered a variety of opportunities for quiet sitting, watching TV or engaging in activities. A pleasant dining room is Childwall Brook DS0000025094.V257045.R01.S.doc Version 5.0 Page 17 located by the front entrance to the home. Dining tables were laid with tablecloths and matching crockery. Furniture and fittings were generally of a good standard but the manager had identified some items to be replaced. Residents could have a key to their own bedroom and were provided with lockable drawer and wardrobe facilities. A nurse call system is installed. One of the residents had been provided with a special bed but there were no other adaptations or specialist items of equipment needed at this point in time. There were no offensive odours present throughout the home. Childwall Brook DS0000025094.V257045.R01.S.doc Version 5.0 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 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): 31, 32, 33, 34, 35 and 36. Residents are protected by the employment practices at the home and by appropriately trained staff. EVIDENCE: The home employs Registered Mental Nurses (RMN) and care staff. An RMN is always on duty at the home ‘though sometimes they are provided from an employment agency. RMN’s are encouraged to undertake continued professional training. There are 9 RMN’s employed at Childwall Brook and 12 of the 16 care staff have an award at NVQ level 2 in care. Seven other staff are employed in ancillary roles. Additional training and support is provided to staff according to an assessed need but the home provides regular update training in fire awareness Childwall Brook DS0000025094.V257045.R01.S.doc Version 5.0 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, 38, 39, 40 41, 42 and 43 Childwall Brook is well managed with the needs and best interests of residents at the forefront of activity. EVIDENCE: The manager of the home has been in post for some time. She is a qualified RMN and has an NVQ level 4 in management. She also has a BSc Honours degree in Psychosocial Interventions. The manager is clear about the role and function of the home and is fully aware of the needs of individual residents. During the course of the inspection staff were observed to get on with their work without constant reference to the manager. Trained staff that manage medicines on a day-to-day basis assisted the inspector with that element of the inspection. Alternative Futures has arranged for the manager of another home to visit Childwall Brook on a monthly basis to prepare a Regulation 26 report. The views and opinions of residents are sought as a part of this procedure. Childwall Brook DS0000025094.V257045.R01.S.doc Version 5.0 Page 20 The organisation has set up a number of working groups to develop standards of good practice across all of its homes and, as reported earlier, they also meet with service user representatives to get feedback on their experiences of care and support. In a pre-inspection questionnaire the home manager confirmed that all the required policies and procedures were in place and the dates on which some had been reviewed. A new policy and procedures were being developed to deal with the control and administration of medicines. The home’s manager presented information to confirm that fire equipment had been tested, that the fire alarm system is checked weekly and that all staff receive six monthly fire awareness training. Checks had also been completed on the emergency lighting system. The home’s gas installations, central heating system and electrical wiring circuits had all been checked within the appropriate time frame. The last visit by an Environmental Health Officer was in March 2001. Policies and procedures are in place to support a safe working and living environment and the organisation has its own Health and Safety Adviser. The temperature of hot water delivered to resident’s rooms is checked regularly and external contractors were adjusting one of the outlets at the time of this inspection. The temperatures of fridges and freezers in the kitchen are recorded daily and the temperature of fresh meat delivered to the home is checked to ensure it has been transported appropriately. Record keeping examined during the inspection was relevant and up to date. Childwall Brook DS0000025094.V257045.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 4 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Childwall Brook Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 DS0000025094.V257045.R01.S.doc Version 5.0 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Childwall Brook DS0000025094.V257045.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. 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