Inspection on 09/11/06 for Church Street Short Breaks

This inspection was carried out on 9th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Church Street Short Breaks 17/11/08

Church Street Short Breaks 28/11/07

Church Street Short Breaks 25/01/06

Church Street Short Breaks 23/05/05

Church Street Short Breaks 16/11/04

Church Street Short Breaks 22/05/04

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 Church Street Short Breaks 88 Church Street Golborne Wigan Greater Manchester WA3 3TW Lead Inspector Lynn Sharples Unannounced Inspection 9th November 2006 09:30 Church Street Short Breaks DS0000005730.V315306.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 Church Street Short Breaks DS0000005730.V315306.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. Church Street Short Breaks DS0000005730.V315306.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Church Street Short Breaks Address 88 Church Street Golborne Wigan Greater Manchester WA3 3TW 01942 272079 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) Wigan Council Social Services Department Christopher Martin Parr Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (4) of places Church Street Short Breaks DS0000005730.V315306.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home is registered for a maximum of 4 service users to include:up to 4 service users in the category of LD (Learning Disability) up to 4 service users in the category of LD(E) (Learning Disability over 65 years of age) The service should at all times employ a suitably qualified and experienced manager who is registered with the CSCI The Registered Manager must spend a proportion of their working hours each week on site to have a clear presence in the home, to oversee the running of the home, and supervision of care staff on the premises, to include weekends and times when service users are present in the home. This must be reflected on records maintained in the premises. 25th January 2006 2. 3. Date of last inspection Brief Description of the Service: 88 Church street is a Local Authority care home, which provides a short-term break service for up to four adults, of either sex, who have a learning disability. The manager of the home is Mr Chris Parr. The home is a small bungalow situated in Golborne, close to the town centre and local shops and amenities. The home is set back from the main road and has a front garden, an enclosed flagged patio to the side of the home and parking to the rear of the building. The home has four single bedrooms, a lounge and dining room and a kitchen. There is a bathroom and shower room and two toilets. The fees for the short term break service are between £10 - £40.66 per night. Church Street Short Breaks DS0000005730.V315306.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. At the time of the visit there were four people staying at the short beak service. The home did not know about the visit and it took four and half hours. Residents, the manager and the care staff were spoken with; completed comment cards were received from relatives. The files relating to the service users, staff and the home were read and the premises toured. What the service does well: What has improved since the last inspection? The home has consulted with the Environmental Health and adapted the utility accordingly. Church Street Short Breaks DS0000005730.V315306.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. The summary of this inspection report can be made available in other formats on request. Church Street Short Breaks DS0000005730.V315306.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 Church Street Short Breaks DS0000005730.V315306.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 1,2,4 The homes Statement of Purpose and Service User Guide are comprehensive providing service users and prospective service users with details of the services the home provides enabling an informed decision about the admission to the home. Prospective service users’ individual needs are assessed ensuring that the home can meet their needs. EVIDENCE: The Statement of Purpose is detailed and contains all the information a service user and carer would need to make an informed choice about whether to stay at the home. The Service User Guide is also presented in a pictorial form and gives services users all they need to know about the service and is a good informative document. Prior to staying at the home a social worker completes a need led assessment/ care plan. The team then has a referral meeting to establish if the home can meet the needs of the service user. If this is agreed, the social worker is notified and the service user and family are invited to look round and look at the Statement of Purpose. If the service user wants to stay, the manager visits the service user at home and help notes are completed with the service user and their family. The help notes are an assessment of need and assessment of Church Street Short Breaks DS0000005730.V315306.R01.S.doc Version 5.2 Page 9 the service users aspirations, which include:- personal and medical information, a personal profile, including cultural needs, interests, communication, eating and drinking, health and safety. The home then individually plans introductions to the home. One service user was visited in a day service for two and half sessions per week over several weeks and then tea visits, before an overnight stay. One service user came for tea and then had an overnight stay. There has been one emergency admission in the last five years. This has to be agreed by the service manager and support needs and additional resources were highlighted and an exit strategy was included in the care plan. If a service user does not use the service on a weekly basis the home has a system where they contact the carers to assess any change in circumstances since the last visit. Church Street Short Breaks DS0000005730.V315306.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 6,7,8,9 The care plans ensure that the service users individual needs are met and that service users can make choices. This ensures that service users can make decisions about their lives with assistance as needed. EVIDENCE: The four care plans looked at contained assessments, care plans, help notes and reviews. In the personal planning there is a section that includes, “a good stay for me at church Street would be the following” and then details all the information a member of staff would need to ensure that the service user had their needs and wishes met. There is also a service agreement that were possible is signed by the service user and is presented in a pictorial format. The care plans are reviewed on a regular basis either six or twelve months by the social worker and the service user, relative or representative and the homes manager attend. The help notes are also reviewed regularly and involve Church Street Short Breaks DS0000005730.V315306.R01.S.doc Version 5.2 Page 11 the key worker, service user and their relative or representative. One plan included reactive strategies to assist the care staff working with a service user who could present challenges to the service provided. The service users make decisions in terms of the food they wish to eat, the clothes they wear and the activities they want to participate in. One service user uses the Picture Exchange Communication System. This is very useful to develop communication, particularly in people with autistic spectrum disorders and uses photographs to assist with communication and choice. The service user chose their evening meal using this system. On reading the daily records one service user was asked if they wanted to go to a local pub last night they did not, but on the day of the visit asked to go out that night instead and this was agreed. The service users have had two service user meetings with evidence that actions have been addressed. It would be useful if an independent advocate could chair these meetings. This would ensure those service users are free to express themselves and assisted to present their concerns to the home. The care files included risk assessments and these are personalised and assess the risk of the activity and of the building in relation to each individual. One risk assessment involved health care professionals. The risk assessments are reviewed regularly at least every six months. Church Street Short Breaks DS0000005730.V315306.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 12,13,14,15,16,17 Service users engage in community and leisure activities appropriate to their needs and wishes and this ensures that service users are stimulated whilst staying at the home. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: During the day most service user attend a day service and consequently prefer to relax in the evenings during the week. Service user watch the television or a can choose a DVD. Each service users bedroom had a television with a DVD player and can chose to watch this instead. Church Street Short Breaks DS0000005730.V315306.R01.S.doc Version 5.2 Page 13 One service user said that they were going out to the pub that night and said that at weekends they tend to go out more. They enjoyed going to the cinema, going bowling. Another service user spoke about going shopping; the staff confirmed that they also go walking to local places of interest. The activities are planned in the diary in advance and the daily records indicated that service users are offered the opportunity to go out. If visitors come to the home they can see the service user in private if they wish to. One service user arranges to meet a social services professional whilst at Church Street. In the care plans there is a section that indicates the service users preferred form of address. The care staff were observed knocking on people bedrooms door before entering and observed talking with service users and interacting appropriately. Service users chose what to eat for the evening meal and this was then prepared. There was a choice of curry and rice, chicken and pasta and fish and chips and peas. The meal was served in a relaxed unhurried manner with staff talking with the service users. Service users nutritional needs are assessed and reviewed including risk factors associated with low weight, obesity and eating and drinking disorders. One service user chose to wash the dishes after the meal. Church Street Short Breaks DS0000005730.V315306.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 18,19,20 There is clear, consistent care planning system in place to provide staff with the information they need to meet service users needs. The medication at this home is well managed promoting good health. EVIDENCE: The care plans indicated that a service users preference about how they are supported is recorded. One service user preferred to be assisted by a female carer only and this was complied with. One service users plan included details of what assistance was required for dressing and explaining what the service user would do independently. Times for going to bed were flexible. The service users health needs are monitored whilst at the home and included in the care plans. The medication is stored and administered correctly at the home. The home has a policy and procedure on medication. Some staff have received training in Church Street Short Breaks DS0000005730.V315306.R01.S.doc Version 5.2 Page 15 medication, one member of staff said that they wish to complete medication training. Church Street Short Breaks DS0000005730.V315306.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 22,23 The home has a documented complaints procedure to ensure residents’ views are listened to and acted upon. Systems are in place to ensure residents are safeguarded from abuse and harm. EVIDENCE: The home operates Wigan Social Services Department’s complaints policy and procedure. The home has received two complaints since the last visit. One has been addressed and the other is currently being investigated. The complaints procedure is explained in the service agreement. The service users spoken with said that they knew whom to complain to if they were unhappy about anything. The home operates Wigan Social Service Departments Protection of Vulnerable Adults policy and procedure. All the staff have attended training in adult protection whilst completing their NVQ level 2 award. The staff spoken with were able to demonstrate an awareness of the different forms of abuse and how to act as an alerter in terms of adult protection. Church Street Short Breaks DS0000005730.V315306.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 24,26,27,30 The recent investment has improved the appearance of the home creating a comfortable and safe environment for those staying there. EVIDENCE: The premises are safe comfortable, bright, cheerful, airy, clean and free from offensive odours. Since the last visit the Environmental Health has visited the home and it now has a separate room with a modern sluice and is used to store equipment that is not in use. There is a programme of redecoration and new furniture has been purchased. There is a new wooden floor, curtains and blinds. The outside patio area is accessible for service users using a wheelchair, there is a wooden bench and chairs and potted plants and is pleasant area to sit in. Church Street Short Breaks DS0000005730.V315306.R01.S.doc Version 5.2 Page 18 Four bedrooms have been redecorated and one bedroom has new kardenan flooring, which is easily cleaned. Each room has a combined television/DVD player. The service users usually choose which room they wish to stay in. There are two bathrooms one has a bath and toilet and the other has a toilet and walk in shower. In the walk in the shower the paint is peeling and spoils the overall appearance of the bathroom. Both bathrooms are lockable. The utility room has a washing machine and a drier. The washing machine has the specified programming ability to meet disinfection standards. On the day of the visit the home was clean and free from malodour. Church Street Short Breaks DS0000005730.V315306.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 32,34,35,36 The recruitment practices are good and appropriate checks are carried out. This ensures that the resident is not put at risk. The staff training provided ensures that the staff are equipped to meet the needs of the service users. EVIDENCE: All the care staff at the home have the NVQ level 2 in care, one member of staff has the NVQ level 3 in care. The care staff were observed being respectful and communicating effectively with the service users. They were friendly and there was a relaxed atmosphere in the home. The care staff spoken with were able to demonstrate a good understanding of the needs of the service users using the service at the time of the visit. There has been one new member of staff since the last visit. The rotas indicate that there are sufficient care staff on duty to meet the service users needs. The manager said that staffing levels would be reviewed to meet service users’ changing needs. There have been five recorded staff meetings this year with evidence of items being addressed. Church Street Short Breaks DS0000005730.V315306.R01.S.doc Version 5.2 Page 20 An examination of a sample of staff records indicated that all staff had two references, enhanced CRB checks, statements of terms and conditions on their personnel file. The application forms are kept separately and could not be viewed. It is important that the CSCI can view application forms as part of the visit, this was discussed with the manager. All staff receive structured induction training. The care staff have received training on fire awareness, epilepsy, physical intervention, manual handling autistic spectrum disorder training. There has also been specific training relating to identified service users. The care staff would also benefit from training regarding specific conditions such as Rhett’s Syndrome and diabetes. The care staff receive regular recorded supervision and have had formal supervision on four or five occasions this year. The care staff also receive an annual appraisal with the manager. Church Street Short Breaks DS0000005730.V315306.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. 37,39,42 The record of self-review by the registered provider is infrequent and does not provide the home with adequate quality assurance. EVIDENCE: The manager has been in post for six years and has many years experience of working with adults with learning disabilities. They have the NVQ level 4 care and the registered managers award. They have applied to participate in the NVQ level 4 in management. The staff spoken with said that the manager was approachable and supportive. The service users spoken with said that the manager was good. The responsible person has only three recorded visits to the home this year. They should visit once a month and prepare a written on the conduct of the Church Street Short Breaks DS0000005730.V315306.R01.S.doc Version 5.2 Page 22 care home each month and these should be made available to the CSCI. The home would benefit from a service user survey and this should be published and made available to service users and their representatives. The fire record book demonstrated that emergency lighting, fire bell are tested regularly. There have been two fire drills this year. It is important that the day staff attend at least two drills a year and that night staff attend three fire drills a year. The home has an accident book that is completed appropriately and a general incident reporting book. Church Street Short Breaks DS0000005730.V315306.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 3 2 3 3 X 4 3 5 X 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 X 26 3 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 2 X Church Street Short Breaks DS0000005730.V315306.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA39 Regulation 26 Requirement The registered person must ensure that they visit the home monthly and prepare a written report on the conduct of the home. The registered person must ensure that staff attend fire drills on a regular basis. Timescale for action 22/01/07 2 YA42 23 22/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA8 YA27 YA35 Good Practice Recommendations It is recommended that the home consult with an advocacy service to ensure service users are consulted. It is recommended that the walk in shower is redecorated. It is recommended that the staff receive training in specific conditions such as Rhett’s Syndrome and diabetes. Church Street Short Breaks DS0000005730.V315306.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Church Street Short Breaks DS0000005730.V315306.R01.S.doc Version 5.2 Page 26 - 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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