Inspection on 31/07/07 for Clare Walk, 3

This inspection was carried out on 31st July 2007.

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

Clare Walk, 3 16/06/06

Clare Walk, 3 25/10/05

Clare Walk, 3 05/05/05

Clare Walk, 3 12/10/04

Clare Walk, 3 04/05/04

Clare Walk, 3 02/02/04

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 Clare Walk, 3 3 Clare Walk Fazakerley Liverpool Merseyside L10 4YG Lead Inspector Mrs Janet Marshall Key Unannounced Inspection 31st July 2007 09:30 Clare Walk, 3 DS0000021519.V341450.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 Clare Walk, 3 DS0000021519.V341450.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. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Clare Walk, 3 Address 3 Clare Walk Fazakerley Liverpool Merseyside L10 4YG 0151-523-5402 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) Clare Care Mrs Valerie Lee Yong Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 3 LD The service should employ a suitably qualified and experienced manager who is registered with the CSCI 16th June 2006 Date of last inspection Brief Description of the Service: 3 Clare Walk is an extended four-bedroom town house located in a popular residential area of Fazakerley. The home is registered as a care home for up to three people with a learning disability. Currently there are two women in residence. The home is located close to local amenities and public transport. An extension on the ground floor of the property provides a bedroom and ensuite, which is occupied by one resident. Another resident occupies one of two registered bedrooms on the first floor of the home. The smallest bedroom on the first floor of the home is used as an office. Shared rooms on the ground floor include a lounge and a kitchen/diner. There is a garden at the front of the house and a good sized yard at the back. 3 Clare Walk is part of a company called Clare Care that is owned by Mr Liam Allmark. The newly appointed manager of the home is Lisa Smith. It costs £754.00 per week to live at the home. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection. The Commission considers 22 standards for Care Homes for Adults as Key Standards, which have to be inspected during a Key Inspection. The report has been put together using information gathered from a number of sources including information that the commission have received about the service since the last inspection, results of surveys which the Commission sent out to people and details provided in the Annual Quality Assurance Assessment (AQAA). The AQAA, which is in two parts, a self-assessment and dataset, has replaced the pre-inspection questionnaire. The document, which is sent out to, the service has to be completed and returned to the commission before an inspection takes place. The inspection also involved an unannounced visit to the home (site visit). Records that were examined, people’s comments and observations made during the visit have also been used as evidence for the report. Two residents were Case tracked during the site visit this involves talking to people and looking at residents records such as assessments, care plans and daily notes to make sure that they are receiving the care and support that they need and have agreed to. The manager Lisa Smith was present and assisted for part of the inspection. Mr David Ash the responsible individual who was visiting the home at the time of the inspected and also assisted. What the service does well: Before moving in people are given information about the home and other opportunities to help them decide if it is the right place for them to live. An individual care plan was in place for each person. The documents clearly set out how staff need to meet the persons health, personal, and social care needs enabling them to live independent, healthy and enjoyable lifestyles. Staff communicate very well with residents who have limited verbal communication skills they do this by use of other methods such as sign language, gestures and body language. Residents are encouraged and supported to make choices and decisions as part of their everyday life. All staff have undertaken specialist training to help them communicate with residents more effectively. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 6 During the inspection visit staff were observed treating residents with respect and carrying out personal care in a flexible and sensitive way. Resident’s surveys show that staff respect their privacy. One resident agreed that staff are always polite and treat them well. The home has in place appropriate procedures for responding to concerns and complaints and for ensuring that residents are safe from abuse, harm or neglect. The commission have not received any complaints about the home since the last inspection. Everybody spoken with during the inspection said that they understand the homes complaints procedure and now how to make a complaint if they needed to. People knew who to talk to if they were unhappy about something and were confident that their complaints would be listened to and dealt with in the correct way. More than half of the staff team have achieved or are working towards a National Vocational Qualification in Care level 2 and above. Staff are involved in an ongoing programme of training, which is relevant to the work that they carry out. The newly appointed manager showed great enthusiasm for ensuring high standards of care, she also showed a commitment to the training and development that is required of her to maintain and update her knowledge, skills and competence while managing the home. What has improved since the last inspection? What they could do better: Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 7 Initial assessments must be obtained prior to admitting new residents to ensure that the person’s needs can be fully met at the home. Residents should be given the opportunity to take part in shopping for food so that their rights and independence is recognised, respected and fully promoted. Details of medication and instructions for use, which are hand written by staff on Medication Administration Record (MAR) sheets should be checked and signed by two people to ensure that the written information is correct. The manager must obtain a satisfactory Criminal Records Bureau (CRB) check for all new staff before they are allowed to work at the home to ensure the full protection of residents. Induction records for new staff should be kept at the home to show that staff have completed induction training, which is relevant to the work that they do. 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. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 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 Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 4 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Before moving in people are given information about the home and opportunities to help them make a positive decision about living there, however not all the relevant assessment information was obtained before admission so there was a risk that the residents needs would not be fully met. EVIDENCE: The AQAA showed that one new resident has been admitted to the home since the last inspection. The resident who was met with during the site visit said that they visited the home on a number of occasions before deciding to move in. The resident confirmed that during the visits they met with the other residents, stayed for a meal, was shown around shared parts of the home and viewed the bedroom which they would be occupying. The resident also confirmed that they were given information about the home. Two of the residents personal files contained copies of initial assessments carried out by social workers prior to their admission to the home, however there were no initial assessments from a social worker for the newly admitted Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 10 resident. A care plan, which has been developed for the resident was based on information, received from other people including family, friends, day care services and the resident themselves. The provider was advised that before admitting a new resident the manager must obtain a copy of a needs assessment carried out by the care management team (health and social services) or were appropriate an assessment carried out by a qualified person on behalf of the home. Results of resident’s surveys showed that they all like living at the home. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 11 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): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual plans of care, which are in place, ensure that staff have the information they need to support residents to live independent and safe lives. EVIDENCE: Each resident had a care plan. Residents are given a choice about were their care plans are kept within the home. They can choose to have them locked away in the office or in a locked cabinet in there own bedroom. A statement showing the choice they have made was available in each of their personal files. All care plans were looked at in detail as part of the case tracking process. They covered all aspects of each person’s personal and social support such personal care, independent living skills, accessing the community, relationships, finances and a personal development plan. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 12 Care plans also included a section about the person’s healthcare needs and how they need to be supported by staff. There was information to show that care plans have been reviewed and updated at regular intervals. Care plans were signed and dated by residents to show that they were involved in putting them together and reviewing them. This was also confirmed during conversation with one resident. All the residents that live at the home have limited verbal communication skills however they are able to communicate clearly in other ways such as by use of makaton sign language, body language, sounds and gestures. Care plans detailed each persons preferred methods of communication. Staff was seen communicating with each of the residents by use of these methods. On the day of the visit residents made choices and decisions about such things as what to eat and what activities they took part in. Resident’s surveys showed that they are all involved in making decisions in their home. All of the residents took an active part in the inspection, they communicated their views, opinions and experiences by use of makaton signing, sounds, body language and gestures. Staff have undertaken training in makaton sign language levels 1 & 2, which enable them to communicate effectively with residents. Due to limitations some residents are unable to manage their own finances. In these situations appropriate support and guidance is given by staff. Financial support that residents need was recorded in their individual plan of care. Residents money and financial records that were examined were well kept and in good order. Residents had a bank account in their own name and address. Statements and records of all transactions made were available at the home. A resident confirmed that they spend their money on the things that they like. For safety reasons there are certain restrictions placed on residents for example access without support to certain parts of the home and the community. There are also instances when some decisions and choices have to be made for residents by others. Restrictions placed upon people and choices, which need to be made by others and the reasons why, were recorded in the individual’s plan of care. Risk assessments were part of each persons care plan. They have been carried out for tasks and activities which residents are involved in that are Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 13 likely to pose a risk to them. Risk assessments that were seen identified potential risks and hazards and detailed the action that staff need to take so that residents are able to take risks safely as part of an independent lifestyle. Risk assessments that were viewed showed that they have recently been reviewed and updated. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 14 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): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s lead active and enjoyable lifestyles, however, more involvement in some activities would further promote their independence. EVIDENCE: Care plans provided information about the kind of things that residents like to do both at home and in the community. Discussion with residents and examination of a selection of daily records showed that residents are provided with a lot of opportunities to do the things that they prefer at home such as watching television, listening to music, art and craft, general cleaning and social gatherings. Displayed around the home were a number of drawings and paintings made by residents. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 15 Staff support residents to plan for outdoor activities. A form called an Activity Planner is completed for planned activities or events. This process enables residents to be fully involved from the beginning in planning their chosen activity. As part of the planning the resident decides about things such as were to go, when, the cost and arranging transport. A selection of activity plans, which were viewed, showed that residents have been to various places throughout the region for example cinemas, libraries, parties, shops, country walks and lunches out. However, recently residents involvement in outdoor activities has reduced significantly because a social support worker who was employed at the home left several weeks ago and has not been replaced. The workers role was to provide residents with the support they need to help them get out and about. The registered provider acknowledged this was an issue and said the manager is in the process of recruiting a replacement social support worker. Two residents attend day care for part of the week. They both confirmed that they enjoy the day care services, which they attend. On the other days of the week and at weekends all residents are supported by staff to pursue their interests and hobbies as well as helping with general routines around the home. On the day of the visit residents were seen polishing furniture, vacuuming and preparing drinks and snacks. One resident confirmed that she regularly helps with the general cleaning of the home and her own bedroom. Discussion took place with staff about ways they could support another resident who is less willing to help with domestic tasks. Following assessments and were appropriate residents are provided with locks to their bedroom doors. Each of the residents had a lockable facility in their bedrooms. One resident confirmed that she had a key to her cabinet. The visitor’s book showed that residents receive visitors at home. Residents are encouraged to maintain contact with family and friends and personal relationships are respected and appropriately supported by staff at the home. Menus which where viewed at the home showed a variety of healthy meals. Staff explained that the menus could be changed if residents request it. Staff showed a good awareness of the importance of nutritious and balanced diets. Records showed that staff have undertaken training in food hygiene. The dining table, which is situated at the end of the kitchen, is mostly used by residents at meals times, however some meals and snacks are taken into the lounge. On the day of the visit one resident chose to eat her lunch in the lounge whilst others sat at the dining table. Resident’s surveys showed that they all like the food at the home. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 16 A good stock of fresh, frozen and tinned food was seen at the home. There were also sufficient crockery, cutlery pots and pans, which were of good quality. There was a fridge, freezer washing machine and microwave which were all of a domestic style and in good condition. The provider explained that there are plans to refurbish the kitchen in the near future. A member of staff confirmed that residents are not always involved in the main weekly shop for food. Although they do shop for daily essentials such as fresh bread and milk. It was confirmed that a member of staff is responsible for this the main food shop and residents are asked to make a list of the food that they want. This was discussed with two residents who stated that they would like to be involved in the weekly shop for their food. The provider agreed to discuss this with the manager and staff and advise them to ensure that residents are given the opportunity to take part in shopping for food so that their rights and independence is recognised, respected and fully promoted. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 17 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): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s health and personal care needs are well recorded and monitored to ensure they stay healthy. Procedures for recording medication should be more robust to eliminate potential risks to resident’s health. EVIDENCE: Care plans provided detailed information about the type and level of personal and healthcare support that each person requires. The persons preferred routines with regards to personal care were also available in very good detail. Information was available in a way, which ensures residents privacy, dignity and independence. Staff were seen providing personal support for one resident. They were seen treating the resident with respect by ensuring that the care was carried out in private. During discussion a member of staff showed that they provide sensitive and flexible personal support to residents ensuring their privacy and dignity. The member of staff made the following comments, which supported this: “I always make sure doors and blinds are shut”. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 18 “I always talk to residents when helping them and explain what I am doing”. Care plans clearly set out the person’s healthcare, needs and procedures that are in place to address them. Records within this section showed that residents are offered minimum annual checks and that there health is regularly reviewed and monitored and dealt with appropriately. As well as visits to primary healthcare services such as dentist, opticians and doctors residents are also supported to attend specialist services. Records of the visits were available in good detail as was information about specialist health care needs and requirements. During this inspection visit all medication and medication administration records were examined. Medication and records were stored securly. Instructions for some items of medication were hand written by a member of staff on one residents medication record sheet (MAR). The member of staff on duty at the time of the visit was advised that details of medication and instructions for use which are hand written on MAR sheets by staff should be checked and signed by two people so that they can be sure the information is correct. The member of staff said that medication is only administered by staff that have completed medication awareness training. discussion with staff and records that were seen evidenced this. A policy for the safe handling and administration of medication was availble at the home. A member of staff showed a good awareness of the homes medication polices and procedures. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 19 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): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have the information they need so that they can a complaint if they need to. EVIDENCE: Records held by the Commission show that they have not received any concerns, allegations or complaints about the home since the last inspection. The AQAA showed that there have been no complaints at the home. A requirement was given as part of the last inspection for the complaints procedure to be developed. This was because the homes complaints procedure, which was viewed at the time, was only available in written format and did not provide people with enough details about how to make a complaint. The complaints procedure, which was viewed during this visit, has been developed. It was available in written and picture format and was more detailed so that people have all the information they need if they wish to make a complaint. One resident confirmed that they understand the complaints procedure. The resident stated that they would make a complaint if they were unhappy about something at the home. Resident’s surveys showed that they all know who to speak to if they are unhappy. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 20 Results of surveys and discussion with residents showed that they are confident about telling somebody if they were uphappy. A copy of Knowsleys Local Authorities Protection of Vulnerable Adults procedure was avaialbe at the home. The provcider confirmed that all staff have undertaken Protection of Vulnerable Adults training. Certificates of attendance confirmed this. Staff training plans records showed that future training for staff includes refreher courses in this subject. During discussion a member of staff showed a good awareness of what to do if they suspected abuse was taking place or if an allegation of abuse was reported to them. Viewed at the home and detailed in the AQAA were a number of other policies and documents which provide staff with information, advice and guidance about the protection of residents. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 21 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): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in an environment, which is homely, clean safe and comfortable. EVIDENCE: The home is an extended four-bedroom town house located in a popular residential area of Fazakerley Liverpool and is close to public transport links such as trains and buses. The house is in keeping with others in the neighbourhood and does not stand out as a care home. An extension on the ground floor provides a large bedroom with en-suite facilities for one resident. The other residents each have a single bedroom on the first floor. The fourth bedroom also on the first floor doubles up as the office and staff bedroom. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 22 The premises are fitted with a number of aids and adaptations making it fully accessible to all residents. Equipment included, handrails, bath aids and easy to reach electrical sockets and switches. Since the last inspection some furniture has been replaced and some parts of the home have been redecorated making it more comfortable for residents. New furniture included a new dining set for the kitchen/diner and two new leather sofas for the lounge. One resident’s bedroom and en-suite bathroom have been refurbished. The resident confirmed that they were fully involved in choosing colour schemes and fittings for their rooms. Another resident said that they helped choose the furniture for the shared rooms in the house. There is a good-sized open plan lawn with planted borders at the front of the house and a yard with potted plants at the back. One resident confirmed that they enjoy pottering around the garden when they feel like it. Residents and staff were welcoming and there was a warm and friendly atmosphere at the home. A tour of the home was carried out as part of the inspection visit. One resident’s comfort was compromised, as they did not have a lampshade or a headboard in their room. This was discussed with the provider who said he would ensure the items were provided. All parts of the home were clean and tidy on the day of the visit and there were no hazards identified. Resident’s surveys showed that they all feel safe at the home. Discussion with staff and residents showed that residents help to keep their home clean and tidy. Cleaning routines and the people responsible for carrying them were in place. Detailed in the AQAA were a number of policies and procedures for ensuring a clean and hygienic environment for all. Related policies and procedures, which were also seen at the home included, Infection control, the use of protective clothing and disposal of waste. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 23 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): 32, 33, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff receive a good level of training which enables them to meet the stated purpose of the home and the needs of the residents, however, recruitment procedures are not as robust as they need to be putting the protection of residents at risk. EVIDENCE: Discussion with the manager and details provided in the AQAA showed that two staff members have left the home and one new member of staff has started since the last inspection. A Personnel file for the new staff member was viewed. The file contained a fully completed application form, 2 references identification, a CRB check and training records. The CRB check was from a previous employer so was not valid for this employment. The registered provider was advised that the manager must apply and obtain a CRB check for all new staff in the name of the company before they are allowed to start work at the home. This is required to make sure that the person is suitable for the job. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 24 An equal opportunities policy and procedure was available at the home. Records viewed and information provided in the AQAA showed that staff of various age, gender, culture and religion are recruited at the home. The manager and a support worker were on duty at the time of the site visit. The registered provider visited the home and assisted with the inspection in place of the manager who was supporting a resident on a medical appointment. Copies of staffing rotas were viewed. They showed that there is a minimum of two staff on duty through out the day and one staff that sleeps in during the night. Examination of records and discussion with staff and residents showed that there are not always enough staff on duty to support residents to go out into the community. This was discussed with the provider who said that the manager was in the process of recruiting new staff to increase the numbers on duty during the day so that residents are given with more opportunities to access the community. At intervals throughout the visit staff were seen interacting well with residents. They were flexible and positive in their approach and appeared to have a good understanding of the needs of the residents. Residents spoken with all indicated that they liked all the staff at the home. Resident’s surveys showed that all residents feel well cared for and are treated well by the staff. Discussion with staff showed that they are interested, motivated and committed to their work. Comments made by staff which supported this included: “I really enjoy working here job”. “I enjoy the training”. “I get on well with the residents and other staff which I think is important ”. A new member of staff said that she had completed an induction programme at the start of her employment. She said that the induction lasted for a couple of weeks and covered areas such as the management structure of the company, workers roles and responsibilities, policies and procedures and emergency procedures. The worker also said that she was on shift with a senior member of staff throughout their induction. There were no induction records available at the home. The provider was advised of this and the need to ensure that they are kept and available for inspection to show that all new staff have followed an induction programme linked to the aims and objectives of the home and the needs of the residents. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 25 Each member of staff had a training and development plan which listed training they have completed and future training needs. These records and discussion with a member of staff showed that staff have completed the following training: fire awareness, first aid, health and safety, protection of vulnerable adults, learning disability awareness, medication awareness and makaton sign language level 1 & 2. At least than half of the staff group have achieved or are in the process of a National Vocational Qualification (NVQ) in care level 2 or above. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 26 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): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed to the benefit of the residents and staff. EVIDENCE: Since the last inspection Mr David Ash has replaced Mr Liam Allmark as the Responsible individual of the service. Mr Allmark is still a part owner of Clare Care. A certificate showing the new details was displayed at the home. Also since the last inspection Mrs Valerie Ye Yong has resigned as the registered manager of the home. Lisa Smith is the newly appointed manager. Records held by the commission show that they were notified of this change. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 27 Miss Smith has obtained, completed and forwarded on to the Commission an application for her approval as the Registered manager of the home and her application is currently being processed. Prior to becoming the manager Miss Smith worked at the home for a number of years as a senior support worker. During her time as a senior support worker Miss Smith gained some managerial experience including supervision of staff and decision making. The manager has commenced the Registered Managers Award and NVQ Level 4 in care. Discussion with the manager and examination of her personal file evidenced that she undertakes regular training and development to update her knowledge, skills and competence while managing the home. The requirements and recommendations given as part of the last key inspection were discussed and examined during the site visit. This showed that since her appointment the manager has addressed most of them to a good standard. During discussion the manager showed a good understanding of her role and knowledge of the residents. Staff at the home made the following comments about the manager: “The manager is fantastic” “She is approachable and positive” “She is very understanding and listens patiently to what people have to say” At the last key inspection there was evidence to show that residents, relatives and advocates were invited to complete surveys as part of the homes quality monitoring processes. This gave people the opportunity to put forward their views and make comments about aspects of the service for example, the manager and staff, the quality and choice of food, and the environment. No surveys have been given out since the last key inspection the registered provider was advised to do this so that people are given the opportunity to put forward their views about the quality of the service. As part of the homes quality assurance process and in accordance with Regulation 26 of the Care Homes Regulations a representative for the home must visit the premises monthly. They are required to interview residents and staff, check records and inspect the environment. It is important that this is done to check the standard of care in the home. Following the visit a report must be written detailing the visit. Previous inspections evidenced that the visits were taking place but the reports were not being produced. During this inspection the provider produced a number of reports detailing monthly provider visits, which he has carried out over the last several months. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 28 A requirement was given as part of the last key inspection because there were a number of required policies and procedures unavailable and others which needed to be developed. This had the potential to compromised the best interests and rights of the residents The AQAA document and examination of the homes policy file showed that all the required policies and procedures have since been put in place. The health safety and welfare of residents are well protected this was supported by a set of policies and procedures, which were detailed in the AQAA and available at the home. Information provided in the AQAA and examination of a selection of health and safety records showed that the required health and safety checks have been carried out on the environment at the required intervals, for example fire system checks, gas and electricity checks and environmental risk assessments. Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 29 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 2 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 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 1 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 2 14 X 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 30 Are there any outstanding requirements from the last inspection? No 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 YA2 Regulation 14(1)(a) Requirement Appropriate assessments must be obtained before admitting a new resident to the home to be sure that their needs will be fully met. Staff must not start work at the home until a CRB check has been obtained and shows that the person is fit to work at the home. Timescale for action 31/08/07 2. YA34 19(1)(b) 31/08/07 Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 31 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 YA16 Good Practice Recommendations Residents should be given the opportunity to take part in shopping for food so that their rights and independence is recognised, respected and fully promoted. Details of medication and Instructions for use which are hand written by staff on Medication administration record (MAR) sheets should be checked and signed by two people to ensure that the written information is correct. 3. YA34 Induction records for new staff should be kept at the home to show that staff have completed induction training, which is relevant to the work that they do. Sufficient numbers of staff should be on duty to meet the needs of residents. 2. YA20 4. YA33 Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Merseyside Area Office 2nd Floor, South Wing Burlington House Crosby Road North Waterloo L22 0LG 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 Clare Walk, 3 DS0000021519.V341450.R01.S.doc Version 5.2 Page 33 - 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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