Inspection on 18/10/06 for Daniel Close, 16

This inspection was carried out on 18th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Daniel Close, 16 11/05/07

Daniel Close, 16 22/02/06

Daniel Close, 16 05/10/05

Daniel Close, 16 09/03/05

Daniel Close, 16 21/04/04

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 Daniel Close, 16 16 Daniel Close Bootle Liverpool Merseyside L20 4UJ Lead Inspector Ms Lorraine Farrar Unannounced Inspection 18th October 2006 02:00 Daniel Close, 16 DS0000005243.V304816.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 Daniel Close, 16 DS0000005243.V304816.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. Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Daniel Close, 16 Address 16 Daniel Close Bootle Liverpool Merseyside L20 4UJ 0151 933 7791 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) Expect Limited Mrs Eleanor Dowling Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to included up to 3 LD The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 22nd February 2006 Date of last inspection Brief Description of the Service: The home is registered to support up to three adults who have a learning disability, however in practice a maximum of two people live there, which provides both with more privacy and access to staff time. Expect LTD run the home, they are a local organisation who support people who have a learning disability or who need support with their mental health. 16 Daniel Close is a semi-detached house in a residential area of Bootle. The house is similar in style to other family properties nearby and is well located for getting to local shops, facilities and public transport. There are three single bedrooms, two lounges and an enclosed back garden with limited car parking available. There is one member of staff in the home 24 hours a day, at night this member of staff sleeps in. During the week there is sometimes an extra member of staff working for several hours a day, giving Service Users the opportunity to get out and about if they wish. Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Information for this inspection was gathered in a number of different ways. This included an unannounced site visit where time was spent reading records, meeting with Residents and Staff, observing life in the home and looking at the building. ‘Case tracking’ was used as part of the visit. This involves looking at the support a person gets from the home including their care plans, medication, money and bedroom, time is also spent meeting with the Residents and with Staff about how they meet the persons needs. Case tracking was used to look at life in the home for both of the people living there. Discussion took place with 1 Resident, 2 Visitors and a member of staff. In addition comment cards were sent out before the visit, 1 Resident returned a card and their views are incorporated within this report. The Manager was given the opportunity to provide information about the service prior to the inspection. This information and any other relevant information the CSCI has received about the home, since the last full inspection in February 2006, is included within this report. Fees for living in the home are £318 per week. What the service does well: This was a positive inspection with the home meeting national standards for supporting adults with a learning disability. Staff have a good understanding of Service users individual needs and of their choices. These are recorded in their care plans and followed by the staff team. Overall the home appears as an ordinary family style home and the atmosphere is relaxed and friendly. Service Users choose how to spend their time and treat the place as their home. Staff spend time with Service Users, including going out and about and spending time at home involved in household tasks and activities of their choice. There is enough space and staff working in the home for Service Users to have privacy and 1-1 support. Staff are well supported, receiving training and information to help them support Service Users effectively. The home is well managed and organised with regular checks carried out to make sure they are providing a good service. Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Daniel Close, 16 DS0000005243.V304816.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 Daniel Close, 16 DS0000005243.V304816.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Staff work with Service Users to identify their support needs and choices and make sure these can be met. EVIDENCE: No new Service Users have moved into the home since the last inspection. However there are clear polices on how to introduce new people to the service and how to assess their needs to make sure they can be met. This had been carried out for the last person who moved in. An assessment for the other Service User, who has lived in the home for some time had been updated in the past twelve months. These assessments help Staff to identity the persons support needs and any changes to them. They also help staff plan how to meet the person’s needs taking into account their choices and lifestyle. Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 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 & 9 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users individual needs and choices are clearly identified and met within the home. EVIDENCE: Full care plans are in place for both of the people living at Daniel Close. These state that they were written with the Service User, Relatives and Staff and a Service User explained she “did it with Mum and Dad”. Plans are up to date with regular reviews taking place and changes recorded. They give clear information about the person, their likes and dislikes, the support they need and how to support then in the way that they prefer and that is safe. This includes information about the person’s personal care, healthcare, how they communicate and how they like to manage their money. During the visit Staff were seen to follow guidelines written in the plans and Service Users were spending their time as plans stated they preferred. A service User explained “I am quite happy” and that “I decide when to get up and go to bed”. Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 Page 10 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): 12, 13, 15, 16 & 17 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service Users are able to live the life style they choose and engage in activities of their choice. EVIDENCE: A Service User and her Visitors explained that she goes out with Staff but likes to spend time at home with her hobbies and that visitors are welcomed at any time. The lounge was seen to be well stocked with a variety of activities including, novels, TV and arts and crafts. The other Service Users plan stated that she liked to get out and about. Records for the previous week showed she had been engaged in a number of different activities. These included, visiting Mum with Staff, shopping, gardening, housework, eating out and listening to music. One Service User said in her comment card that she would like to get out and about in the car more. The home does not provide transport and not all staff have or are able to use their own car for this purpose. Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 Page 11 However records showed that Service Users are supported to go out using public transport if they wish. During the visit Service Users were engaged in a number of different activities, including, entertaining visitors, reading and talking with Staff. The member of Staff communicated differently with each Service User, according to their needs. She spent a lot of time engaged with Service Users, explaining things and engaging them in basic decisions such as what to eat for tea. As there are two lounges in the home, both Service Users can choose to spend their time on different activities and have some privacy, this was seen to work well during the visit. A Service User described the meals as “okay” and individual menu sheets showed that a variety of meals are offered. The kitchen was well stocked with a variety of food and Staff responded positively to requests for a drink. The menu sheets for one Service User recorded only four portions of fruit and vegetables offered over a two day period, which does not meet current guidance for healthy eating. This was discussed with the Manager at a later date, who said that she had begun monitoring this and making sure more fruit and vegetables were offered. Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 Page 12 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 & 20 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service Users health and personal care needs are met. EVIDENCE: Care plans contain detailed information about how to support the person with their physical and mental health and personal care. For example one plan records that the person likes a hot drink and something to eat before going to bed and gives clear guidance on how to support them with their mental health. A yearly planner records the dates the person had regular healthcare checks such as the Optician and Dentist, records confirmed that Service Users are supported to attend these appointments and the outcome. If they do not wish to attend, their wishes are also recorded. Information about how the person’s health has been in the past month is recorded as part of the monthly care plan review. This is good practice and helps to ensure Service Users are having their healthcare checked regularly and any issues are identified and dealt with. Daily records for Service Users showed that they get up and go to bed at different times and receive the personal care they need. This was confirmed in discussion with a Service User. Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 Page 13 An entry in one daily record stated, “hair washed, creamed, teeth cleaned, breakfast and meds given, no problems”. During the visit the member of Staff interacted with Service Users throughout and spoke respectfully with them. However this method of recording is impersonal and should be reviewed by the Manager. Records and storage of medication was checked for both Service Users. There is suitable, locked storage provided and records of medication received and given were up to date and tallied with the medication held in the home. Details about what the medication is for and any side effects is readily available and in discussion with a member of Staff, she was able to explain this information. Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The quality in this outcome area is average. This judgement has been made using available evidence, including a visit to this service. Service Users know what to do if they are unhappy and there are policies and procedures in place to protect them. EVIDENCE: In her comment card, a Service User confirmed that she knows who to speak to if unhappy and stated, “tell the staff” if she wished to make a complaint. Her care plan records that Staff have talked to her about their complaints procedure. No complaints or concerns about 16 Daniel Close have been raised since the last key inspection of the service. There are polices and procedures in place for dealing with complaints and for reporting allegations of abuse under the Local Authority Adult Protection procedures and records show that Staff have had training in this area. There are also polices in place for managing Service users monies and these were being followed during the site visit. Money held in the home for both Service Users was checked, this was clearly recorded, with receipts held and amounts matching records. Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 28, 30 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service Users live in a home, which is, comfortable, clean, well presented and safe. EVIDENCE: 16 Daniel Close is an ordinary house in a residential area of Bootle. Both inside and outside it has the appearance of a family home and is nicely presented, appearing warm and comfortable throughout. There is enough room inside for Service Users, Visitors and Staff and an enclosed back garden and limited parking outside. Upstairs each Service User has their own bedroom, which has been individually decorated and furnished. There is a small study and a sleep in room for staff. The household bathroom provides a bath with overhead shower. Downstairs there is a domestic kitchen and two rooms, one of which has a TV, activities, suite and dining table. The member of Staff explained that they have recently changed the second room to another lounge so that both Service Users can have some privacy and take part in different activities and this was seen to work well during the visit. Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 Page 16 A Service Users Relative explained, “they keep up with the place” and all areas were clean, well maintained and decorated. There is a cleaning schedule in place, which was filled in to show when household tasks had been carried out and records showed that Service Users are as involved as possible in this work. Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 & 35 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service Users are supported by a well established Staff Team who have a good knowledge of their needs and how to meet them. EVIDENCE: In their comment card one Service User, said Staff always treat them well and usually listen and act on what they say, commenting, “the Staff are nice”. There are four Staff who work in the home permanently, most of whom hold a qualification in care. They have also had training in specific areas such as medication and supporting people when they become upset. This helps to make sure Staff know about and can meet Service Users individual needs. There is a member of Staff in the home 24 hours a day, at night this person sleeps in, however records showed that if a Service User wakes during the night Staff provide support. Several days a week there is another member of Staff for part of the day, and records showed that this gives Service Users the chance to spend some time alone with Staff, taking part in activities they enjoy. Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 Page 18 Regular Staff meetings are held, these cover different subjects, including, Service Users, health and safety and the quality of the service and help to make sure all Staff are fully aware of what is happening in the home. Staff files showed that the organisation follow good practices for recruiting new Staff, including carrying out checks such as police checks and references. This helps to make sure any new Staff are suitable to work with Service Users. Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users live in a well managed and safe home. EVIDENCE: The Registered Manager of the home is Ms Eleanor Dowling. She has qualifications in care and management and is experienced in supporting adults with learning disabilities. Records in the home showed that Ms Dowling undertakes regular training to keep up to date and improve her knowledge, she is currently working towards a qualification in supporting people with their mental health. The home and organisation check the quality of the service they provide regularly. This is carried out in a number of different ways such as, regular care plan reviews, staff meetings, regular unannounced visits by a Manager from the organisation and a yearly audit of the service. The last audit was in September 2006 and did not identify any significant issues. This audit included, meeting with Service Users and Staff and discussing the service with Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 Page 20 Relatives of Service users. These different methods of checking the service help to make sure that everyone’s views are taken into account and that any issues are quickly identified and acted upon. Records and certificates showed that regular health and safety checks are carried out on the environment, to make sure it is safe. This includes, testing the fire system, main electrics and the temperature of hot water. Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 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 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 Page 22 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. 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. 1. 2. Refer to Standard YA17 YA19 Good Practice Recommendations The Registered Manager should monitor the meals offered to Service Users to ensure they are offered a healthy diet. The Registered Manager should review the wording used in daily records to ensure it is written respectfully. Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Daniel Close, 16 DS0000005243.V304816.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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