Inspection on 22/02/06 for Daniel Close, 16

This inspection was carried out on 22nd February 2006.

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Daniel Close, 16 11/05/07

Daniel Close, 16 18/10/06

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 Debbie Corcoran Unannounced Inspection 22nd February 2006 2:15 Daniel Close, 16 DS0000005243.V286477.R01.S.doc Version 5.1 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.V286477.R01.S.doc Version 5.1 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.V286477.R01.S.doc Version 5.1 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 Ann Theresa Mockler Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Daniel Close, 16 DS0000005243.V286477.R01.S.doc Version 5.1 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. Date of last inspection Brief Description of the Service: 16 Daniel Close is a home registered for three people who have a learning disability. The service provider for this home is Expect and the property is owned by Pier Head Housing Association. Expect Limited is an organisation in the voluntary sector and is a registered charity. The property is located in a Cul de sac in a residential area in Bootle. The home is in keeping with other properties in the area and lends itself to the principles of ordinary community living. 16 Daniel Close is registered for three people, however there are only ever a maximum of two people living at the home, this ensures that service users individual needs and preferences can be met by a staffing ratio of 1- 2 or 1 -1 for part of the week. Daniel Close, 16 DS0000005243.V286477.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over a half day period. The inspector met both of the service users and gained some feedback on the home from these discussions. The inspector met with the one member of staff on duty and examined numerous records including the service user’s care plans, staff training, staff duty records, medication records and health and safety records. What the service does well: What has improved since the last inspection? Two requirements were given following the last inspection and these have been met. These were regarding fire safety checks and electric safety. There continues to be a greater emphasis on supporting the service user with activities outside of the home and community access and this is very pleasing to see. Daniel Close, 16 DS0000005243.V286477.R01.S.doc Version 5.1 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. Daniel Close, 16 DS0000005243.V286477.R01.S.doc Version 5.1 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.V286477.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 5 The home has a statement of purpose and service user guide to provide service users and their representatives with information on the home. An assessment of needs for new service users is attained before they move to the home. Service users have a contract with the home. EVIDENCE: The home has a statement of purpose and service user guide to provide prospective service users with information on the home. The guide includes a good level of information on the home and the services offered. To date this information hasn’t been provided in different formats in line with the needs of the service users. A new service user has moved in to the home since the last inspection. The inspector checked the records for this person and these included an assessment of the person’s needs and a good level of information on how to meet their needs. Each of the service users has a contract with the home. This is a signed agreement stating what the home offers and what might be expected from the service user. The manager should ensure that these are signed by all relevant parties where appropriate. Daniel Close, 16 DS0000005243.V286477.R01.S.doc Version 5.1 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, 9,10 Each service user has a plan of care which clearly reflects their needs and the plans are reviewed and updated regularly. When a service user is involved in an activity involves risks plans are put in place to manage the risk. Confidential information is stored appropriately and staff are aware of their responsibilities in this area. EVIDENCE: Daniel Close, 16 DS0000005243.V286477.R01.S.doc Version 5.1 Page 10 Each of the service users has a care plan which is clear, informative and easy to follow. The plan is reviewed regularly and is kept up to date. The plans include information on service users daily routines, likes and dislikes, skills and needs, a health action plan, weekly activity plan, a finance action plan and a care plan which includes targets for development. When appropriate care plans include guidelines for supporting the service users with their emotions and or behaviours. Along with having a care plan each of the service users also has an ‘Essential Lifestyle Plan’ (ELP). This is a plan which contains detailed information on what is essential to the person to support them successfully and what is important to the person. One of the ELPs which was looked at had been signed as agreed by the service user, members of their family and staff involved in drawing up the plan. Along with the Service user’s care plans being monitored/ reviewed monthly community care reviews are carried out with a representative from the relevant Social Services Department on a yearly basis. Service users and members of their family are invited to these. Where a service user is involved in an activity which is thought to present a risk to the person then the risk is assessed. Plans are then put in place to manage the risk and to ensure that the activity takes place. Risk assessments were viewed and were found to be fairly detailed and reviewed regularly. The home had attained risk assessment information from Social Services for a new service user before they moved in to the home. As at previous inspections all personal or confidential information in the home is kept securely. The home has a confidentiality policy and expectations of staff in terms of confidentiality are also included in the organisations information pack. Daniel Close, 16 DS0000005243.V286477.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15,17 The home works on the principle of ordinary community living and the service users are supported by staff to use local facilities and join in activities of their choice. Service users are choosing what to eat on a daily basis with some guidance and support from staff. EVIDENCE: The service users are being supported in pursuing leisure activities and community access on a regular basis. The service users are also encouraged to be involved in activities within the home and these are very much geared to the service users own choices and interests. Staff support the service users in regular contact with members of their family and in things such as care planning and reviews. One of the service users gave good feedback on their meals and food and said that they choose their food. The home has a four week menu but this is used only as a guide and is not followed strictly. The service users choose their meals on a daily basis and what they have chosen is then recorded. A Daniel Close, 16 DS0000005243.V286477.R01.S.doc Version 5.1 Page 12 separate record is kept for each of the service users. There was a good variety of food available at the home including fresh food. Service users likes, dislikes and needs of food are recorded in their care plan. Staff encourage and support the service users in maintaining a healthy diet whilst also very much respecting their choice. One of the service users is being encouraged to use their independent living skills in food preparation and this should be encouraged as much as possible. Daniel Close, 16 DS0000005243.V286477.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 The service users are supported by a staff team who know their personal care needs and preferences well. The service users are supported in all aspects of their physical and emotional needs. Medication is handled safely and in accordance with policies and procedures. EVIDENCE: The service users are supported by a small staff who know the person’s personal care needs well. Each of the service users has a care plan and this includes information on how to support the service user with personal care. Staff have reported that service users choose times for getting up, going to bed and for when to have assistance with personal care and this was confirmed during discussions with one of the service users Daniel Close, 16 DS0000005243.V286477.R01.S.doc Version 5.1 Page 14 Service user’s personal records contain a record of all health related issues and appointments. These records show that the service users are being regularly supported in attending a range of appointments and in remaining healthy. Service user’s plans include a health action plan. This enables the staff team to readily identify when the most recent annual health checks have taken place and when the target dates are for future checks. More specialist health related professionals are also involved in supporting service users as appropriate. The home has a policy and procedure for the administration of medication. Medication storage and records were checked. The home keeps a record of all medication received and administered and staff carry out a stock check of medication regularly. Medication administration records were examined and found to be completed appropriately. Medication was stored securely in a locked cabinet. The home maintains information on what medication is taken for and on the possible side effects of each of the medications held. Service user’s are supported to have their medication reviewed and staff monitor and report any relevant issues concerned with the service users medication or health. All staff are responsible for the administration of medication and they have received medication training. Daniel Close, 16 DS0000005243.V286477.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this occasion. EVIDENCE: Daniel Close, 16 DS0000005243.V286477.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28, 30 The service users live in a home which is well presented, homely, safe and comfortable. Each of the service users has a nicely presented bedroom which is personalised with their own belongings. The home is presented as clean and hygienic and staff have relevant training in health and safety. EVIDENCE: A tour of the premises was carried out. The home is an ordinary sized domestic property which meets the standard for average living space. A dining room provides space for service users to have some privacy if they so wish. The house is nicely presented and feels relaxed, homely and welcoming. All furnishings and fittings and décor are of a suitable standard across the home and including in the service user’s bedroom. One of the service users said that they were happy with all aspects of the home and felt that it is a nice house. The home was presented as clean and hygienic. Policies and procedures are in place in relation to; health and safety, control of infection, contaminated laundry, protective clothing, Legionnaires disease and food safety and hygiene and staff have been provided with training in many of these topics. Daniel Close, 16 DS0000005243.V286477.R01.S.doc Version 5.1 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, 35, 36 The service users benefit from the support of a small well established staff team who have a good knowledge of their needs. Staff training opportunities are good and in line with the needs of the service users. EVIDENCE: The service user are supported by a small staff team. There is one member of staff at the home 24 hours per day and there is additional staffing each day to meet the needs of the service users and ensure that each service user has some one to one support. The level of this additional support needs to be reviewed by the manager to ensure it is in line with the assessed needs of the service users. One of the service users gave good feedback on the staff team and on all aspects of their care and support. The level of staff training is generally very good and in line with the needs of the service users. Staff have been provided with training in health and safety topics, fire safety and food hygiene. All staff have received mental health awareness training, medication training and adult protection training. Records indicate that staff team meetings are taking place on a regular basis, and a member of staff said that they are receiving regular supervision and have an annual appraisal of their work. Daniel Close, 16 DS0000005243.V286477.R01.S.doc Version 5.1 Page 18 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, 41, 42 Service users live in a well run, well organised home. The quality of the service is monitored at regular intervals. Procedures and practices are in place which aim to safeguard and protect the well being of service users and staff. Records are well maintained, up to date and stored appropriately. EVIDENCE: The home is well run and managed effectively and any service development is in the best interests of the service users and in ensuring a good quality of service is provided. The manager has applied for registration with the Commission and this application is being processed. There are a number of systems in place for checking on the quality of the service provided at the home. There was evidence that six monthly audits take place by a senior manager in Expect. The home is visited monthly, on an unannounced basis, by a member of the management team of Expect. Reports on these visits are forwarded to the Commission. The home has a business / service plan for 05/06. One of the service users has been included in a survey Daniel Close, 16 DS0000005243.V286477.R01.S.doc Version 5.1 Page 19 on the quality of the service and the results from this along with other service users from across the organisation have been published. All information relating to service users is maintained confidentially and securely in line with the Data Protection Act 1998 and staff are aware of their responsibilities in maintaining confidentiality. A record of all complaints, accidents and incidents is maintained. All records are well constructed, clear and up to date. The home has a number of policies and procedures in place and practices adopted aimed at ensuring the safety of service users and staff and these include policies and/or training on health and safety, first aid, fire safety, food hygiene, moving and handling, medication, COSHH, control of infection. Fire safety checks were examined and found to be up to date. Gas and electricity certificates were examined and were in date. Water temperatures are regulated and checked and records of these checks were evidenced to be up to date. The temperature was checked and found to be safe. A risk assessment has been carried out in relation to safe working practices, the environment and activities undertaken by service users and staff. Daniel Close, 16 DS0000005243.V286477.R01.S.doc Version 5.1 Page 20 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 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 x 28 3 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 2 34 x 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 x x 3 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x 3 3 x Daniel Close, 16 DS0000005243.V286477.R01.S.doc Version 5.1 Page 21 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 YA33 Regulation 18 (1) (a) Requirement The registered person must review the staffing levels to ensure they are sufficient to meet the assessed needs of the service users. Timescale for action 22/03/06 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 YA1 Good Practice Recommendations The home should look to develop information in alternative formats in line with the needs of service users. Daniel Close, 16 DS0000005243.V286477.R01.S.doc Version 5.1 Page 22 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.V286477.R01.S.doc Version 5.1 Page 23 - 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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