Inspection on 05/10/05 for Daniel Close, 16

This inspection was carried out on 5th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Daniel Close, 16 11/05/07

Daniel Close, 16 18/10/06

Daniel Close, 16 22/02/06

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 5th October 2005 2.00 Daniel Close, 16 DS0000005243.V261379.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Daniel Close, 16 DS0000005243.V261379.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Daniel Close, 16 DS0000005243.V261379.R01.S.doc Version 5.0 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.V261379.R01.S.doc Version 5.0 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. 9.03.2005 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. 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. At the time of this inspection there was only one service user living at the home. Daniel Close, 16 DS0000005243.V261379.R01.S.doc Version 5.0 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 with the service user but was unable to gain a great deal of feedback on the home on this occasion. The inspector met with the member of staff on duty and examined numerous records including the service user’s care plan, staff training records, staff duty records, medication records and health and safety records. What the service does well: What has improved since the last inspection? Since the previous inspection the service user is being encouraged more use and develop some of their independent living skills and this is being done in line with the needs of the service user. There has also been a greater emphasis on supporting the service user with activities outside of the home and community access and this is very pleasing to see. The home has developed the process for reviewing service user’s care and support to include a representative from Social Services and personal representatives of the service user. Daniel Close, 16 DS0000005243.V261379.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Daniel Close, 16 DS0000005243.V261379.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Daniel Close, 16 DS0000005243.V261379.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 The home has a statement of purpose and service user guide to provide service users and their representatives with information on the home. To date this hasn’t been provided in different formats in line with the needs of the service users. The service provided is meeting the needs of the service user. EVIDENCE: There is a good information pack at the home which includes information on the philosophy of care and aims and objectives of the home, the services and facilities provided, qualifications and experience of the staff team, a policy on the rights of service users and a complaints notice and leaflet. This pack includes a service user guide, however this information should be made more accessible as appropriate to the needs of the service users. The service provided at the home is centred around the needs of the service user. There is currently only one service user living at the home. Records and discussions with staff indicate that staff are clearly aware of the needs of the service user and have appropriate training and support. Daniel Close, 16 DS0000005243.V261379.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9, 10 The service user has a plan of care which clearly reflects their needs and the plan has been reviewed and updated regularly. The service user is making decisions regularly about their lifestyle. When a service user is involved in an activity which involves taking risks then level of risk is assessed and 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.V261379.R01.S.doc Version 5.0 Page 10 The service user 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, guidelines for supporting the service users with challenging are included in the individual’s plan. Along with having a care plan the service user also has an ‘Essential Lifestyle Plan’. Care plans are reviewed monthly and a community care review has recently been carried out with a representative from the relevant Social Services Department. The minutes of this were available and were positive in how the home meets the needs of the person concerned. This means of review is an area in which the practice at the home has improved. Staff were able to explain how they support the service users with independence and decision making and this is also backed up in the service users care plan and in daily records. Where a service user is involved in an activity which is thought to present a risk then the risk is assessed and managed to ensure the activity takes place. Risk assessments are detailed and reviewed every six months. It was evidenced that all information in the home is kept securely in accordance with the 1998 Data Protection Act. 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.V261379.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 14, 16, 17 The home works on the principle of ordinary community living and the service user is supported by staff to use local facilities and join in activities of their choice. The service user is now being encouraged and supported to develop their independent living skills and is supported to develop socially and emotionally. The service user is choosing what to eat on a daily basis with some guidance and support from staff and is being encouraged to be involved in the preparation of meals. EVIDENCE: The service users has a plan of care which includes goals for their personal development and which give the service users and staff targets to aim for. Staff have clearly given thought as to how they can provide greater opportunities for the service users to use and develop their independent living skills. Daniel Close, 16 DS0000005243.V261379.R01.S.doc Version 5.0 Page 12 The service user is regularly being supported in leisure activities and community access. This is an area which has improved since the last inspection and may well be as a result of the current one to one support available to the service user. The service user has an ‘Essential lifestyle plan’ and this makes frequent reference to the persons choices and how these must be respected. Daily records also indicate that the service user is given lots of choices and opportunities and is making decisions for themselves. A four week menu plan is in place. This is often used only as a guide and is not followed strictly. The service users choices of meals is recorded daily. There was a fair variety of food available on the day of inspection including fresh food. Service users likes, dislikes and needs regarding food are recorded in their care plan. Staff are encouraging and supporting the service user in maintaining a healthy diet whilst also very much respecting the individual’s choice. There was some evidence that the service user is now being encouraged to use their independent living skills in food preparation and this should be encouraged further. Daniel Close, 16 DS0000005243.V261379.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 The service user is supported by a staff team who know their personal care needs and preferences well. The service user is supported in all aspects of their physical and emotional needs. Medication is handled safely and in accordance with policies and procedures. EVIDENCE: The service user is supported by a small staff who know the person’s personal care needs well. Care plans also include information on how to support the service user with personal care. Times for getting up, going to bed and assistance with personal care are flexible and in line with the needs of the service user. Daniel Close, 16 DS0000005243.V261379.R01.S.doc Version 5.0 Page 14 A record of all health related issues and appointments for the service user is maintained. These records evidenced that service user is being supported in accessing primary health care resources as appropriate to their needs. Service user’s plans include a health action plan and all health related checks are recorded. 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. A record of all medication received and administered is maintained at the home. Staff also carry out a stock check of medication regularly. The home maintains information on medication and possible side effects. There was evidence that service user’s medication has been reviewed and that staff are monitoring and reporting any relevant issues concerned with this. The home has a policy and procedure for the administration of medication. Medication was stored securely in a locked cabinet. Medication administration records were examined and found to be completed appropriately. Staff who are responsible for the administration of medication have received medication training. Daniel Close, 16 DS0000005243.V261379.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 The home has an appropriate complaints procedure for dealing with complaints made. This procedure isn’t currently provided in alternative formats. Policies, procedures and practices are in place which aim to protect service users against abuse or neglect. Systems are in place for dealing with allegations of abuse and staff are trained in identifying signs of abuse. EVIDENCE: The home has a complaints procedure which is time scaled appropriately. A comments, complaints and suggestions notice is also available in the home along with a complaints leaflet. The service user is aware of how to make a complaint and will tell staff is they are unhappy with any given situation and staff will address issues as they arise. However, for other service users the complaints procedure should be produced in a more service user friendly format. There have been no complaints made to the home since the previous inspection. The home has a protection of service users policy and an abuse policy. There is also a management of service users money and financial affairs policy and a physical intervention by staff policy. All staff have received protection of vulnerable adults training. A record of key events is maintained for example incident reports, accident reports, service user’s monies and medication administration records. Daniel Close, 16 DS0000005243.V261379.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 The service user lives in a home which is well presented, homely, safe and comfortable. The home is presented as clean and hygienic and staff have relevant training in this area. EVIDENCE: A tour of the premises was carried out. The home is an ordinary sized domestic property which meets the standard for minimum 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. The home appears to be maintained appropriately clean and hygienically. 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.V261379.R01.S.doc Version 5.0 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): 31, 33, 34, 35, 36 Staff roles and responsibilities are clear. The service user benefits from the support of a small 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. Recruitment procedures are good and aimed at the ensuring the protection of service users. EVIDENCE: The service user is supported by a small staff team and all staff have clear roles and responsibilities and lines of accountability within the home and across the organisation are clear. Staff have clearly defined job descriptions which include their responsibilities in supporting service users to achieve aims and goals. There are staff at the home 24 hours per day and when there are two service users living at the home there have been additional staff hours provided each day to enable some one to one support for the service users. The staffing compliment is full and there is a good level of consistency of care staff for the service users. Daniel Close, 16 DS0000005243.V261379.R01.S.doc Version 5.0 Page 18 The manager of the home was not available at the time of the inspection and therefore there was no access to staff files in order to assess the staff recruitment and selection procedures. Previous inspections have shown that the staff recruitment procedures adopted by Expect are good, thorough and aim to protect the service users. There was evidence in staff files that core skills training has been provided to staff. This includes training in health and safety, fire and food hygiene. All staff have received mental health awareness training, medication training and adult protection training. The level of staff training is generally very good and in line with the needs of the service users. Records indicate that staff team meetings are taking place on a regular basis, staff are receiving regular supervision and undergo an annual appraisal. Daniel Close, 16 DS0000005243.V261379.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38, 40, 41, 42 The home does not currently have a manager who is registered with the Commission. Policies and procedures 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 registered manager has left the home since the previous inspection and therefore the home does not have a registered manager at present. A team leader is in post. This person has made an application to the Commission for her registration as a manager and the application is being processed. Daniel Close, 16 DS0000005243.V261379.R01.S.doc Version 5.0 Page 20 The home has a number of policies and procedures which aim to ensure the health and safety of service users and staff and these include policies on health and safety, first aid, fire safety, food safety, medication, COSHH and control of infection. Staff have received some training in health and safety related issues. An environmental risk assessment has been conducted and COSHH assessments are in place. All relevant records were maintained securely in line with the Data Protection Act. The home maintains a record of all complaints, accidents and incidents. The health and safety of service users and staff is promoted. Health and safety policies, procedures and practices are in place and records of health and safety related checks are maintained. Staff have received training in health and safety related issues for example food hygiene, first aid, health and safety, risk assessment. A risk assessment has been carried out in relation to the environment and safe working practices. The home has valid gas certificate. A copy of an up to date electric safety certificate should be forwarded to the commission. Fire safety checks were examined and found to be up to date although the frequency of detector testing should be reviewed. Daniel Close, 16 DS0000005243.V261379.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 X 3 X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score 3 X 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Daniel Close, 16 Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score X x X 3 3 2 x DS0000005243.V261379.R01.S.doc Version 5.0 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA42 YA42 Regulation 13 (4) (c) 23 4 (c) (v) Requirement A copy of an up to date electrical safety certificate must be forwarded to the commission. The home must review the frequency of some of the fire safety checks. Timescale for action 16/11/05 16/11/05 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.V261379.R01.S.doc Version 5.0 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.V261379.R01.S.doc Version 5.0 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!