Inspection on 20/03/07 for East Cheshire Housing Consortium

This inspection was carried out on 20th March 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 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

East Cheshire Housing Consortium 03/03/06

East Cheshire Housing Consortium 26/09/05

East Cheshire Housing Consortium 29/03/05

East Cheshire Housing Consortium 06/12/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 East Cheshire Housing Consortium 20/22 Nixon Street Macclesfield Cheshire SK11 8DP Lead Inspector Ms Julie Porter Unannounced Inspection 20th March 2007 09:30 East Cheshire Housing Consortium DS0000006550.V335144.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 East Cheshire Housing Consortium DS0000006550.V335144.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. East Cheshire Housing Consortium DS0000006550.V335144.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service East Cheshire Housing Consortium Address 20/22 Nixon Street Macclesfield Cheshire SK11 8DP 01625 619146 F/P 01625 619146 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) East Cheshire Housing Consortium Miss Deborah Royall Care Home 14 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (14), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (14) East Cheshire Housing Consortium DS0000006550.V335144.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered to provide personal care for 14 residents to include: • up to 14 residents in the category of MD (mental disorder excluding learning disability or dementia) • up to 14 residents in the category of MD(E) (mental disorder excluding learning disability) over the age of 65. 3rd March 2006 Date of last inspection Brief Description of the Service: Two separate houses make up this home. Both have garden areas and limited parking. They are close to local amenities and on bus routes into the town of Macclesfield. 20/22 Nixon Street: these are two four bed-roomed houses, linked downstairs by the staff office. The houses are purpose built; there are four single bedrooms in each house and a bathroom on the first floor. The ground floor provides office accommodation, two lounges, two lounge/dining rooms, wc, kitchen and laundry room. There is no passenger lift. 254 Chester Road is an older property that has been adapted to provide accommodation for six service users. Three are four bedrooms on the first floor and two on the ground floor. The ground floor also has two lounges, a dining room, kitchen and laundry room. One of the downstairs bedrooms has an en-suite shower room and WC. There is no passenger lift. East Cheshire Housing Consortium DS0000006550.V335144.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on the 20 March 2007 and lasted 6 hours. The visit was carried out by one inspector. This visit was just one part of the inspection. Before the visit the home manager was asked to complete a questionnaire to provide up to date information about services in the home. CSCI questionnaires were made available for residents, families, and health and social care professionals to find out their views. Other information received by CSCI since the last key inspection was also reviewed. During the visit various records and the premises were looked at. A number of residents and visitors were also spoken with and they gave their views about the service. What the service does well: What has improved since the last inspection? The kitchen has been refurbished which provides the residents with improved facilities in the home. East Cheshire Housing Consortium DS0000006550.V335144.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. East Cheshire Housing Consortium DS0000006550.V335144.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 East Cheshire Housing Consortium DS0000006550.V335144.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are assessed before they move into the home so they know their needs can be met there. EVIDENCE: One resident’s care plan was checked during the visit and contained a full assessment of the resident’s needs undertaken by their social worker. A needs assessment questionnaire had been completed by the resident and gave the staff valuable information of how she liked to be supported. The resident said that she had visited the home before moving there. She said that it was better than her previous accommodation, although she had been concerned as it was in an area she wasn’t familiar with. The resident said that she had made the decision to “give it a try.” East Cheshire Housing Consortium DS0000006550.V335144.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. 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. Residents in the home are supported by staff who know them well and work within the agreed care plans so that residents’ independence continues to be promoted. EVIDENCE: One care plan was checked at the visit. The resident had been involved in writing the plan and had agreed how it would be followed by all concerned, including herself, the staff at the home, her social worker and health professionals. There were some restrictions to this resident using the community but, in discussion with her, it was clear that she understood why these were necessary. The resident spoke of her recent achievement in preparing a meal for her and a member of her family, something she had not done for a long time. On the day of the inspection a review meeting was being held and included the resident, social worker, staff from the home and family. East Cheshire Housing Consortium DS0000006550.V335144.R01.S.doc Version 5.2 Page 10 Risk assessments were seen as documents that enabled the resident achieve personal goals e.g. staying well, accessing the community and managing their own medicines. East Cheshire Housing Consortium DS0000006550.V335144.R01.S.doc Version 5.2 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. 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. Service users are encouraged so they can maintain as much independence as possible and make their own decisions about how they live their lives. EVIDENCE: There are local shops, the post office and a pub within walking distance of the home; some residents are able to go there on their own. None of the service users in the home currently have any paid employment. Staff confirmed that they will help service users to get work, depending on their wishes and mental health status. Although no visitors came to the home on the day of the inspection, family and friends are encouraged to spend time with their relatives and friends. One service user has regular visits from a friend and visits her house regularly for meals. East Cheshire Housing Consortium DS0000006550.V335144.R01.S.doc Version 5.2 Page 12 The service users’ tenancy agreements and contracts were checked. They did not identify if the service user could or could not invite guests to stay overnight, although the house manager said there was an unwritten rule about this. It needs to be clarified in writing so all staff and service users know what the situation about overnight guests is. There are two lounges in the home and one is currently used as a smoking room. Service users can choose to spend time alone in their own bedrooms and staff were seen knocking and waiting before entering bedrooms. Service users help themselves to breakfast and lunch; food was available to cater for individual choices and diets. Staff help service users with specific dietary needs to make appropriate choices, eg: to try to lose weight. One resident was preparing the evening meal for some of the other residents. East Cheshire Housing Consortium DS0000006550.V335144.R01.S.doc Version 5.2 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. 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. Staff at the home and from the community psychiatric services monitor the residents’ physical and mental health so their health needs are met. EVIDENCE: Staff at the home do not provide personal care for the service users. When this is needed, staff from domiciliary care agencies are used. At the time of the visit, one resident was receiving care from an agency care worker who was very positive in her comments about the home. However, the arrangements for providing personal care were discussed with the manager, as there were concerns about whether the service users had choice and the ability to consent to all the care being provided. The home has good links with community health workers, GPs, district nurses, and community psychiatric nurses. Regular reviews with the psychiatrist are held. On the day of the visit one resident was attending an outpatients appointment due to deterioration with his mental health. The home has a policy about the administration of medicines and residents are encouraged to manage their own medicines, subject to the home’s risk assessment. East Cheshire Housing Consortium DS0000006550.V335144.R01.S.doc Version 5.2 Page 14 The medication records, including the controlled drug record book, were checked and found to be well maintained. Staff receive regular updates about the administration of medication. East Cheshire Housing Consortium DS0000006550.V335144.R01.S.doc Version 5.2 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. 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. There are policies, procedures and training available to staff about adult protection so that residents are protected from potential harm. EVIDENCE: Two residents were spoken with about what action they would take if they were unhappy with any aspect of living in the home. Both said that they would see the house manager or the registered manager and they felt they could talk to them about anything. The home has a written complaints procedure available for residents and their families; however residents spoken with said that they would just tell staff. A record was maintained in the home of all verbal complaints made. All staff at Chester Road attended training on adult protection in January 2006. No referrals have been made in relation to adult protection. East Cheshire Housing Consortium DS0000006550.V335144.R01.S.doc Version 5.2 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. 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. The home is clean and well maintained so residents live in safe, comfortable and homely surroundings. EVIDENCE: The visit included a tour of the communal areas in the home and was clean and fresh throughout. A new kitchen has been fitted at Chester Road and this improves the standard of the accommodation for the service users. Finance has been agreed for redecorating the smokers’ lounge although a date for this work has yet to be confirmed. East Cheshire Housing Consortium DS0000006550.V335144.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust recruitment processes, training and supervision are in place to ensure that residents are protected from possible harm and poor practice. EVIDENCE: The home has six permanent members of staff; all staff have achieved or are currently enrolled to undertake a National Vocational qualification (NVQ) at level 2 or above in care. The organisation promotes continued learning and encourages staff to further their learning once they have achieved level 2 qualifications. A rolling programme of mandatory training is in place to ensure staff knowledge is up to date and in line with current good practice. One new member of staff who started work at the home on 5 March 2007 had already completed fire safety training, training on the protection of vulnerable adults, guidance on completing support plans and emergency aid training. East Cheshire Housing Consortium DS0000006550.V335144.R01.S.doc Version 5.2 Page 18 Only one new member of staff has been employed since the last inspection and records showed that references and a criminal record bureau disclosure were obtained before she started work. Staff spoke positively about the support and guidance they get from the manager of the home. Team meetings, house meetings and formal staff supervision are in place to ensure the staff work in a consistent manner with the service users. East Cheshire Housing Consortium DS0000006550.V335144.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. 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 well managed to make sure that the service users get all the support they need and that the home is run in their best interests. EVIDENCE: The manager of the home is registered with the Commission for Social Care Inspection and was available at the time of this visit. Staff were complimentary about the support and guidance she offers. The two members of staff were spoken with clearly enjoy their work in the home. Insurance certificates and public liability insurance as in place for the home. During the inspection the following records were checked and found to be in order: accident records, fire alarm testing and emergency lighting. East Cheshire Housing Consortium DS0000006550.V335144.R01.S.doc Version 5.2 Page 20 Information provided by the manager before this visit indicated that up to date safety certificates were in place for the following: • • • • fire safety equipment gas installation electrical wiring emergency call systems East Cheshire Housing Consortium DS0000006550.V335144.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 3 3 X 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 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 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 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 3 X 3 X X 3 X East Cheshire Housing Consortium DS0000006550.V335144.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 Refer to Standard YA15 Good Practice Recommendations A review about the arrangements regarding overnight guests should be carried out and written information about the home’s policy in this respect should be available for residents. Staff from the home need to be involved in the care planning for personal care done by domiciliary care agencies to make sure that the residents’ wishes are followed. 2 YA18 East Cheshire Housing Consortium DS0000006550.V335144.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 East Cheshire Housing Consortium DS0000006550.V335144.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. 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