Inspection on 26/09/05 for East Cheshire Housing Consortium

This inspection was carried out on 26th September 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

East Cheshire Housing Consortium 20/03/07

East Cheshire Housing Consortium 03/03/06

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 26th September 2005 10:00 East Cheshire Housing Consortium DS0000006550.V253373.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 East Cheshire Housing Consortium DS0000006550.V253373.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. East Cheshire Housing Consortium DS0000006550.V253373.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service East Cheshire Housing Consortium Address 20/22 Nixon Street Macclesfield Cheshire SK11 8DP 01625 619146 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.V253373.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The total number of Service Users must not exceed 14 14 of the Services Users may be MD 14 of the Service Users may be MD(E) 8 Service Users to be accommodated at Nixon Street; 6 Service Users to be accommodated at Chester Road. Date of last inspection Brief Description of the Service: 20/22 Nixon Street: These are two separate four bed-roomed houses that are linked downstairs by the staff office. The houses are purpose built and accommodate service users of both sexes. 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: This is an older property that has been adapted to provide accommodation for six service users. Four bedrooms are provided on the first floor and two on the ground floor. Two lounges, a dining room, kitchen and laundry room are situated on the ground floor. One of the downstairs bedrooms has an en-suite shower room and WC. There is no passenger lift. Both houses have garden areas and limited parking. They are close to local amenities and are both on bus routes into the town of Macclesfield. East Cheshire Housing Consortium DS0000006550.V253373.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one for approximately eight hours and included a tour of the premises, discussions with three residents, all of the staff on duty and a brief meeting with the proposed responsible individual. Two resident comment cards were received following the inspection and have been included in this report. Records kept at the home were also checked. What the service does well: What has improved since the last inspection? What they could do better: Staff could support the residents better in challenging the housing association regarding the terms of their tenancy, in relation to maintenance and repairs to provide a safe living environment. A record of all complaints made, the investigation and the outcome must be kept, including verbal complaints made by residents. East Cheshire Housing Consortium DS0000006550.V253373.R01.S.doc Version 5.0 Page 6 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. East Cheshire Housing Consortium DS0000006550.V253373.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 East Cheshire Housing Consortium DS0000006550.V253373.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): 1-5 Residents have their care needs assessed, they are provided with full information about the home and visits are offered before they make a decision to move in. EVIDENCE: The home has a detailed service user guide that provides the reader with information about the home, the staff and what to do in the event that they are unhappy with any aspect of living in the home. Residents care needs are assessed before they move to the home to ensure the home and staff can meet their needs. One care plan reviewed provided background information about the resident and his life before moving to the home, and his care plan had been further developed since his move to the home. All new residents are encouraged to visit the home before making a decision to move there. Individual contract are available between Contour Homes and each resident, this gives information about the annual/monthly cost of living in the home. Separate contracts are available for the cost of staff support. East Cheshire Housing Consortium DS0000006550.V253373.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 - 10 Residents are encouraged to plan their activities and are supported with their chosen lifestyle, including assessing the risks involved with their choices to ensure they remain safe. EVIDENCE: Care files, health records and daily records were kept in locked cabinets in both the offices in Nixon Street and Chester Road. Records looked at provided current information about the residents’ chosen lifestyles and associated risks. Two residents spoken with during the inspection confirmed that they are involved with their care planning and encouraged by the staff to make choices and set themselves targets. One resident spoke about his long-term plan to move away from the home but he did not feel that this was possible yet. Staff were observed throughout the day promoting independence and encouraging residents to make decisions. The home has good links with other health professionals, doctors, community nurses and community psychiatric nurses, residents’ files showed evidence that their health care was being monitored closely. East Cheshire Housing Consortium DS0000006550.V253373.R01.S.doc Version 5.0 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): 11 - 17 Residents are encouraged to make decisions about how they live their lives. They are encouraged to maintain their current lifestyles and become involved in new activities to give them new experiences and help their personal development. EVIDENCE: One resident spoken with had moved to the area when she came to the home, her interests included karaoke, socialising with friends and spending time with her family, she said that the staff in the home supported her with her choices and discussed with her how she could “stay safe and well.” All the residents spoken with spoke highly of the staff and support they give, one stated, “its wonderful here and I’ve come on since moving in.” One resident is a member of a local band and obviously gets great pleasure from music. A number of the residents have regular weekly activities they participate in or social engagements, like regular meals out. Visitors were seen on the day of the inspection chatting with residents or picking them up to go out for dinner. Residents in the home lead very busy lives and enjoy socialising both in and East Cheshire Housing Consortium DS0000006550.V253373.R01.S.doc Version 5.0 Page 11 out of the home, at the moment neither the tenancy agreement nor the policies of East Cheshire Housing Consortium have provision for over night guests and some decisions need to be made about this before the situation arises. Residents help themselves to breakfast and lunch, food was available to cater for individual choice and diet. Evening meal tends to be prepared and cooked by the staff with help from the residents when they are able. East Cheshire Housing Consortium DS0000006550.V253373.R01.S.doc Version 5.0 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 - 20 Staff have been employed at the home for a number of years so they know the residents needs well. EVIDENCE: Three residents were spoken with during the inspection and were able to discuss in detail the support they received from the staff, all residents were positive regarding their care. They spoke of the staff being “great” “fun” and were they live as a “happy home.” Two resident comment cards were received following the inspection which were equally positive, one resident states “the staff are very kind and caring. I feel safe here.” Residents have their own medication in locked containers in their bedrooms and are encouraged to take it under close supervision. Residents administering their own medicines do so following an assessment of the risk. The home has developed their own policy on medicine administration since the last inspection and it is now clear to staff of the action they should be taking. A controlled drug was in use in the home, records inspected demonstrated that this was being managed securely, however the information was being recorded in a diary, the house manager said that she was having difficulty in obtaining a “Controlled drug” record book which remains an outstanding recommendation from the last inspection. See recommendation 1 East Cheshire Housing Consortium DS0000006550.V253373.R01.S.doc Version 5.0 Page 13 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 Residents know who to speak to so their views will be listened to. There are policies and training available to staff in respect of adult protection so that residents are protected from potential harm and poor practice. EVIDENCE: The home has regular residents meetings and records were seen from the last meetings. The home has a written complaints procedure and residents knew who to complain to should they be unhappy with any aspect of the service. Other verbal complaints made by the residents are not always recorded, however in discussion with residents they felt sure that staff responded to issues promptly. The absence of records in respect of all complaints and the availability of records regarding the action taken was discussed with the manager and a complaint log should be developed to ensure the staff are improving the service by acting on the residents wishes. See requirement 1 Staff were aware of the procedure to follow in relation to reporting suspected abuse. East Cheshire Housing Consortium DS0000006550.V253373.R01.S.doc Version 5.0 Page 14 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 Residents at Nixon Street and Chester Road live in a homely environment, maintenance and repairs to the home are not responded to promptly which may put residents safety at risk. EVIDENCE: Nixon Street property is in effect two houses linked together by a central office, the houses have separate kitchens and bathrooms. The inspection involved a tour of the building and when invited some bedrooms were seen, which were nicely furnished and showed individual tastes and interests. Chester Road property has two ground floor bedrooms that could accommodate people with mobility difficulties. The homes were clean and fresh throughout. Both houses are within walking distance of local shops, pubs and are on local bus routes. The manager provided evidence of a number of requests to the housing association regarding completing work in one of the kitchen’s, residents should expect the housing association to fulfil its responsibilities regarding repairs and decoration as part of their tenancy agreement. On the day of the inspection there was an outstanding requirement made by the fire officer during a visit on 2nd March 2005 to replace the office door with a “fire door affording 30 minute fire resistance,” for which an immediate requirement was issued. East Cheshire Housing Consortium DS0000006550.V253373.R01.S.doc Version 5.0 Page 15 See requirement 2 East Cheshire Housing Consortium DS0000006550.V253373.R01.S.doc Version 5.0 Page 16 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 - 36 Staff have worked in the home for a number of years and are supported by a training plan that has developed their understanding of the residents’ needs. EVIDENCE: The three residents spoken with during the inspection understood the role of individual members of staff, knew all staff by their first name and what their jobs involved. Staff and residents were seen during the day speaking about problems and making plans for the future. One resident was discussing with staff plans for her birthday party, what food she wanted and who would be coming. Staff were enthusiastic about the training available to them and had recently completed training relating to; fire, safe load management, 1st Aid, dual diagnosis and training regarding protection of vulnerable adults had been planned. Six staff have either completed or are currently doing NVQ level 3 and the manager expects to complete NVQ level 4 in February 2006. Two staff personnel files were reviewed during the inspection and contained current and relevant information regarding their employment in the home. The manager holds regular staff meetings in both the homes. A record of the minutes of these meetings was seen. All staff are supervised formally by the registered manager of the service, a house manager is in place at Chester Road who has responsibility for day to day staffing matters. East Cheshire Housing Consortium DS0000006550.V253373.R01.S.doc Version 5.0 Page 17 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 - 43 The residents best interest are important to the staff in the home, however their safety may be compromised by delays in repairs to the property. EVIDENCE: Residents spoken with during the inspection enjoy living in the home, they spoke about the decisions they make and their involvement in the running of the home. The atmosphere was light-hearted and fun, staff were observed encouraging residents in making choices and decisions. Records were checked relating to; accidents, incidents, fire alarm checks, emergency lighting, fire drills, fire training, water temperatures and fridge temperatures and all were recorded appropriately. Certificates were seen regarding gas safety and the fire alarm system. A report by environmental health in September 2005 reported “no problems.” Three recommendations and one requirement made by the fire officer in March 2005 had been reported to the housing association but no further action had been taken. See requirement 2 East Cheshire Housing Consortium DS0000006550.V253373.R01.S.doc Version 5.0 Page 18 A director of the company visits the home regularly in accordance with Regulation 26 and a report is available. East Cheshire Housing Consortium DS0000006550.V253373.R01.S.doc Version 5.0 Page 19 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 3 3 3 3 Standard No 22 23 Score 2 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 East Cheshire Housing Consortium Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 2 3 DS0000006550.V253373.R01.S.doc Version 5.0 Page 20 yes 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 Standard YA22 Regulation 22 Requirement The staff must ensure that all complaints are recorded, investigated and a record kept of the outcome Staff after consultation with the fire authority must make adequate arrangements for containing fires. Timescale for action 31/12/05 2 YA24 23 05/10/05 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 YA20 Good Practice Recommendations The registered manager should introduce a controlled drugs record book in the home. East Cheshire Housing Consortium DS0000006550.V253373.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 East Cheshire Housing Consortium DS0000006550.V253373.R01.S.doc Version 5.0 Page 22 - 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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