Inspection on 17/02/06 for Elizabeth Road Nursing Home

This inspection was carried out on 17th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elizabeth Road Nursing Home 10/12/07

Elizabeth Road Nursing Home 31/07/06

Elizabeth Road Nursing Home 27/10/04

Elizabeth Road Nursing Home 02/04/04

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 Elizabeth Road Nursing Home 45 Elizabeth Road Huyton Liverpool Merseyside L36 0TG Lead Inspector Miss Orla Murphy Unannounced Inspection 17th February 2006 12:30 Elizabeth Road Nursing Home DS0000005456.V284213.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 Elizabeth Road Nursing Home DS0000005456.V284213.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. Elizabeth Road Nursing Home DS0000005456.V284213.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Elizabeth Road Nursing Home Address 45 Elizabeth Road Huyton Liverpool Merseyside L36 0TG 0151 4430732 0151 4430732 elizabethroad@c-i-c.co.uk www.c-i-c.co.uk. Community Integrated Care 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) Miss Geraldine Atkinson Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Elizabeth Road Nursing Home DS0000005456.V284213.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 5 LD Date of last inspection 1st November 2005. Brief Description of the Service: Elizabeth Road is a bungalow providing accommodation & nursing care for up to 5 adults with a learning disability. The service is provided by Community Integrated Care (CIC), a voluntary organisation and is managed by Ms Geraldine Atkinson, a qualified nurse. The home is located in a residential estate, in Huyton. As a bungalow, all accommodation is located on one level. There is a private garden to the rear of the bungalow. Shops are a short distance by transport, along with leisure and community facilities. Buses and other transport serve the area and Liverpool/Merseyside is accessible. On street parking is available for visitors. Elizabeth Road Nursing Home DS0000005456.V284213.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection was unannounced and neither residents nor staff knew the Inspector was coming. The last inspection report was examined and some requirements needed to be followed up on this visit. The Inspection was the first in the home’s required visits, which are 2 inspection visits per year. 3 residents were observed and staff were spoken to at the inspection. One resident was “case tracked”. Case tracking means that the Inspector concentrates on the care given and experiences of one or more residents to get an idea of what is like to live there and how that person’s needs are being met. Case tracking also shows the inspector where needs aren’t being met. A variety of records (care plans, medical notes, complaints records, assessments, reviews, medication sheets, meeting minutes, menus, timetables, risk assessments and significant events) were examined. What the service does well: Residents at the home have very complex needs and find communication difficult. Staff are very aware of the individual, their likes/dislikes, and what behaviour/gestures are communicating about the resident. This comes from an in depth knowledge and skill in being able to communicate with residents where verbal communication is not always possible. There is a very positive atmosphere in the home and staff were observed being patient, kind and positive with residents. Essential Lifestyle Plans (ELP’s) are very detailed, positive & empowering. Pictures are used to help residents be aware of and understand aspects of their care. Detailed advice regarding resident’s gestures/behaviour & what this means is provided for staff. All support staff are in various stages of completing NVQ Levels 2 & 3 in Care. Elizabeth Road Nursing Home DS0000005456.V284213.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Elizabeth Road Nursing Home DS0000005456.V284213.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 Elizabeth Road Nursing Home DS0000005456.V284213.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): These standards were met at the last inspection. EVIDENCE: These standards were met at the last inspection. Elizabeth Road Nursing Home DS0000005456.V284213.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): 7 & 9. Most residents make day-to-day decisions about their lives. Residents are supported to take assessed risks. EVIDENCE: Residents of this service have complex learning & physical disabilities and find verbal communication difficult. It is difficult to determine residents opinions and values in relation to this, but the staff have an excellent knowledge of residents likes/dislikes and actively encourages them to have as much choice control as they can, in areas such as food, activities, clothes choices, interaction and leisure. These are all recorded in detail. One resident has had a long-standing issue with not being in control or direct receipt of their benefits. This issue is still nor resolved and means she has no choice or control in her personal affairs but is led by when she can access funds that a third party chooses to give to the home. This is an infringement of her rights and legally entitled income and must be addressed. The risk assessments of the resident case tracked were examined. Risk assessments were in place for the resident’s health, wellbeing, vulnerability, diet, mobility and the environment. These were all detailed & relevant and Elizabeth Road Nursing Home DS0000005456.V284213.R01.S.doc Version 5.1 Page 10 were regularly reviewed. They were also linked to the resident’s Essential Lifestyle Plan (ELP). It was evident that taking calculated risks are promoted by the home to enhance the independence of the resident. Elizabeth Road Nursing Home DS0000005456.V284213.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): 13 & 15 The service enables residents to be involved in every day experiences and opportunities. Relationships are recognised as very important and encouraged EVIDENCE: The resident case tracked does not attend day services and spends days at home to spend one to one time with staff, relax and go out locally shopping and for lunch. All residents have weekly timetables, 2 of which were examined. Activities and opportunities include trips, meals out, shopping, arts, walks, visiting friends/family, barbeques, video evenings and music sessions. Residents have made links locally and it was obvious the residents like their local community. All residents have relationships with their families/friends and visits to the home and to family homes are encouraged. Staff support the resident case tracked to have very regular visits from family & to spend quality time with them. Essential Lifestyle Plans seen detailed all the important people in resident’s lives, their contact details and the routine of their relationships (i.e. visits, calls, holidays, special events). Elizabeth Road Nursing Home DS0000005456.V284213.R01.S.doc Version 5.1 Page 12 Elizabeth Road Nursing Home DS0000005456.V284213.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): 20. Medication is administered safely. EVIDENCE: No residents can currently take responsibility for taking their own medicines and all have risk assessments explaining this. Medication is administered via a blister pack system. The medication records for the resident case tracked were seen and were up to date, signed for and satisfactory. Sets of sample signatures from staff were in place and details regarding the latest medical guidance on medicines & their administration. A qualified nurse is always on duty in the home. The storage of medicines is also safe & satisfactory. Elizabeth Road Nursing Home DS0000005456.V284213.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 The service encourages, listens to and acts upon complaints made to them. EVIDENCE: There have been no complaints in this cycle. The service has referred to an advocacy service for 1 resident. Residents would not be able to verbalise a complaint and in that sense, rely upon relatives/friends/professionals. ELP’ s very clearly detail how to tell from sounds, gestures & body language whether residents are happy/angry/sad or unwell and this is an excellent example of developing alternative understanding of non-verbal communication. Staff also record and monitor when residents are showing signs they are unhappy or worried. Elizabeth Road Nursing Home DS0000005456.V284213.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 The home is clean & hygienic. EVIDENCE: All areas of the home were found to be clean & hygienic on the day of the visit. As mentioned in the previous inspection report, some areas require redecoration and refurbishment, which would improve the appearance internally of the home. Elizabeth Road Nursing Home DS0000005456.V284213.R01.S.doc Version 5.1 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): 35 Skilled, trained and competent staff supports the service, and the residents. EVIDENCE: Residents are supported by a group of qualified nurses and support staff. Staff demonstrated throughout this & previous inspections that they are skilled, competent and committed to the welfare of residents. This was evident through observations of staff and residents lifestyle plans, reviews and daily records. Staff evidently respect residents and strive to get the best quality of life for them, through opportunities, activities and care. Staff undergo training in good practice areas, health & safety, essential lifestyle planning, food hygiene and manual handling. Training records were examined and were up to date & satisfactory. Elizabeth Road Nursing Home DS0000005456.V284213.R01.S.doc Version 5.1 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): 39 & 42. Quality is reported to be part of the service and is important to staff and the service. The service mostly promotes the health, safety & welfare of residents but is lacking in some areas. EVIDENCE: There is reported to be an annual audit of the quality of the service but this was not available on the day of the inspection. It is important that any audit incorporates the views & opinions of residents and relatives/friends. The fire safety records were examined and were found to be mostly up to date. There has been no recorded fire drill since May 2005, and this needs to be addressed, as drills should be reasonably regular for both resident and staff safety. Gas & electrical safety tests were examined and were up to date & satisfactory. During a tour of the building it was noted that the main hoist used by residents was out of order since November 2005, three months previously. Another hoist had been borrowed to use in the interim, but staff admitted it was insufficient, as it did not have the same quality or specification as the Elizabeth Road Nursing Home DS0000005456.V284213.R01.S.doc Version 5.1 Page 18 original. This must be addressed as urgency as both staff and residents have the right to have the appropriate equipment to use to attend to their personal care & daily living. A 3-month delay in repairing/replacing such a vital piece of equipment is unacceptable. Elizabeth Road Nursing Home DS0000005456.V284213.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 X 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 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 2 X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X X X 2 X X 2 X Elizabeth Road Nursing Home DS0000005456.V284213.R01.S.doc Version 5.1 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 YA23 Regulation 13 Requirement The resident identified at the inspection must receive all monies awarded to them & this must be addressed via negotiation or referral to appropriate agencies. Communal carpets must be replaced. The carpet in the bedroom identified must be replaced. The hoist identified must be repaired immediately or replaced by an equivalent model. The annual quality audit must be forwarded to CSCI. Regular fire drills must be carried out. Timescale for action 30/04/06 2. 3. 4. 5. 6. YA28 YA26 YA29 YA39 YA42 23 23 12 26 16 23/05/06 23/05/06 01/04/06 01/04/06 17/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Elizabeth Road Nursing Home DS0000005456.V284213.R01.S.doc Version 5.1 Page 21 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 Elizabeth Road Nursing Home DS0000005456.V284213.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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