Inspection on 13/01/09 for Elm Road

This inspection was carried out on 13th January 2009.

CSCI found this care home to be providing an Good service.

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

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 10/04/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Elm Road 23 Elm Road North Prenton Birkenhead Wirral CH42 9PB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Ingerbritt Moynihan     Date: 1 4 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Elm Road 23 Elm Road North Prenton Birkenhead Wirral CH42 9PB 01512002444 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Potensial Limited care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care Home only Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following category: Learning Disability. Code LD maximum number of places 6 Date of last inspection Brief description of the care home 23 Elm Road North is registered to provide support and accommodation for six adults who have a learning disability. Their statement of purpose states that the service currently only supports men, who have a learning disability. The house is owned and run by Potensials, a company who provide care and support services across the country. Located in the middle of Prenton, Elm Road North is well located for accessing local, shops, transport and other amenties. Parking is restricted to on street residents parking, with non restricted street parking available a short walk away. Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 6 0 6 0 2 2 0 0 9 Brief description of the care home The house is a mid terrace that fits in well with other domestic properties in the local area. Everyone living there had thier own bedroom and there are sufficient communal rooms and space for everyone to comfortably share. Staff are available twenty four hours a day to provide support to the people living there. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Information about the home was obtained through discussion with the manager, members of the staff team and service users. Policies, procedures and supporting documentation were also looked at along with a selection of service users case files. We also obtained information from the Annual Quality Assurance Assessment (AQAA). The AQAA if a self assessment document that is filled in once a year by all providers. It is one of the ways that we get information from providers about how they are meeting outcomes for people using the service. A part of the inspection process includes sending surveys to service users and staff in order to obtain their views on the standard of the service provided. Four staff surveys and four service user surveys were returned to us. Comments made in these surveys are included in the report and contribute to the basis of any judgments made. Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: The service users spoken to during the visit said they are happy with the care they receive. One service user said The staff are great, they look after me very well. Another service user said I like the staff a lot they are always there when I need them. Service users are involved in a range of leisure activities both inside and outside the home. Service users attend day centres, go out to the local shops, pubs and restaurants and join in with planned days out. Service users spoken to during the visit said they are happy with the homes routines. Regular meetings take place so they can voice their opinions on the way the home is run. During the visit staff interacted with service users in a friendly and professional manner. When asked what does the home do well, one survey noted Nice meals are provided, it is warm, I am happy to live here and I love my room. Mealtimes are flexible and service users are involved in the menu planning. One service users said The food is always very good and I always have lots to eat. Service users are encouraged to keep themselves healthy and well and they receive regular healthcare checks. Service users know who to speak to if they are unhappy and want to make a complaint. Staff are trained on how to ensure service users are protected from abuse, neglect and self harm. The service users spoken to during the visit said the staff are friendly and they have never experienced any form of abuse. One of the service users said The staff are great, they are all my friends. Service users live in a homely, comfortable and safe environment. The premises are secure, bright and airy. The home is in keeping with the local community and transport links to other part of the Wirral are nearby. There is ongoing training which means staff are clear on their responsibilities and know what is expected of them. The staff recruitment and selection procedures ensure suitably qualified and competent staff are employed. The staff spoken to said they enjoy their work and feel well supported in their role. Staff meet regularly with their manager or a senior member of staff so they can discuss their work and develop in their role. One of the staff surveys returned to us noted Elm Road is an enjoyable place to work with a consistent, friendly and develop staff team. The staff recruitment and selection procedures ensure suitably qualified and competent staff are employed. The manager is qualified, competent and experienced to run the home. Staff spoke highly of the manager saying she is always available for support and advice. One of the Care Homes for Adults (18-65 years) Page 7 of 26 staff surveys noted the management is very supportive. Quality assurance systems are in place to ensure the ongoing monitoring and improvement of the service. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users care needs are assessed before services offered so they know they will receive the care and support they need. Evidence: Service users care needs are assessed before they move into the home. The service user, their family and any relevant health care professional can contribute to the assessment to ensure the staff have all the information they need on how to provide the right level of care. Issues relating to equality and adversity such as service users disability, gender, age and religion are addressed to ensure their holistic care needs are met. Service users have an opportunity to visit the home before they move in permanently. This gives them an opportunity to view the facilities provided and meet the staff and other service users. Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users access to changing needs are reflected in their individual care plan.. Evidence: Details about the way service users are supported is recorded in an individual plan of care. This provide staff with the information they need on how to support service users with their individual care needs. Issues relating to equality and diversity are addressed to ensure service users holistic care needs are met. A large amount of information is held in the care plans and they would benefit from being re organised and streamlined so that staff can easily see which information is most current. The staff surveys returned to us noted they are always given enough information about the service users they care for. When asked what does the home do well, one survey noted Maintain and share information so we are all aware of the issues. The service users spoken to during the visit said they are happy with the care they receive. One service user said The staff are great, they look after me very well. Another service user said I like the staff a lot they are always there when I need them. Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: During discussion staff explained how they encourage service users to make decisions for themselves to ensure their independence is maintained. The service user surveys returned to us indicated they always make decisions about what they do each day. They also indicated the staff treat them well and they act and listen to what they say. Service users are supported to take risks as part of an independent lifestyle. Their care plans include a range of risk assessments which are reviewed regularly to ensure service users safety and welfare. Action is taken to minimise identified risks and hazards and staff are given training on how to ensure service user and their own personal safety. Staff know that information about service users must always the handled appropriately and that their confidences are kept. Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are encouraged to be part of the local community so they have opportunity for personal development. Evidence: Staff support service users with their social, emotional and independent living skills. Although none of the service users living in the home are in paid employment, staff will support service users in this area of care if needed. Service users are involved in a range of leisure activities both inside and outside the home. This area of care is assessed at the point of admission service users confirmed they can pursue their own interests and hobbies and are fully involved in the planning of any activities. Service users attend day centres, go out to the local shops, pubs and restaurants and join in with planned days out. Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: Service users spoken to during the visit said they are happy with the homes routines and said they can come and go they wish. They confirmed they meet regularly with staff to discuss how the home is run and whether any changes need to be made. They confirmed their views are always taken on board. One of the staff surveys returned to noted Service users take an active role in the house. During the visit staff interacted with service users in a friendly and professional manner. When asked what does the home do well, one service user survey noted Nice meals are provided, it is warm, I am happy to live here and I love my room. Another survey noted I like it here, I like my room, I like my bed, I like Katie and the staff. Mealtimes are flexible and service users are involved in the menu planning. A varied diet is provided to ensure service users good health and interest. Special diets can be provided when necessary. Service users dietary needs are assessed when they first move into the home to ensure staff provide meals that they enjoy. The service users spoken to during the visit said they enjoy the food and always have plenty to eat. One service users said The food is always very good and I always have lots to eat. Another service user said The food is great. Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users receive support in the way they prefer and their emotional and physical health care needs are met. Evidence: Personal care is provided in private. Staff respect service users privacy and dignity when carrying out personal care which is done in a flexible and sensitive manner. Advice from health care professionals is sort when necessary so that service users receive their personal care in the way they prefer. Service users are encouraged to keep themselves healthy and well. They receive regular healthcare checks to ensure any problems are identified and dealt with promptly. Service users health care is monitored regularly and staff are proactive in planning and addressing service users health care. Systems are in place for the administration of medication and staff are trained in this area of care so they are aware of their responsibilities and know how to work safely. Policies and procedures are in place to support staff in their role. Service users confirmed they always receive their medication on time. A number of errors arose in Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: the way medication was being managed. The manager dealt with this issue immediately and introduced a more effective system of checks to ensure the matter did not arise again. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place to ensure service users are safeguarded from abuse and harm. Evidence: Service users know who to speak to if they are unhappy and want to make a complaint, this was also noted in the service user surveys returned to us. Staff are clear on the action they should take in the event of them receiving a complaint and a procedure is in place to ensure all complaints managed correctly. We have not received any complaints about the service. Staff are provided with training on how to ensure service users are protected from abuse, neglect and self harm. During discussion demonstrates the basic understanding of the different types of abuse that can occur and what they should do if they know or suspect abuse is happening. A copy of the Wirral adult protection procedure is in place to support the manager her investigations. The service users spoken to during the visit said the staff are friendly and they have never experienced any form of abuse. One of the service users said The staff are great, they are all my friends. Another service user said I like living at the home and the staff are all very nice. I have never been treated badly. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises are well maintained and provide a comfortable and homely environment for service users to live. Evidence: Service users live in a homely, comfortable and safe environment. The premises are secure, bright and airy. The home is in keeping with the local community and transport links to other part of the Wirral are nearby. The furnishings and fittings are of a good quality and domestic in style. All of the service users spoken to during the visit said they like living at the home. All service users have their own bedroom and there is a large lounge and kitchen/dining room available for service users use. Specialist equipment is provided when necessary. Service users care needs are monitored by staff to ensure they have the equipment and support they need to maintain their independence and to keep them safe and well. A bigger shower should be provided in the ground floor bathroom as staff explained they were experiencing difficulty supporting service users with their personal care. The home is clean, tidy and comfortably warm. Systems are in place to prevent the spread of infection and staff have completed training in this area of care. Supporting Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: policies and procedures are also available to staff. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported by an effective and efficient staff team Evidence: During discussion staff demonstrated an understanding of the aims and values of the home which means the service remains focused on the service users care needs. They have the skills and experience necessary for the tasks they are expected to carry out. There is an ongoing programme of training to the National Vocational Qualification standards which means staff are clear on their responsibilities and know what is expected of them. Staff are provided with regular ongoing training to support them in their role and keep them up to date with new ways of working, this was also confirmed in the staff surveys returned to us. The staff spoken to during the visit commented the company is very good at providing training. Newly appointed staff are provided with induction training which means they are clear on their responsibilities and know what is expected of them. The staff surveys returned to us indicated this training covered everything they needed to know to do their job and they started. When asked what does the home do well, one staff survey noted The company provides thorough induction training. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: The manager said there are sufficient staff available each day to support the service users with their particular care needs. Additional staff are provided when necessary. Staff reported the communication in the team is good and regular staff meetings take place. The staff recruitment and selection procedures ensure suitably qualified and competent staff are employed. All of the necessary security checks completed before staff begin work. The staff surveys indicated their employer carried out the necessary checks before they started working at the home. The staff spoken to said they enjoy their work and feel well supported in their role. Staff meet regularly with their manager or a senior member of staff so they can discuss their work and develop in their role. This was also confirmed in the staff surveys returned to us. One of the staff surveys returned to us noted Elm Road is an enjoyable place to work with a consistent and friendly and develop staff team. Another survey said Elm Road is a good place to work. We get good training and there is always opportunity to develop within the company. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run for the benefit of the service users. Evidence: The manager is qualified, competent and experience to run the home. She is also responsible for managing another nearby service belonging to the same company. Staff spoke highly of the manager saying she is always available to support and advice. She has undertaken regular training to update her knowledge, skills and competence while managing the home. One of the staff surveys noted the management is very supportive. Quality assurance systems are in place to ensure the ongoing monitoring and improvement of the service. This includes supervising and monitoring staff, reviewing administrative systems and ensuring service users are happy with the standard of care they receive. The health, safety and welfare of service users and staff is promoted through the provision of policies and procedures and regular staff training. Regular health and Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: safety checks are carried out around the building such as fire safety, water temperatures and food hygiene. The home has undergone an external health and safety audit. While it acknowledge that regular checks are being completed, it identified that the way information is recorded should be improved. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 The care plans should be re organised and streamlined. This will ensure staff are clear on the details of the care they are providing to individual service users. 2 24 A bigger shower should be provided in the ground floor bathroom. This will enable staff to support service users with their personal care properly. 3 42 A more efficient health and safety recording system should be introduced. This will ensure the staff know all the necessary checks are completed properly. Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - 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!