Inspection on 01/12/05 for Foxwood (2)

This inspection was carried out on 1st December 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Foxwood (2) 06/09/06

Foxwood (2) 02/02/06

Foxwood (2) 25/11/04

Foxwood (2) 12/05/04

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

CARE HOME ADULTS 18-65 Foxwood (2) 2 Foxwood Parklands Estate Liverpool Merseyside L12 0HZ Lead Inspector Lynn Sharples Unannounced Inspection 1st December 2005 09:30 Foxwood (2) DS0000025266.V270238.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 Foxwood (2) DS0000025266.V270238.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. Foxwood (2) DS0000025266.V270238.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Foxwood (2) Address 2 Foxwood Parklands Estate Liverpool Merseyside L12 0HZ 0151 220 2578 0151 524 3602 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) North West Community Services (Merseyside) Limited Patricia Raynard Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Foxwood (2) DS0000025266.V270238.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th November 2004 Brief Description of the Service: Number two Foxwood is a large modern bungalow that provides accommodation and care for three adults with learning disabilities. The home is owned and managed by an independent company, North West Community Services. The home is located in a residential area of Liverpool, which is situated on the edge of Croxteth Country Park. The home is spacious, comfortable and well maintained. Accommodation comprises of a lounge/dining area, kitchen, bathroom and four bedrooms. Each service user has their own bedroom and the fourth bedroom is used as a staff office/’sleep in’ room. Service users also have access to a garden area at the rear of the premises. Foxwood (2) DS0000025266.V270238.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. There were three people living at 2 Foxwood at the time of the visit. The home did not know about the visit and took four hours. The inspector spent time with the service users and spoke to the three staff on duty and the registered manager. What the service does well: What has improved since the last inspection? What they could do better: The tile in the bathroom still requires repair from the last inspection. The registered manager needs to complete the information required in schedule 2. The disposal of medication and stock control of drugs needs improvement. The weekly activity chart should be recorded. The responsible person needs to record their monthly visits and sent a copy of their finding to the CSCI office. Foxwood (2) DS0000025266.V270238.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. Foxwood (2) DS0000025266.V270238.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 Foxwood (2) DS0000025266.V270238.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): 2,5. The homes Statement of Purpose and Service User Guide are good providing service users and prospective service users with details of the services the home provides. EVIDENCE: The current service users have lived in number two Foxwood for several years. Two have been resident in the home for 17 years and the third for 8 years. It is understood that if a new service user were to be admitted to the home the service manager and the registered manager would undertake a full assessment of their care needs. Documentation used for this purpose was not available for inspection as it is kept at the organisations head office. The Statement of Purpose and Service User Guide were read, the Service User Guide included a pictorial representation, which would benefit people who had difficulty reading. Foxwood (2) DS0000025266.V270238.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. Service users needs are reflected in their care planning and they are supported in making decisions and taking risks as part of their lifestyle and routines. EVIDENCE: The home operates a key worker system and each service user has an Essential Lifestyle Plan (ELP) that provides holistic information regarding their assessed needs, likes/dislikes, personal goals etc. In addition, service users have a care plan, which documents how individual needs are generally met, but it does not identify daily living activities. This information is available within service users files however it is fragmented and recorded in different formats on various documents. The manager said that there was a daily activity plan but this was being updated at the office. The inspector recommends that this be returned. Risk assessment documentation is located in several files and it would be beneficial if this were located in one file. There is evidence that other professional have been involved in risk assessments. Foxwood (2) DS0000025266.V270238.R01.S.doc Version 5.0 Page 10 Due to profound learning difficulties all the service users have limited verbal communication. However through words, gestures and body language they can make their needs known to the care staff. When possible service users are encouraged to make choices in their lives, this includes choosing what to eat each day. None of the service users are able to manage their own finances however they have individual bank accounts and money is withdrawn when required and a record and receipts are kept of any purchases. Due to profound learning difficulties service users are unable to take informed risks as part of an independent lifestyle. The home uses a MOST (maximising opportunities safely together) pro forma for new activities i.e. holidays and the inspector viewed evidence of this. Foxwood (2) DS0000025266.V270238.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17. Service users engage in community and leisure activities appropriate to their age, although daily activity plans should be contained on file. Visitors are welcomed at the home and people do call in at the home. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. Foxwood (2) DS0000025266.V270238.R01.S.doc Version 5.0 Page 12 EVIDENCE: Due to profound learning difficulties formal education and employment are not appropriate however all the service users participate in a wide range of leisure activities. Service users are enabled to integrate into community life through participation in a variety of activities. For example, they attend several different classes at a local college, which include calligraphy and soft furnishings. The manager stated that even though the service users cannot always participate in an activity their attendance enables them to socialise and subsequently feel part of the local community. Service users also attend line dancing in a local church; access a local swimming baths/hydro pool and staff take service users for pub lunches, bingo and shopping trips. A daily activity chart should record these activities The organisation periodically arranges ‘Family Fun Days’ and staff at the home support service users to maintain family links and friendships. Service users attend parties at other NWCS care homes and invitations are reciprocated. Daily living activities are recorded retrospectively in service users individual diaries. Due to profound learning difficulties the key workers usually open service users mail and read the contents to them. Staff was observed interacting and talking to service users in an appropriate and respectful manner and service users were able to communicate through verbal and nonverbal communication. One of the service users went out shopping whilst the inspector was there. Service users are offered a healthy diet and meals served are recorded retrospectively in a book that was viewed by the inspector. The manager has developed a second picture book of food that is more colourful and detailed. The books are used to assist service users to choose their preferred food and meals. Meals are served in the dining area of the lounge on appropriate furniture that is suitable for the service users needs. Foxwood (2) DS0000025266.V270238.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. There is a clear care planning system in place to provide staff with the information they need to meet service users needs. The health needs of service users are well met with evidence of some multidisciplinary working. The medication at this home is well managed promoting good health. EVIDENCE: Service users preferences and morning nighttime routines are recorded in their individual ELP’s. All the service users require support with personal care and it is understood that staff carry out this task with dignity and respect. Health appointments are written in the diary and personal file of the service user, but this is difficult to track. The inspector recommends that in each service users ELP a Health Action Plan is included, this could list visits to the GP, dentist and psychiatrist. Due to profound learning difficulties none of the service users are able to self medicate an inspection of medication procedures identified a surplus stock of a particular drug. There was no stock count of the paracetamols kept; arrangements must be made to ensure a record of all medication is kept. The Medication Administration Records were examined. The medication is stored in a locked cupboard in the staff bedroom, it is recommended that this is replace with a lockable metal cupboard. Foxwood (2) DS0000025266.V270238.R01.S.doc Version 5.0 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): 22,23. Staff have a sound knowledge and understanding of Adult protection issues, which protects service users from abuse. EVIDENCE: Staff have a good knowledge and understanding of Adult Protection issues, which protects service users from abuse. The home has a policy and procedure relating to complaints. Complaints are recorded in the communication book, which would be difficult to find easily, it is recommended that a separate file be used to record complaints. All staff is aware of the home’s Adult Protection Policy and the Whistle Blowing Procedure. There have been no incidences reported since the last inspection. Staff is given training on induction on issues surrounding adult protection. Foxwood (2) DS0000025266.V270238.R01.S.doc Version 5.0 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): 24, 25, 29. The overall quality of the furnishings and fittings is good The home is comfortable and creates a pleasing and pleasant environment for the service users to live in. EVIDENCE: Service users live in a homely, comfortable and safe environment, which is suitable for its stated purpose. A tour of the premises identified some maintenance issues that require attention; one of the tiles around the bath is damaged and requires replacement; this was a requirement from the last inspection. It is understood that the home is in the process of acquiring a ‘walk in’ shower that would be more suitable for the needs of the service users. The service users bedroom were individually decorated and appeared to reflect that persons tastes. There is a tracking hoist in the bathroom, which is regularly maintained. On the day of inspection the home was viewed to be clean, hygienic and free from offensive odours. It is understood that care staff undertake all the domestic duties within the home, which is a credit to them. This is recorded in the communication book. Foxwood (2) DS0000025266.V270238.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): 32, 34,35. Staff morale appears high resulting in an enthusiastic workforce that works positively with service users to improve their whole quality of life. EVIDENCE: Four of the seven staff have or are undertaking NVQ III training. The staff team has a good understanding of the issues that relate to the service users in the home and were able to demonstrate this during the inspectors visit. The home has recruited a new member of staff who is currently receiving induction training, this lasts six weeks and includes:- Foxwood (2) DS0000025266.V270238.R01.S.doc Version 5.0 Page 17 • • • • • • • People we Support Getting to Know Activities Medication Document Reading Housekeeping Information Sleep in’s In addition to the above, new staff undertake mandatory training courses and evidence of this practice was viewed in the staff personnel files. The registered manager has started to compile a file to include all the items listed in Schedule 2 the inspector recommended that this be completed. The recruitment and selection procedure is undertaken at corporate level and records are kept at the organisations head office. The manager has personnel files for each member of staff and copies of appropriate documentation are kept in the home. Foxwood (2) DS0000025266.V270238.R01.S.doc Version 5.0 Page 18 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): 37,39,41,42. There is a clear care planning system in place to provide staff with the information they need to satisfactorily meet service users needs. EVIDENCE: The manager has recently achieved an NVQ IV and supervises the staff every six weeks. There is no record of a quality assurance audit being completed this year and no record of the monthly visits by the responsible person. The inspector looked at the daily diary of one service user, there had been an incident involving a service user but no evidence of this in the incident form file. The fire drills, emergency lighting and smoke detectors records were up to date. There was written evidence that the fire extinguishes and hoist was serviced. Foxwood (2) DS0000025266.V270238.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 X 3 X X 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X X X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 2 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Foxwood (2) Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 2 X 2 3 X DS0000025266.V270238.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 YA20 Regulation 13 Timescale for action The registered manager and staff 05/12/05 encourage and support service users to retain, administer and control their own medication, within a risk management framework and comply with the home’s policy and procedure for the receipt, recording, storage, handling, administration and disposal of medicines. There was surplus stock of a particular drug and no record how many tablets were in stock of a particular drug. The registered person must 06/02/06 ensure that the following maintenance issue is addressed:One of the tiles around the bath is damaged and requires replacement. (Timescale of 28.02.05 not met). The registered person must 12/12/05 ensure that all information and documentation listed in Schedule 2 of the Care Homes Regulations are available for inspection. (Timescale of 31.01.05 not met). Requirement 2 YA24 23 3 YA34 19 Foxwood (2) DS0000025266.V270238.R01.S.doc Version 5.0 Page 21 4 YA39 26 5 YA41 17 The registered person must ensure that a nominated representative of the organisation undertakes a visit to the home at least once a month and prepares a written report and sends a copy to CSCI. (Timescale of 31/01/05 not met). Incidents involving service users should be recorded in the incident form file 02/01/06 12/12/05 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 YA6 Good Practice Recommendations It is recommended that a plan of daily living activities be produced for each service user in order that care staff has immediate reference to service users daily care needs. It is also recommended that a single risk assessment document be used to record identified risks and subsequent management strategies. Photocopies of incident forms are kept if the original form has to be sent to the office. A plan and record of health appointments is included in the service users plan. A lockable metal cupboard is purchased to ensure safe storage of medication. A separate file is used to record any complaints received. 2 3 4 YA19 YA20 YA22 Foxwood (2) DS0000025266.V270238.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Foxwood (2) DS0000025266.V270238.R01.S.doc Version 5.0 Page 23 - 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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