Inspection on 02/02/06 for Foxwood (2)

This inspection was carried out on 2nd 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

Foxwood (2) 06/09/06

Foxwood (2) 01/12/05

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 2nd February 2006 10:00 Foxwood (2) DS0000025266.V279897.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 Foxwood (2) DS0000025266.V279897.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. Foxwood (2) DS0000025266.V279897.R01.S.doc Version 5.1 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.V279897.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st December 2005 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.V279897.R01.S.doc Version 5.1 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 three hours. The inspector spent time with the service users and spoke to the three care staff on duty and read the files at the home. What the service does well: What has improved since the last inspection? What they could do better: The home should ensure that all the items listed in regulation 5 are included in the Service User Guide. All service users should be provided with adequate comprehensive risk assessments. The home should ensure that the health needs of the service user are met and recorded in a Health Action Plan. The registered person must ensure that the staff are trained to cut service users toenails or make alternative arrangements. Foxwood (2) DS0000025266.V279897.R01.S.doc Version 5.1 Page 6 The registered person should visit the home monthly and forward the report to the CSCI office. The home should have regular fire drills and keep a record of staff attendance. 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.V279897.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 Foxwood (2) DS0000025266.V279897.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): 1,2,5 The homes Statement of Purpose is very good providing details of the services the home provides. The homes Service User Guide is inadequate and does not provide sufficient information for prospective service users to be clear about the services the homes to meet their needs. EVIDENCE: The home’s Statement of Purpose is a well written document that is also available in pictorial format. The Service User Guide did not include the relevant qualifications and experience of the staff team. The current service users have lived in number two Foxwood for several years. Two have been resident in the home for 18 years and the third for 9 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 service users had a copy of the written contract and statement of terms and conditions with the home in their Service User Guide. Foxwood (2) DS0000025266.V279897.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): 6,7,9 There is clear care planning in place to adequately provide staff with the information they need to satisfactorily meet service users needs. The lack of risk assessments leaves the service users unprotected from harm. Foxwood (2) DS0000025266.V279897.R01.S.doc Version 5.1 Page 10 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, this is reviewed annually. 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 written on an activity chart in the staff bedroom and within service users files. It would be beneficial to the service users if this was represented in a format they can understand. The staff team have devised the menus using photographs and the service user chose what they want to eat. There is other evidence where service users exercise choice, for example choosing clothes, when to go to bed. In the care plans there is a section on communication, which explains some of the communication preferences of the service users. 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. The risk assessments only cover getting in and out of the car, getting into the bath and getting in and out of the wheelchair. The risk assessments should be comprehensive covering all conceivable risks. Foxwood (2) DS0000025266.V279897.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): 12,13,14,16,17 Service users engage in community and leisure activities appropriate to their age. 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.V279897.R01.S.doc Version 5.1 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. Service users also access a local swimming baths/hydro pool and staff go with service users for pub lunches, bingo and shopping trips. 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. The staff team were observed interacting and talking to service users in an appropriate and respectful manner and service users were able to communicate through verbal and non-verbal communication. One of the service users was 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. The inspector ate lunch with the service users which was nutritious and it was served in a relaxed manner. Foxwood (2) DS0000025266.V279897.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): 18,19,20 The staff have a good understanding of the service users’ support needs. This is evident from the positive relationships, which have been formed between the staff and service users. The records to indicate the health needs of service users are poor and it is difficult to assess if the health needs have been met. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure service users medication needs are met. Foxwood (2) DS0000025266.V279897.R01.S.doc Version 5.1 Page 14 EVIDENCE: Service users preferences and morning night time 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. The inspector was informed that the staff cut the service users toe nails, but are not trained to do so. The inspector said that this practice should cease and the staff receive appropriate training or seek other arrangements. Due to profound learning difficulties none of the current service users are able to self medicate. On the day of inspection the management and administration of medication was found to be in accordance with the Care Homes for Younger Adults and Adult Placements National Minimum Standards 2001. All the staff team receive instruction from the manager regarding recording and security of medication. A record of the stock of paracetamols is kept and a metal cabinet has been purchased to store the medication. Foxwood (2) DS0000025266.V279897.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The staff team have a good knowledge and understanding of Adult Protection issues which protects service users from abuse. EVIDENCE: The organisation has a complaints policy and procedure that meets the requirements referred to in the Care Homes for Younger Adults and Adult Placements National Minimum Standards 2001. There have been no complaints/concerns received since the last inspection. There is an Adult Protection policy that including a whistle blowing procedure. Physical intervention is not used in the home. Staff have a good knowledge and understanding of Adult Protection issues, which protects service users from abuse. Staff are given training on induction on issues surrounding adult protection. The finances of one service user was examined and found to be correct. The inspector recommended that the sum of money is put into the service users bank account. Foxwood (2) DS0000025266.V279897.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,29,30 The overall quality of the furnishings and fittings is very 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. Furniture and fittings are of a good quality and it is tastefully decorated throughout. The gardens/patio area outside are well kept and the home has a gardener who regularly maintains the gardens. The service users bedroom were individually decorated and appeared to reflect that persons tastes. The bedding and curtains are of a good quality. There is a tracking hoist in the bathroom, which is regularly maintained. The tile that is broken in the bathroom is being replaced tomorrow. It is understood that the home is still in the process of acquiring a ‘walk in’ shower that would be more suitable for the needs of the service users. This should be planned to take place in the near future. Foxwood (2) DS0000025266.V279897.R01.S.doc Version 5.1 Page 17 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.V279897.R01.S.doc Version 5.1 Page 18 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): 32,33,35,36 Staff morale appears high resulting in an enthusiastic workforce that works positively with service users to improve their whole quality of life. EVIDENCE: The care staff team has six staff, of which two have achieved NVQ 2 and one member of staff is currently completing her units on the course. The staff team appears motivated and there is low sickness record within the team. The staff on duty demonstrated a good understanding of the service users and communicated effectively with them. One member of staff was a new starter, they explained that they had received an induction and showed the inspector their induction file. The manager was not duty so the inspector could not view the staff records. Some of the staff team have not received 5 days paid training and development days (pro rata) this year. The staff on duty informed the inspector that they are formally supervised monthly; they also said that the manager was very supportive and approachable. The inspector viewed the minutes of the last staff meeting, which was held in January. The staff said that they have staff meetings every month. Foxwood (2) DS0000025266.V279897.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 The manager has a clear development plan and vision for the home, which she effectively communicates to the service users and staff team. The lack of self review by the registered provider leaves the home without adequate quality assurance. EVIDENCE: The manager has the NVQ 4 and from speaking with the care staff supervises them regularly. The manager has many years experience working in the caring profession. 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 and the evidence of this was in the incident form file. The emergency lighting and smoke detectors records were up to date. There was written evidence that the fire extinguishes and hoist was serviced. There was evidence that fire drills were undertaken but no record of the staff who Foxwood (2) DS0000025266.V279897.R01.S.doc Version 5.1 Page 20 has attended. The manager should ensure that a record of attendance of fire drills is kept and that all staff attend two fire drills every year. Foxwood (2) DS0000025266.V279897.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 4 27 3 28 X 29 3 30 4 STAFFING Standard No Score 31 3 32 3 33 3 34 X 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 X 2 X X 2 2 Foxwood (2) DS0000025266.V279897.R01.S.doc Version 5.1 Page 22 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 YA1 Regulation 5 Requirement The registered person must ensure that all the items listed in regulation 5 are included in the Service User Guide. The registered person must ensure that all service users are provided with adequate comprehensive risk assessments. The registered person must ensure that the health needs of the service user are met and recorded in a Health Action Plan. (This remains unmet timescale 31.01.05). The registered person must ensure that the staff are trained to cut service users toenails or make alternative arrangements. The registered person must ensure that they visit the home monthly and forward a copy of the report to the CSCI office. (This requirement remains unmet timescale 31.01.05). The registered person must ensure that the home has regular fire drills and that a record of staff attendance is kept. DS0000025266.V279897.R01.S.doc Timescale for action 06/03/06 2 YA9 13 06/03/06 3 YA19 12 09/06/06 4 YA19 13 06/03/06 5 YA39 26 06/03/06 6 YA42 23 09/06/06 Foxwood (2) Version 5.1 Page 23 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. 2 Refer to Standard YA23 YA35 Good Practice Recommendations It is recommended that service users money is put into their bank accounts. It is recommended that all staff receive at least 5 days paid training and development days (pro rata) per year. Foxwood (2) DS0000025266.V279897.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Liverpool Local 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.V279897.R01.S.doc Version 5.1 Page 25 - 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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