Inspection on 06/09/06 for Foxwood (2)

This inspection was carried out on 6th September 2006.

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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Foxwood (2) 02/02/06

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 6th September 2006 09:30 Foxwood (2) DS0000025266.V304374.R01.S.doc Version 5.2 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.V304374.R01.S.doc Version 5.2 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.V304374.R01.S.doc Version 5.2 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.V304374.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd February 2006 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. The fees for the home are £1091.50 per week. Foxwood (2) DS0000025266.V304374.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home did not know about the visit and took place over two days, as the manager was not on duty on the first day of the visit. The manager and staff were spoken with and time was spent interacting with the service users. Files relating to the service users and the home were read and the premises toured. What the service does well: What has improved since the last inspection? What they could do better: The Service User Guide should be complete. The home should apply to the CSCI to vary their conditions of registration as a matter of urgency. The health needs of the service user should be met. The staff team should receive training appropriate to the work they perform. Staff should not commence work unless they have two references on file and police clearance. The registered person should visit the home monthly and record their visit. Foxwood (2) DS0000025266.V304374.R01.S.doc Version 5.2 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.V304374.R01.S.doc Version 5.2 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.V304374.R01.S.doc Version 5.2 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): 1,2,3,5 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. The homes Statement of Purpose is 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. One service user has moved to another house this year, there are no plans for another service user to move in. One service user is now over 65 years old and the home should apply for a variation on their conditions of registration as a matter of urgency. 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 as it is kept at the organisations head office. Foxwood (2) DS0000025266.V304374.R01.S.doc Version 5.2 Page 9 The service users had a copy of the written contract and statement of terms and conditions with the home in their care files. Foxwood (2) DS0000025266.V304374.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. There is clear care planning in place to adequately provide staff with the information they need to satisfactorily meet service users needs. 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, this is reviewed annually. In addition, service users have a care plan, which documents how individual needs are generally met, this includes: - physical health, personal hygiene, likes/dislikes, sexuality, leisure activities and spiritual needs. In the care plans there is some evidence on what issues service users make decisions and how they make some choices, for example choosing clothes and 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. This would be greatly improved if the service users had access to a local Foxwood (2) DS0000025266.V304374.R01.S.doc Version 5.2 Page 11 advocacy service to assist the service users in making decisions. The use of photographs would also improve the choices the service users could make. Risk assessment documentation is located in one file. The risk assessments cover getting in and out of the car, getting into the bath and getting in and out of the wheelchair, out in the community, walking long distances and moving round the house. Foxwood (2) DS0000025266.V304374.R01.S.doc Version 5.2 Page 12 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 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. 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. EVIDENCE: Foxwood (2) DS0000025266.V304374.R01.S.doc Version 5.2 Page 13 Due to profound learning difficulties formal education and employment are not appropriate however, 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. Service users also access a local swimming baths/hydro pool and staff team go with service users for pub lunches, bingo and shopping trips, days out. The daily records indicate that service users go out regularly and the staff spoken with confirmed this. Both service users have been on holiday this year and are going away later in the year. The service users see visitors in the home and if they wish they can see them in private. Daily living activities are recorded retrospectively in service users individual diaries. 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 on the day of the visit. Service users are offered a healthy diet and meals served are recorded retrospectively in a book that was viewed. 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.V304374.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. The service users receive the appropriate personal support in the way they prefer and require. The lack of records of visits to the dentist and opticians ensures that their health needs are not met. EVIDENCE: Service users preferences and morning night time routines are recorded in their individual files. All the service users require support with personal care and it is understood that staff carry out this task with dignity and respect. The service users have seen the doctor and chiropodist this year, there was no evidence to suggest that the service users had seen an opticians or dentist in the last twelve months. The manager confirmed that the service users have not visited an optician in the last twelve months. It is important that the service users health is monitored and they have access to all the healthcare facilities in the locality. Foxwood (2) DS0000025266.V304374.R01.S.doc Version 5.2 Page 15 None of the service users would be able to manage their own medicines. A check of medicines kept in the home identified that those supplied in “ blister packs” were being managed appropriately. The staff team have received medication training this year. Foxwood (2) DS0000025266.V304374.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. The home has a documented complaints procedure to ensure service users views are listened to and acted upon. Systems are in place to ensure that service users are safeguarded from abuse and harm. EVIDENCE: The organisation has a complaints policy and procedure in place at the home. There have been no complaints received by the home since the last visit, the CSCI has received one concern since the last visit, this was unsubstantiated. There is an Adult Protection policy that including a whistle blowing procedure. Physical intervention is not used in the home. The staff demonstrated an awareness of how to ensure service users were protected from abuse and the staff team have received training in adult protection. Foxwood (2) DS0000025266.V304374.R01.S.doc Version 5.2 Page 17 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): 24,26,27,30 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. 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: Foxwood (2) DS0000025266.V304374.R01.S.doc Version 5.2 Page 18 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 areas outside are well kept and the home has a gardener who was there at the time of the visit. There is a planned maintenance and renewal for the fabric and decoration of the premises. The home is having new double-glazing fitted and a new central heating system fitted this autumn. The garage door is being repainted. The service users bedroom were individually decorated and appeared to reflect that persons tastes. The bedding and curtains are of a good quality. The bedrooms are lockable There is a tracking hoist in the bathroom, which is regularly maintained. The tile that is broken in the bathroom has been replaced. 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. On the day of the visit the home was viewed to be clean, hygienic and free from offensive odours. Foxwood (2) DS0000025266.V304374.R01.S.doc Version 5.2 Page 19 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): 32,33,34,35,36 Quality in this outcome is poor. This judgement has been made using available evidence including a visit to this service. The recruitment practices are inadequate and appropriate checks are not carried out, hence the service users are put at risk. The staff training provided does not ensure that the staff team are equipped to meet the needs of the service users. EVIDENCE: There are six care staff, of which two have achieved NVQ 2 and one member of staff is to start 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. There are regular team meetings that are recorded. An examination of a sample of staff records indicated that not all the staff had two references and the enhanced Criminal Records Bureau checks on their files could not be found. New workers commence work without having two references or CRB checks on file. The staff team have not received 5 days paid training and development days (pro rata) this year and have had limited opportunity for personal development. It is recommended that the staff team receive training on Foxwood (2) DS0000025266.V304374.R01.S.doc Version 5.2 Page 20 epilepsy and cerebral palsy and the ageing process. This will ensure that the staff team have training appropriate to the work they perform. The staff team receive regular recorded supervision and the staff spoken with said that the manager would arrange further supervisions if requested. Foxwood (2) DS0000025266.V304374.R01.S.doc Version 5.2 Page 21 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 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. 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. The staff spoken with said that the manager was approachable and supportive and would listen to any concerns. 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 manager said that they had last visited three months ago. This was also reported at the last visit. Foxwood (2) DS0000025266.V304374.R01.S.doc Version 5.2 Page 22 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 and a record of the staff that has attended. Foxwood (2) DS0000025266.V304374.R01.S.doc Version 5.2 Page 23 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 2 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 3 25 X 26 3 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 X 2 X X 3 X Foxwood (2) DS0000025266.V304374.R01.S.doc Version 5.2 Page 24 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 the Service User Guide is complete. (This requirement remains unmet timescale 06/03/06). The registered person must ensure that they apply to the CSCI to vary their conditions of registration. The registered person must ensure that the health needs of the service user are met. (This requirement remains unmet 09/06/06). The registered person must ensure that the staff team receive training appropriate to the work they perform. The registered person must ensure that staff do not commence work unless they have two references on file and police clearance. The registered person must ensure that they visit the home monthly and record their visit. (This requirement remains unmet timescale 31.01.05). DS0000025266.V304374.R01.S.doc Timescale for action 09/10/06 2. YA3 Care Standards 2000 12 09/10/06 3. YA19 09/10/06 4. YA32 18 06/11/06 5. YA34 19 09/10/06 6. YA39 26 09/10/06 Foxwood (2) Version 5.2 Page 25 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. 3. 4. Refer to Standard YA7 YA7 YA35 YA35 Good Practice Recommendations It is recommended that the service users have access to a local advocacy services. It is recommended that the staff team extend the use photographs to assist the service users in making choices. It is recommended that all staff receive at least 5 days paid training and development days (pro rata) per year. It is recommended that the staff receive training in the ageing process, epilepsy and cerebral palsy. Foxwood (2) DS0000025266.V304374.R01.S.doc Version 5.2 Page 26 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.V304374.R01.S.doc Version 5.2 Page 27 - 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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