Inspection on 12/05/05 for Gainsborough Avenue, 1a

This inspection was carried out on 12th May 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gainsborough Avenue, 1a 29/08/06

Gainsborough Avenue, 1a 27/10/05

Gainsborough Avenue, 1a 23/09/04

Gainsborough Avenue, 1a 27/04/03

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

CARE HOME ADULTS 18-65 1a Gainsborough Avenue 1a Gainsborough Avenue Maghull Liverpool L31 7AT Lead Inspector Janet Mordaunt Unannounced 12 May 2005 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 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 Stationary 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. Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Gainsborough Avenue Address 1a Gainsborough Avenue Maghull Liverpool L31 7AT 0151 520 3176 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Expect Limited Carl Conlon Care Home 3 Category(ies) of Learning Disability - 3 registration, with number of places Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 3 LD Date of last inspection 23 September 2004 Brief Description of the Service: 1a Gainsborough Avenue is a small residential care home operated by Sefton Support Services. It is registered to accommodate three service users who have learning disabilities. Currently there are three women living at the home. The property is a detached dormer style bungalow situated in a popular residential area of Maghull. Its location is close to local amenities such as shops, public houses, and restaurants and is easily accessible to all forms of public transport. The home is well maintained both internally and externally and combines the requirements of a care facility with a comfortable domestic environment that gives no appearance of an institution. The philosophy of care continues to be focused on maximising independence for the service users and supporting them to achieve this. Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over 6 hours. Neither the residents nor staff knew that the inspector was coming. The home was clean and tidy and furnished to a high standard, some items of furniture have been replaced since the last inspection. During the inspection residents were encouraged to carry on with their routines and take part in the activities they had pre-arranged for that day. At intervals throughout the inspection discussion with all three residents took place. Their comments and views about the home and staff were positive. The manager who was in post at the last inspection has been relocated to another service within the organisation. The new manager has managed the home in the past. The manager has obtained an application form for her approval as registered manager of the home but has not yet completed it. The majority of requirements and recommendations given at the last inspection have not been fully met, however, during discussion with the manager and on examination of documentation it was clear that some developments have been made and plans are underway to improve the shortfalls. Care plans and other records about residents have not been reviewed or updated since the last inspection, which took place in September 2004. What the service does well: What has improved since the last inspection? New sofas have been purchased for the lounge since the last inspection. Residents commented on how comfortable the sofas are. They match the décor in the room and are of good quality leather. Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 Page 6 The home is in the process of altering their care planning system, with the intention of providing Essential Lifestyle Plans (ELPs) for all residents. An ELP was part completed for one resident. The ELPs will provide a great deal of information concerning the residents support needs and lifestyle, and provide an excellent basis for planning their care on an individual basis. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 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 standard(s) 1 2 4 Information about the home is available in good detail enabling residents to make a choice about living there. Before admission prospective residents try out the home so that they can make a positive choice about living there. The documents were only available in small written type making it difficult for some residents to access. Assessment information about one newly admitted resident was not available. Unless a full assessment of needs is undertaken by the home before admission, there is no assurance that care needs will be met. EVIDENCE: A Statement of Purpose and resident Guide was viewed they included information for new residents about the service and facilities available at the home. The homes Statement of Purpose and Resident Guide was written in small type, one resident found it difficult to read the information, she stated that the print was too small. A newly admitted resident said that she was given information about the home before deciding to live there. Assessments for two residents were viewed. The manager was unable to find assessment information completed by the home for a newly admitted resident. There were care management assessments available for all residents. Information about trial visits for prospective residents was available within the Statement of Purpose it clearly described the process that the home follows for introducing new residents. One new resident confirmed that she was Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 Page 9 introduced to the home and visited on several occasions before making a decision to live there. Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 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 standard(s) 6 7 9 Care plans are in place to support residents changing needs, these are are not reviewed regularly or always acted upon, and therefore do not encourage residents independence, or are a true reflection of changing needs. A new care planning system is being introduced which will provide better information about residents. Independence is not always encouraged to allow residents to develop their daily living skills. Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 Page 11 EVIDENCE: A care plan was viewed for each resident. The care plans provide some good information about aspects of resident’s lives including communication, financial information, support and assistance with behaviour, mobility, health and personal care. Some of the information in the care plans have not been reviewed or updated since the last inspection, which took place in September 2004. Copies of a new care planning system which is being introduce to the home was viewed, The Essential Lifestyle Plans (ELPs) will provide a great deal of information concerning the residents support needs and lifestyle, and provide an excellent basis for planning their care on an individual basis. One resident spoken with confirmed that she is involved in putting together her care plan. Staff were observed making drinks and sandwiches for one resident who stated that she was able and would like to do this for herself. Her care plan stated that she was able to carry out these tasks with support. Risk assessment for each resident were viewed, they have not been reviewed or updated since the last inspection. Risk assessments have not been reviewed and updated to ensure that residents are taking responsible risks. Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 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 standard(s) 11 13 15 The service encourages and supports residents to participate in community activities, and actively encourage residents to maintain relationships with family and friends, and consequently prevents isolation. The service falls down in not encouraging residents to do things for them selves in the home, which can lead to learned helplessness. EVIDENCE: One residents care plan was discussed with the manager. It stated that the resident was able to make drinks and snacks with a little help. Staff prepared lunch for her without her involvement. The resident said that she was able and would like to make her own drinks and snacks as long as a member of staff was with her in the kitchen. One resident spoken with attends a day centre and college on weekdays. The resident said that the staff know how important these activities are to her. The resident is also involved in a variety of other activities during the weekend and of an evening, she particularly enjoys gardening often spending a lot of time tidying the gardens at home. Other residents are supported by staff to go to the local shops, pubs, and cinemas and to attend social events that take Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 Page 13 place in the local community. One resident was getting ready to attend a tea dance at the local Town Hall. Discussion with residents and records showed that all residents are in regular contact with their family and friends. One resident spent a lot of time talking about her father who she goes out with every weekend. Another resident has regular contact with her parents who live locally. Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 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 standard(s) 18 19 Personal support is carried out in a sensitive and flexible way to ensure the privacy and dignity of residents at all times. Information about residents health care is not recorded as well as it needs to be to ensure that their health care needs are understood and fully met. EVIDENCE: One resident spoken with was very complimentary of the way in which staff support her with personal care. She said that they always treat her with respect and in a dignified way. Another resident said that staff always knock and wait to be invited in before entering her room. Staff were observed treating residents with respect, they referred to residents by their chosen name. One resident confirmed that she attends for regular health care checks to the dentist, chiropodist, opticians and Doctors. Details of these health care checks were not recorded in the residents care file. The care files for other residents did not include up to date information about their health care. Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 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 standard(s) 22 23 There were no recorded complaints since the last inspection. Residents were confident that their concerns or complaints would be listened to and acted upon. The complaints procedure was only available in small print, one resident was unable to read. Safeguards were in place to protect the people living in the home from abuse. EVIDENCE: A complaints procedure was viewed at the home, it included details about the action and timescales involved in the process, and it also included details of the Commission for Social Care and Inspection (CSCI). The complaint record showed that no complaints had been made since the last inspection. Residents spoken with had no concerns about the service and said that if they did they would be confident in approaching the staff should any arise. One resident struggled to read the complaints procedure, she said that she would be able to read it better if the print was bigger. A number of policies and procedures were in place to protect the safety, health and welfare of residents including a Protection of Vulnerable Adults Procedure (POVA), which clearly describes what action, must be taken in response to suspicion or evidence of abuse. Records showed that staff have completed Protection of Vulnerable Adults training. Staff spoken with showed a good awareness of the different types of abuse and their responsibility to protect vulnerable adults. Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 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 standard(s) 24 27 30 The home was clean, tidy and maintained to a good standard providing a comfortable and safe environment for the people who live there. The lock on the downstairs bathroom was faulty making it difficult for residents to use, putting their dignity and privacy at risk. Cleaning timetables and routines were in place to ensure that a high standard of cleanliness and hygiene is maintained at all times. EVIDENCE: The inside of the home was nicely decorated, well lit and ventilated. The outside of the home was attractive and well maintained. One resident said that she enjoys gardening so spends a lot of time looking after the plants and shrubs. Pictures, photographs and other items chosen by residents were displayed around the home. The home provides both private and shared communal spaces for the use of all residents. There is a small conservatory linked to the back of the house, which offers a quiet area for residents and visitors. All residents were observed using all communal areas of the home. Residents stated that they are happy with all aspects of the home. The sofas in the lounge have been replaced since the last inspection. A resident said that she was involved in choosing the new furniture and commented on how much more comfortable the sofas are compared to the ones they had before. Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 Page 17 The override lock on the door of the downstairs bathroom was faulty. The manager was able to lock the door, however, one resident struggled to lock it. Keeping the house clean and hygienic is important to both residents and staff this showed by how clean the house was. One resident said that she cleans her own room as well as helping to clean and tidy other parts of the home. Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 34 35 Staff complete training that is required for them to carry out their work and which enables them to meet the needs of residents. The homes recruitment process ensures the protection of residents. EVIDENCE: Staff rotas showed that sufficient numbers of staff are on duty throughout the day and night. There is usually at least two staff on duty when there is more than one resident at home. One sleep in staff is on duty at night. Extra hours are provided to ensure that resident’s social needs are met. One resident said that she likes all the staff and that they are good at their jobs. Records examined and staff spoken with confirmed that staff complete training that is required as well as training that is specific to the needs of the residents. Training courses that staff are due to complete include Handling of Medication and Protection of Vulnerable Adults. A new member of staff has started work at the home since the last inspection. All recruitment records for her were in place and up to date. Records showed that the new member of staff took part in an induction programme. Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 42 The manager has not yet forwarded onto the Commission for Social Care and Inspection an application for her approval as registered manager to ensure that the home is being well managed. Processes are carried to ensure that resident’s views are listened to and acted upon. Policies and procedures were in place to protect the health, safety and welfare of the residents and staff. EVIDENCE: The manager is in receipt of an application for her approval as Registered manager of the home but has not yet fully completed it. Staff and residents were complimentary of her. One resident stated that she was glad that the manager has returned to work at the home. Two residents spoken with confirmed that they complete a questionnaire about the home and that people from the company visit to make sure that we are happy with everything. Staff spoken with confirmed that they have completed health and safety training. Certificates were available to support this. Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 Page 20 A detailed health and safety manual was available at the home. The manual included certificates of safety checks and details of tests carried out on the environment, they were all well kept and up to date. All the required health and safety policies and procedures were available in the homes handbook. Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 2 x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 2 x x 3 Standard No 11 12 13 14 15 16 17 2 x 3 x 3 x x Standard No 31 32 33 34 35 36 Score x 3 x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Gainsborough Avenue 1a Score 3 2 x x Standard No 37 38 39 40 41 42 43 Score 2 x 3 x x 3 x F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 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(1) Requirement Timescale for action 12/07/05 2. 3. YA22 YA37 22 8(2) 4. YA2 14(1)(b) The manager must produce a service user guide in a format that is accessible to service users. The manager must provide a 12/07/05 complaints procedure in a format accessible to service users. The organisation must inform the 12/07/05 commission of the appointment of the manager and put forward an application to the CSCI for their approval. The manager must obtain copies 30/06/05 of assessments undertaken by the home prior to the admission of prospective service users. 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 The manager must obtain copies of assessments undertaken prior to the admission of prospective service users . Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 Page 23 2. 3. 4. YA7 YA8 YA11 Information recorded in care plans should be more specific about when decisions for service users are made by others and why. Care plans should be developed to provide more information about how service users are supported to participate in the day-to-day running of the home. Service user care plans should be developed to include more information about their personal development and how it is supported. Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing, Burlington House Crosby Road North, Waterloo Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Gainsborough Avenue 1a F53 F03 S5244 GainsboroughAvenue V230241 120505 Stage 4.doc Version 1.30 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. 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