Inspection on 20/09/05 for Giles Shirley Hall

This inspection was carried out on 20th September 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 but made no statutory requirements on the home.

Other inspections for this house

Giles Shirley Hall 13/07/09

Giles Shirley Hall 12/12/07

Giles Shirley Hall 13/11/06

Giles Shirley Hall 11/03/06

Giles Shirley Hall 29/04/04

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

CARE HOME ADULTS 18-65 Giles Shirley Hall York Street Bromborough Pool Wirral CH62 4TZ Lead Inspector Beate Roth Unannounced Inspection 26th September 2005 4.30 Giles Shirley Hall DS0000028492.V254838.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 Giles Shirley Hall DS0000028492.V254838.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. Giles Shirley Hall DS0000028492.V254838.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Giles Shirley Hall Address York Street Bromborough Pool Wirral CH62 4TZ 0151 643 5563 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) Wirral Autistic Society Mrs Helen Louise Rudd Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Giles Shirley Hall DS0000028492.V254838.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th October 2004 Brief Description of the Service: Giles Shirley Hall is registered to provide personal care for eleven adults with a learning disability. The home consists of four flats, which are accessible to one another and share the same main entrances. All bedrooms are single and have en-suite facilities. Each flat has a communal area comprising of a domestic style kitchen and dining/lounge area. There are gardens to the front and side of the home. The home is close to local shops and to public transport services. Parking is available on the main road. The home is run by Wirral Autistic Society who have several care homes for adults with a learning disability in the area. Wirral Autistic Society provides a range of day services and facilities, which are fully utilised by the service users, accommodated at Giles Shirley Hall. The home is contained within a converted village hall. Wirral Autistic Society has a conference hall and technology suite also housed within the building. These facilities are open to the general public. There is a separate point of access to the building for the general public. Giles Shirley Hall DS0000028492.V254838.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 4 hours. During the inspection time was spent in the office examining records and policies and procedures. Staff and service users were spoken with. A tour of the home was undertaken. Staff were observed delivering care to service users. Following the inspection a discussion took place with the manager of the home. What the service does well: What has improved since the last inspection? What they could do better: The content of the contracts/terms and conditions and the way they are drawn up could better support the interests of service users. Service users would benefit from staff receiving accredited training around the management of challenging behaviour. Further improvements could be made to the security of the building. Please contact the provider for advice of actions taken in response to this Giles Shirley Hall DS0000028492.V254838.R01.S.doc Version 5.0 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Giles Shirley Hall DS0000028492.V254838.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 Giles Shirley Hall DS0000028492.V254838.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 and 5 A full assessment would take place to ensure that a service user’s needs could be met. The contracts/terms and conditions could better support the interests of service users. EVIDENCE: There have been no new service users admitted to the home since the last inspection. New service users would be assessed by the manager for the home and by a representative from day services. The manager would visit a prospective service user where they are living. Information would be gathered from the service users’ carers, social worker and any other relevant agencies. An examination of an initial assessment pro forma at a previous inspection indicated that all the information recommended in this standard is available. An assessment would be made if a service user moved to the home from another home within Wirral Autistic Society. This information would be recorded. The contracts/terms and conditions between the home and the service user were available for inspection. These contain the required information. However, the current fee charged was not entered on the contract. A record of this information was available. The contracts seen were signed by the service users and a representative from Wirral Autistic Society. It would be good practice to involve the service users family, friends or an advocate when drawing up the contract with service users. Giles Shirley Hall DS0000028492.V254838.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 and 9 Care planning reflects the assessed and changing needs of service users. Service users would benefit from staff receiving accredited training around the management of challenging behaviour. EVIDENCE: A sample of service user plans were examined and contained detailed and clear information to enable staff to provide appropriate support around day-to-day living and personal goals. These plans are formulated at a service users review and cover the information required by the National Minimum Standards. A review had taken place within the last 6 months. The documentation available from reviews indicated that the service user, their relatives, social worker and other relevant individuals are invited to contribute to reviews. An examination of the service user plans indicated that service users’ rights to live as independently as possible, in accordance with their abilities, is promoted by the home. Risk assessments are available which indicate why service users’ rights need to be limited in order to safeguard their well-being. Reactive plans which detail behaviour management strategies are also Giles Shirley Hall DS0000028492.V254838.R01.S.doc Version 5.0 Page 10 available. These indicate that as a last resort physical intervention is used. The records made following an incident of physical intervention were in general satisfactorily maintained and indicate that physical intervention is not used frequently. One record did not clearly indicate the behaviour that had led to the need for physical intervention to be used. Two records did not adequately describe the nature of the physical intervention used. This is to be addressed. Staff are trained in behaviour management strategies such as supportive holds and breakaway techniques as part of their induction. The manager reported that this training is not accredited. Any training that provides guidance on physical intervention must be accredited. Giles Shirley Hall DS0000028492.V254838.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): 11, 12, 13 and 16 Service users are able to take part in appropriate activities that provide opportunities for their educational, social and personal development. Links with the local community are good. The daily routines ensure that the preferences of service users are provided for. EVIDENCE: Service users attend day services five days a week where they are provided with a range of opportunities to promote their personal development. Service users have a timetable of activities, which has been drawn up to meet their needs, skills and individual preferences. Some of the opportunities available are horticulture, craftwork, community work experience, drama and physical education. Activities are provided by either Wirral Autistic Society’s day services or by outside organisations such as local colleges. Service users are provided with work experience opportunities in accordance with their abilities. There are opportunities for service users to become involved in the local community. For example, the service users visit local shops, go to the gym, cinema, bowling and participate in community life through attendance at Giles Shirley Hall DS0000028492.V254838.R01.S.doc Version 5.0 Page 12 college courses. The home has access to private transport and there is easy access to train and bus services. Discussions with the staff and observations confirmed that the home’s routines are flexible as much as possible. The records inspected indicated the support service users need in their daily lives in order to make decisions and encourage independence. Giles Shirley Hall DS0000028492.V254838.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): 19 and 20 The physical and emotional health needs of service users are met. Service users are in the main protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Visits to service users from medical/health care professionals take place in private. Records of reviews indicate that service users have access to medical/health care professionals as needed. Service users are supported to attend health care appointments. Service users are supported and facilitated to take control of and manage their own healthcare in accordance with their abilities. A record of accidents is maintained. A revised medication procedure is available which provides clear guidance. Observations of staff administering medication indicated that they are following this procedure. Medication is stored securely. Three members of staff interviewed reported that they were trained in the administration of medication during their induction period. A selection of medication administration record sheets and corresponding medication were inspected. A record was not being consistently made of medication leaving and being returned to the home when service users make visits to their families. This record needs to be made so the whereabouts of medication and whether it has been taken can be Giles Shirley Hall DS0000028492.V254838.R01.S.doc Version 5.0 Page 14 determined. Any service users who self – administer their own medication do so in accordance with a risk assessment. Giles Shirley Hall DS0000028492.V254838.R01.S.doc Version 5.0 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): 23 The practices at the home provide protection for service users. EVIDENCE: A copy of Wirral Borough Council’s adult protection procedure was available at the home. A shorter and more accessible version of the adult protection procedure has been made available by Wirral Borough Council and was at the home for staff to refer to. Staff have received training in the adult protection procedures. From discussion with members of staff and from an examination of the financial records, the home’s policies and practices with regards to service users’ money and financial affairs safeguard service users. Giles Shirley Hall DS0000028492.V254838.R01.S.doc Version 5.0 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, 26 and 30 In general, the home provides a safe, comfortable and pleasant environment for service users. Giles Shirley Hall DS0000028492.V254838.R01.S.doc Version 5.0 Page 17 EVIDENCE: The home is well maintained. The premises are accessible to all service users. The home offers access to local amenities, transport and relevant support services. Furnishings, fittings and equipment are of a good quality. The home is contained within a converted village hall. Wirral Autistic Society has a conference hall and technology suite also housed within the building. These facilities are open to the general public. There is a separate point of access to the building for the general public, which the manager has reported at previous inspections, is only open when the community facilities are being used. A homely atmosphere is not promoted by public facilities being housed within the same building. The manager is keeping under review the risk assessment of public access to the building and service users accessing the public areas of the building. At the last inspection the manager reported that consideration is being given to erecting a gate at the side of the home to further secure the building. The manager reported that on occasion members of the community cut across the grounds of the home and having a gate in place would deter them from doing this. At this inspection this was not reported to be an issue, however, it is recommended that this be pursued as it will further improve the security of the home. An inspection of a sample of bedrooms indicated that good quality furnishings and fittings are provided. Service users have individualised their bedrooms. As indicated in previous inspection reports, one of the bedroom windows does not open. Following this inspection the manager reported that there has been no progress on this matter since the last inspection. An air conditioning unit is provided for the service user occupying this bedroom. An air brick has also been put in the wall. A tour of the home showed that the home was clean. There are procedures for staff to refer to about hygiene and infection control. Giles Shirley Hall DS0000028492.V254838.R01.S.doc Version 5.0 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): 33 and 35 Service users are supported and protected by the number of staff available and the induction and foundation training they have received. EVIDENCE: An examination of the rota for the week of the inspection indicated that staff are appropriately deployed to meet the needs of the service users. A discussion with the staff indicated that they consider the home is sufficiently staffed to meet the needs of the service users currently living at the home. The service users spoken with at the time of the inspection said that they are happy with the support they receive from staff and that the manager is available when they want to speak to her. There is a core staff team employed at the home. Bank staff are used to cover absences. Bank staff have been recruited to work for Wirral Autistic Society to cover absences in the homes if needed or to provide support within the day care service. The staff interviewed and rota indicated that the same bank staff are employed at Giles Shirley Hall in order to promote continuity of care. Giles Shirley Hall DS0000028492.V254838.R01.S.doc Version 5.0 Page 19 A comprehensive induction and foundation training programme is provided to permanent staff. Steps have been made to encourage bank staff to attend this training so as to ensure that they are appropriately trained should they need to be deployed. The induction and foundation training programmes have been developed in accordance with the National Training Organisation training targets. Giles Shirley Hall DS0000028492.V254838.R01.S.doc Version 5.0 Page 20 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): 38 and 39 The quality assurance systems and management approach of the home support service users. EVIDENCE: Staff interviewed reported that they consider their views regarding the running of the home are sought and listened to. Staff reported that they are well supported by the manager of the home and by the practices of Wirral Autistic Society as an employer. A clear complaint procedure is available. An equal opportunities policy is available. Staff meetings are held every 4-5 weeks. There are a range of quality assurance systems in place. Wirral Autistic Society is accredited by the National Autistic Society which carries out an inspection of services provided. Wirral Autistic Society conducts an internal audit of the society as a whole on an annual basis. The views of service users are obtained by key workers and the manager. A service user survey form is being used to also ascertain their views. There was evidence that the views of relatives and social and health care professionals are obtained about the service provided at the service users reviews. The day service also provides a Giles Shirley Hall DS0000028492.V254838.R01.S.doc Version 5.0 Page 21 forum for service users to give their views on the services provided there. The service users were encouraged to meet with the inspector. Giles Shirley Hall DS0000028492.V254838.R01.S.doc Version 5.0 Page 22 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 2 Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X 2 X X X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X 3 X 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Giles Shirley Hall Score X 3 2 X Standard No 37 38 39 40 41 42 43 Score X 3 3 X X X X DS0000028492.V254838.R01.S.doc Version 5.0 Page 23 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 9 Regulation 12, 18 Requirement Timescale for action 26/03/06 2 9 13 3 4 20 25 13 23 Training provided to staff around any physical interventions used to support a service user’s behaviour must be accredited. A clear record must be made of 26/09/05 the nature of any physical intervention used and the circumstances that led to the use of physical intervention. A record must be made of 26/09/05 medication leaving and being returned to the home. The bedroom window that does 26/12/05 not open must be adjusted to ensure that it opens sufficiently to provide ventilation (previous timescale not met). 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 5 Good Practice Recommendations It is recommended that service users be supported by family, friends and/or advocate, as appropriate when DS0000028492.V254838.R01.S.doc Version 5.0 Page 24 Giles Shirley Hall 2 24 drawing up the contract. It is recommended that a gate/fence be put in place at the side of the home to further secure the building. Giles Shirley Hall DS0000028492.V254838.R01.S.doc Version 5.0 Page 25 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. 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