Inspection on 24/10/05 for Gladstone Road, 29

This inspection was carried out on 24th October 2005.

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

Other inspections for this house

Gladstone Road, 29 07/06/07

Gladstone Road, 29 09/05/06

Gladstone Road, 29 02/02/06

Gladstone Road, 29 14/12/04

Gladstone Road, 29 08/07/04

Gladstone Road, 29 01/03/04

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

CARE HOME ADULTS 18-65 Gladstone Road, 29 29 Gladstone Road Seaforth Liverpool Merseyside L21 1DG Lead Inspector Mrs Janet Marshall Unannounced Inspection 24th October 2005 09:30 Gladstone Road, 29 DS0000005237.V262354.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 Gladstone Road, 29 DS0000005237.V262354.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. Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Gladstone Road, 29 Address 29 Gladstone Road Seaforth Liverpool Merseyside L21 1DG 0151 949 0966 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) Autism Initiatives Mr Simon Thomas Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 3 LD. Date of last inspection 14th December 2004 Brief Description of the Service: 29 Gladstone Road is a mid-terraced house in a residential area of Seaforth. Parking is outside the property in the street. The home is managed by Autism Initiatives. The home is registered as a care home to provide care and support for 3 adults who have a learning disability. There are currently three men living at the home. The staff group appears committed in providing a high level of support. Relationships with neighbours are reported being good and the service users continue to benefit from an active involvement in the community. The overall philosophy of care is to promote independence and to maximise ordinary living for all the service users. Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspection visits are required at the home each year, this was the first. There has been no cause for any visits to the home since the last routine inspection in December 2004. The inspection was unannounced and took place over five hours. The requirements and recommendations from the last inspection report were discussed and checked with the manager. A partial tour of the home was conducted. A selection of care records and other required records were inspected. Records that were examined included residents care plans, daily diaries, medical notes, medication sheets, staff rotas and records of health and safety checks. Two residents were at home during the visit, their views about the home were obtained along with those of a relative who was visiting the home on the day of the inspection. Both residents were ‘case tracked’. Case tracking means that the inspector concentrates on the care given and experiences of one or more residents to ensure that the persons needs are recorded in their care plan and are being met. What the service does well: What has improved since the last inspection? A lid has been fitted to the toilet cistern making it safe. Staff have been given copies of their job descriptions, which are signed by them to show that they understand their roles and responsibilities. Staff training and development plans are now available. They identify training that staff need to complete enabling them to meet the needs of residents. Staff files are now kept in a lockable cabinet, which ensures confidentiality. Staffing arrangements during the night have been reviewed to ensure the needs of the residents are fully met. Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 Page 6 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. Gladstone Road, 29 DS0000005237.V262354.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 Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2&5 Assessments were available which showed that residents needs are assessed and met. Contracts were available for each resident but were not signed to show residents agree to the terms and conditions of the home. EVIDENCE: There have been no new residents admitted to the home since the last inspection. Two residents care files were looked at, information included in the files showed their needs are regularly assessed, understood and met. Through discussion staff also showed they have a good understanding of residents needs. A contract was available in each of the residents care files, however they were not signed. Contracts must be signed by the resident and/or their representative to show they agree with the terms and conditions of the home. Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 & 10 The service provides good care plans for all residents, which are reviewed and updated regularly with the involvement of residents to ensure that changing needs are met. Residents care plans reflect they are encouraged to make decisions and take responsible risks in their lives, which are safe and effective. Information about residents was stored securely to ensure that their confidences are kept. EVIDENCE: A detailed Care Plan was available for each resident. Care plans seen include good information about individuals abilities, routines, likes and dislikes, medical and personal care. They are well written and include a good amount of information, which enable staff to meet each persons needs. Care plans seen showed regular reviews take place ensuring changing needs are identified and met. The parent of one resident said she is involved in putting together and reviewing her sons care plan. Case tracking showed residents needs are recorded in their care plan and are being met. Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 Page 10 Staff said they encourage and support residents to take part in aspects of live in the home. Residents level of involvement, and ability is recorded in their individual care plans. Through discussion staff showed they respect residents rights to make decisions. Choices and decisions made for residents by others and why are well recorded in their care plans. For example, none of the residents have a key to the front door of the house, the reason for this was recorded in their individual care plans. Risk assessments and support guidelines viewed for residents showed they have been reviewed and updated since the last inspection. They ensure that residents independence is encouraged and that they continue to take responsible risks in their every day lives. Medication and records that were examined were in good order and kept securely in a locked cabinet. Care plans for all residents were kept securely in the office. Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, & 17 Residents take part in a variety of activities both at home and in the local community, which are appropriate to their needs and wishes. Relationships are encouraged so that residents maintain contact with family and friends. Residents are encouraged to eat food that is healthy and enjoyable which ensures their health and wellbeing. EVIDENCE: Records seen and discussion with the manager, staff and a relative showed that opportunities are provided for residents to take part in activities of their choice. Daily notes also supported this and timetables viewed in resident’s care files, which showed that they are involved in a varied programme of activities both at home and in the local community. Staff said residents are supported to shop for personal items as well as things for the home. The records seen also showed that residents are supported and encouraged to develop and maintain contact with family and friends. The mother of one resident said she is always made to feel welcome when visiting the home. Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 Page 12 There was plenty of fresh, tinned and frozen foods kept at the home. Staff spoken with said they involve residents in shopping for food and in planning menus. A residents mother was pleased to report her son had lost weight recently whilst following a healthy eating plan that is encouraged and supported by staff. She said ‘he looks much better for it’. Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Resident’s health care is well recorded and monitored to ensure that their health care needs are met. Medication was stored appropriately and records were well kept to ensure the protection of residents. EVIDENCE: Records show that the health care needs of residents are recorded in good detail and are up to date. The manager said staff fully support all residents to attend regular healthcare appointments. A record of this was seen in care files. Necessary arrangements are made for one resident who refuses to visit surgeries. All medication is administered by staff. Medication was in date and stored in a locked cabinet in the office. A new medication cabinet has been provided since the last inspection. The cabinet has not yet been secured to the wall, this needs to be done to make it safe. Items of unused or unwanted medication are returned to the pharmacist a record of this was kept at the home. Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 There were no recorded complaints made by residents since the last inspection. A relative is confident that their concerns or complaints would be listened to and acted upon. The homes complaints procedure needs to be made available to relatives so that they know how to and whom to complain to. A record of residents money was not available, to show that they are fully protected from financial abuse. EVIDENCE: The complaints book showed that no residents have made a complaint about the home. A complaints procedure was available at the home. It clearly describes how a person can make a compliant about the service and how they would respond. A relative spoken with said that she is very confident about raising any concerns should any arise, but was not fully aware of how to go about it. The relative said that she has not been given a copy of the homes complaints procedure but would like one. The manager needs to provide a copy of the homes complaints procedure to all persons who act on behalf of residents so that they know how to complain and whom to complaint to. None of the residents bank books or bank statements were available at the home. The manager said that they were at head office. Residents bank books must be kept at the home so that they can access their money when they wish. Residents bank statements must also be kept at the home so that have available a record of their savings and all transactions made. Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28 & 30 Since the last inspection there has been limited progress with the homes plans for upgrading some areas, this compromises the comfort, privacy and dignity of some residents. Broken locks on bathrooms compromise the privacy and dignity of residents. There were policies and procedures in place that ensure a clean and hygienic environment. EVIDENCE: A tour of the home was carried out. Communal areas of the home are nicely decorated and furnished to a good standard. Pictures and photographs chosen by residents were displayed on the wall in the lounge. The kitchen, which has recently been refurbished, was bright and clean. Requirements were given at the last inspection for improvements to be made to a residents bedroom and bathrooms. No progress in these areas has been made. All residents bedrooms were looked at. Two bedrooms are generally well furnished and decorated. The other bedroom is in poor condition and requires the following improvements to ensure the dignity, comfort and respect of the resident: Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 Page 16 • • • • • • • • The carpet that is heavily stained needs replacing. The ceiling light did not have a lampshade. A lampshade needs to be provided. There was no headboard on the residents bed. A headboard needs to befitted to the bed Bedroom furniture that was in poor condition needs to be repaired or replaced, this includes a dressing table and a wardrobe Instructions for staff written in black marker pen on the inside of the wardrobe doors needs to be removed. The wallpaper, which is poorly hung and painted, needs to be replaced. A valance sheet needs to be provided to cover the base of the bed, which was exposed. If the resident wishes, personal items, pictures and family photographs need to be displayed in his room. The main bathroom and shower room on the first floor of the home, which were seen, are in poor condition, which undermines the dignity and comfort of the residents. The bathroom suite, which is old and in poor condition needs replacing. Tiles on the wall, which have previously been painted over, now peeling, need replacing. The floor, which is heavily stained in parts, also needs replacing. There were no personal items belonging to residents displayed around the bathroom making it feel clinical. The shower room has recently been fitted with a new shower and re-tiled. The shower is modern and in good working order, however the walls outside the shower and the ceiling need painting as they are in poor condition with paint peeling in parts. Locks on the upstairs bathrooms and downstairs toilet were broken. All broken locks need to be repaired or replaced to ensure residents privacy and dignity. All areas of the home were clean and tidy. Policies and procedures that describe how to control the spread of infection were seen in the staff handbook. Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Staff have completed training, which enables them to meet the needs of residents. Training and development plans for staff are available to show that training and development is linked to the aims of the service and residents needs. Staff records need to be made available to show that the residents are supported and protected by the homes recruitment process. EVIDENCE: Staff training records were available at the home. They showed that staff have completed training that is required of them. A relative of one resident said ‘all staff are very nice and very good at their jobs, I can’t fault them’. An individual Training and development plan was seen for each member of staff. The plans show a structured plan that includes a programme of training that meets the aims of the home and the needs of the residents. A selection of staff files was looked at. Staff files showed that’s since the last inspection staff have been given copies of their job description, which they have signed and dated to show they understand their roles and responsibilities. Staff files that were seen did not include all the information that needs to be kept at the home following their employment. References and completed application forms were amongst those records unavailable. All the required records for staff need to be available at the home to show that the homes Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 Page 18 recruitment process protects residents. There was evidence of Criminal Records Bureau checks having taken place for staff that work at the home. Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 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, 41, & 42 The manager has not applied to the Commission for Social Care Inspection (CSCI) so the home does not have a Registered Manager. Records that are not available compromise residents rights and best interests. The homes policies and procedures ensure the health and safety of residents, however, areas of the home, which undermine their dignity, respect and comfort, compromise their welfare. EVIDENCE: Since the last inspection Collette Heyes has been appointed as manager of the home. The manager has obtained an application from CSCI for her approval as Registered manager but has not yet completed it. She must return her completed application as soon as possible so that the process of approving her as registered manager of the home can begin. A selection of health and safety records and other records about residents were seen. Most of them are well kept and up to date. Records that are not well kept include staff records and residents contracts. Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 Page 20 A handbook, which contains the homes policies and procedures, was seen in the office. The policies and procedures, which are detailed cover topics relating to the Health, Safety and Welfare of the residents and staff. However some of these are negated by areas of the home that are in poor condition (as described in the section of the report about the environment) which compromise the dignity, respect and comfort of residents. Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 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 X 3 X X 2 Standard No 22 23 Score 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 2 X 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 1 1 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Gladstone Road, 29 Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 1 X X X 2 2 X DS0000005237.V262354.R01.S.doc Version 5.0 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. Standard Regulation Requirement Timescale for action 30/11/05 1 YA5 2 YA7 3 YA22 4 YA26 5 YA27 6 YA27 The manager must ensure that all residents and/or their 5(1)(b) representatives sign their contracts. The manager must ensure that residents have bank accounts in their own name 20(1) and address, and that bankbooks and statements are kept at the home. The manager must ensure that a copy of the homes 22(5) complaints procedure is supplied to any person acting on behalf of a resident. The manager must ensure that one residents bedroom is 23(2)(b)(c)(d) decorated and the damaged furniture is repaired or replaced. The manager must ensure that the bathrooms on the 23(2)(b)(c)(d) first floor are decorated and refurbished. The manager must ensure that the broken locks on all bathrooms and toilets are 23(c) repaired or replaced. 30/11/05 30/11/05 24/10/05 24/10/05 24/10/05 Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 Page 23 7 YA37 9(1)(2) 8 YA41 17(2)(b) The manager of the home must make an application to the Commission for Registration as manager. The manager must ensure that staff files are kept at the home and include all the required information. 30/11/05 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North 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 Gladstone Road, 29 DS0000005237.V262354.R01.S.doc Version 5.0 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!