Inspection on 01/07/05 for Gladstone Road, 31

This inspection was carried out on 1st July 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Gladstone Road, 31 12/06/09

Gladstone Road, 31 10/07/08

Gladstone Road, 31 31/07/07

Gladstone Road, 31 15/05/06

Gladstone Road, 31 14/12/05

Gladstone Road, 31 04/03/05

Gladstone Road, 31 23/09/04

Gladstone Road, 31 01/03/04

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

CARE HOME ADULTS 18-65 31 Gladstone Road 31 Gladstone Road Bootle Liverpool L21 1DG Lead Inspector Debbie Corcoran Unannounced 1st July 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. 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 31 Gladstone Road Address 31 Gladstone Road Bootle Liverpool L21 1DG 0151 476 1964 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 Ms Tracey Jackson Care Home 3 Category(ies) of MD Mental Disorder (3) registration, with number of places 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Service users to include up to 3 MD Date of last inspection 04/03/05 Brief Description of the Service: 31Gladstone Road is a four bedroom terraced house situated in a residential area of Bootle. The home is registered to provide accommodation to three adults who have a mental health concern. There are currently only two service users living at the home. The service provider for the home is Expect, formerly know as Sefton Support Services. This organisation is in the voluntary sector and is a registered charity. The registered Landlord for the property is Hornby Housing Association. The home provides staff 24 hours per day and operates on the principle of ordinary community living. 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and carried out over a period of three hours. During the visit one of the two service users were spoken with and one member of the staff was spoken with. A tour of the home was carried out. Service user plans, health and safety records, medication administration records, staff rotas, menus and other relevant records were examined in some detail. What the service does well: What has improved since the last inspection? The quality of information relating to service user’s need has improved since the last inspection. Each of the service users has a care plan and they now also have an Essential Lifestyle Plan (ELP), which outlines the information required to successfully support the service users and includes information on their goals and aspirations. Records indicate that service users are involved in a greater variety of leisure activities on a more regular basis than at the last inspection. Staff have received training in the protection of vulnerable adults and in supporting the service users in a specific health condition in line with the needs of one of the service users. 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 Stage 4.doc Version 1.30 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. 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 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 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 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, 5 The home has a statement of purpose and service user guide to provide service users and their representatives with information on the home. Systems are in place for assessing the needs of prospective service users, arranging introductory visits and a trial stay. Each of the service users has a contract with the home. EVIDENCE: A pack containing a statement of purpose and service user guide is available at the home. The pack includes information on the aims and objectives of the home and the services and facilities provided. This information should also be produced in more service user friendly formats. The home has a referral and admissions policy and a policy on introductory visits. There is also a policy on service user care plans which includes a statement that each service users file will contain a copy of initial assessment documentation. There have been no new service users to the home since the introduction of the national minimum standards and therefore these particular standards cannot be practically assessed. Each service user has a contract statement. The contracts are signed appropriately and a copy is kept in service user’s personal files. The format of the contract should be made as service user accessible as possible. 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 Stage 4.doc Version 1.30 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 standard(s) 6, 8, 9, 10 Service users have a plan of care which clearly reflects their needs and the plans are reviewed and updated regularly. Service users are not consistently being encouraged to use and develop their independent living skills When service users are involved in an activity which involves taking risks the risk is assessed and managed. Confidential information is stored appropriately and staff are aware of their responsibilities in this area. EVIDENCE: Each of the service users has a care plan. These were examined and found to be of a good standard and include information on the individual’s daily routines, likes and dislikes, skills and needs, targets for personal development, a health action plan, weekly activity plan, finance action plan. Areas for improvement of one of the service user’s care plans were recommended following the last inspection and these recommendations have been adopted. Each of the service users care plans had been reviewed and were up to date. In addition to the care plan each of the service users has an Essential Lifestyle Plan (ELP). These include a good level of detail as to how to successfully 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 Stage 4.doc Version 1.30 Page 10 support the service user, who and what is important in their lives and what their aspirations are. Each of the service users has had the opportunity of a community care review and this has included inviting the service user and their relatives / representatives and relevant others to a review meeting chaired by Social Services. A risk taking and risk management policy are in place at the home. When a service user is involved in any activities which are thought to present a risk then a risk assessment is carried out. The risk assessments were examined and found to include a good level of information on what the potential risks are to the service user and the steps which staff need to take to minimise the risk or prevent the risk from occurring. The risk assessments cover many different aspects of the service user’s support. The risk assessments had recently been reviewed and updated. It was observed that all personal / confidential information in the home is kept securely in accordance with the 1998 Data Protection Act. The home has a policy on confidentiality and the statement of purpose makes reference to the subject and states that information will only be shared with other parties with the permission of the service user concerned. There is room for improvement in the level of consultation with service users, for example there is no evidence that service user meetings take place. There is also room for improvement in staff encouraging and supporting the service users to be involved in all aspects within the home and in using and developing their independent living skills. For example the staff should be supporting the service users to go shopping for the home’s weekly shopping and their own personal items as opposed to staff doing this for and without the service users. 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 Stage 4.doc Version 1.30 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 standard(s) 11, 14, 17 Service users have a good level of opportunity to be involved in leisure activities and are regularly supported in a variety of activities. Service users should have more opportunities to use and develop their independent living skills and promote ‘ownership’ of their home. EVIDENCE: Daily records show that the service users are supported in leisure activities for example visiting the pub, eating out, going to the cinema and shopping on a regular basis. This was confirmed during discussions with one of the service users. One of the service users gave good feedback on the home and said that they are “very happy” with all aspects including their opportunities for leisure. Each of the service users has a plan of care which includes goals for their personal development and which give the service users and staff targets to aim for. Staff should give more thought to how they can provide greater opportunities for the service users to use and develop their independent living skills. 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 Stage 4.doc Version 1.30 Page 12 One of the service users said that they choose their own food and that the food is good. Service users are not involved in the preparation or cooking of food and this is something which service users should have the opportunity to develop their skills in. A four week menu plan is in place. This is often used only as a guide and is not followed strictly. The service users choices of meals is recorded daily. There was a fair variety of food available on the day of inspection including fresh food. Service users likes, dislikes and needs regarding food are recorded in their plans. 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 Stage 4.doc Version 1.30 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 standard(s) 18, 19, 20 Service users are supported by a staff team who know their personal care needs and preferences. Service users are supported to remain healthy. Medication is handled safely and in accordance with policies and procedures. EVIDENCE: Staff have supported the service users for a considerable length of time and therefore have a good understanding of their personal support needs. Service user plans include written guidelines as to how to support the service users with personal support. Each service user has an action plan in relation to their health related needs. This includes information on the individual’s last annual health checks and ensures that target dates are set for further checks. Service user’s records show that the staff team are referring for specialist support in meeting the health related needs of the service users. Records indicate that staff are supporting the service users in accessing primary care resources including G.Ps, nurses, dentists, consultants and chiropodists. Information on specific health conditions is in place. 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 Stage 4.doc Version 1.30 Page 14 A medication policy is in place at the home. The home maintains a record of all medication received, administered and stock checked. Medication storage and administration records were examined and found to be appropriate. Information is maintained on what medication is taken for and the possible side effects of the medication. The majority of staff have received medication training. 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 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 Policies, procedures and practices are in place which aim to prevent an abusive, neglectful or issue self harm from occurring. Systems are in place for dealing with allegations of abuse and staff have received training in the protection of vulnerable adults. EVIDENCE: The home has a complaints procedure which is time scaled appropriately and includes details of the Commission. A comments, complaints and suggestions notice is also available in the home along with a complaints leaflet. The complaints information should also be produced in more accessible formats. Through discussions with one of the service users it was clear that they are aware of how to make a complaint. There have been no complaints over the past 12 months. There is a protection of service users policy and an abuse policy in place at the home. A copy of Sefton Borough Council’s adult protection procedures is also available. Staff have received training in protection of vulnerable adults. 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 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, 25, 26, 30 The home is generally well presented, homely, safe and clean. Service users bedrooms are personalised with their own belongings and can be locked for their privacy. Health and safety precautions are taken and all relevant safety checks are up to date. EVIDENCE: A tour of the premises was carried out. 31Gladstone Road is a four bedroom terraced house situated in a residential area of Bootle, it is in keeping with other properties in the area and is indistinguishable as a care home. The house has one main lounge area, a dinning area, 1 ground floor bedroom and 3 first floor bedrooms. A stair lift is in situ but this is not currently used. Furnishings, fittings and décor are of a good standard and the home appears well maintained. The hall and landing areas are a little stark and could be presented more homely. Service user’s bedrooms are nicely decorated and personalised with their own belongings. Furniture and fittings are of a suitable standard. All service users 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 Stage 4.doc Version 1.30 Page 17 have a lockable space in their bedroom. Bedrooms doors are fitted with override locks. The home has a designated smoking area which is the dining room. It was recommended that this arrangement was reviewed following the last inspection. The dining room continues to be a smoking area. This must be reviewed again, particularly considering the service users do not smoke. It is recommended that alternative arrangements are made. 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 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) 33, 35, Service users benefit form being supported by a stable and long standing staff team who have had the opportunity to build relationships with the service users. Staff training opportunities are good and staff have received training in some specialised areas. EVIDENCE: Staff rotas were examined. The staff team appears to be quite stable and this provides consistency for the service users and enables staff to get to know the needs of the service users. The home is staffed by one member of staff 24 hours per day and additional staff are rotad to ensure a level of one to one support for the service users. The home is meeting the target of 50 of the care staff being qualified to N.V.Q level 2 by 2005. Staff receive training in core health and safety related skills and some members of the staff team have received training more specifically related to the needs of service users. Overall, the level of training opportunities available to staff are good. There was no evidence to suggest that each member of staff has an individual training and development assessment and profile or that a training needs assessment has been carried out for the staff team as a whole. 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 Stage 4.doc Version 1.30 Page 19 There was no access to staff records during the inspection and it was therefore not possible to ascertain whether or not staff are receiving regular supervision. Staff recruitment and selection procedures were not assessed on this occasion as the inspector did not have access to staff files at the time of inspection. Sefton Support Services do have a recruitment and selection policy and procedure. This includes potential employees having to provide at least two written references and a criminal records disclosure prior to the commencement of their employment. Staff meetings are regular and recorded. 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 Stage 4.doc Version 1.30 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 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, 41, 42 Practices that promote the health and safety of service users and staff are in place. Service user’s rights are safeguarded by the safe keeping and security of records and all records are up to date and maintained appropriately. Quality assurance processes are in place, however, these need to be developed further. EVIDENCE: The home has a number of policies, procedures and practices in place which aim to ensure the health and safety of service users and staff and these include procedures on issues such as infection control, fire safety and moving and handling. Records of fire and other health and safety checks were examined and found to be up to date. 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 Stage 4.doc Version 1.30 Page 21 The records kept at the home are in good order, up to date and maintained securely. A record of all accidents, injuries, incidents and complaints is maintained. All records were available for inspection with the exception of staff files as the member of staff on duty did not have access to these. The registered person ensures that the home is visited on an unannounced basis at least once per month and provides a report on the findings of the visit to the Commission in line with Regulation 26 of the Care Home Regulations 2001. These visits form part of the quality assurance process. The quality assurance process should be developed to include seeking the views of service users, their representatives as appropriate, and staff, in order to form an opinion on the standard of care provided. 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 Stage 4.doc Version 1.30 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 3 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x 2 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x x x 3 Standard No 11 12 13 14 15 16 17 2 x x 3 x x 2 Standard No 31 32 33 34 35 36 Score x x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 31 Gladstone Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 2 x 3 3 x F53 F03 S5247 31Gladstone Road V239933 010705 Stage 4.doc Version 1.30 Page 23 No 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 YA 8 & YA 11 Regulation 12 (3) Requirement Service users must be given greater opportunities to be involved in the daily running of the home and encouraged to use and develop their independent living skills. A system for quality assurance should be introduced which includes seeking the views of service users and relevant others. The results of this should be published. Timescale for action 1.08.05 2. YA 39 24 1.09.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA 35 Good Practice Recommendations The manager should produce individual training and development plans for each member of staff. The manager should also develop a training needs assessment and programme for the staff team as a whole. This training should be linked to the needs of the service users. A review on the appropriateness of the designated smoking area should be carried out. The hall and landing areas should be presented more homely. 2. 3. YA 16 YA 24 31 Gladstone Road F53 F03 S5247 31Gladstone Road V239933 010705 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 2nd Floor Burlington House Crosby Road North Waterloo 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. 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