Inspection on 23/08/06 for Glendyke Road 54

This inspection was carried out on 23rd August 2006.

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 no outstanding requirements from the previous inspection report, but made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Glendyke Road 54 02/03/09

Glendyke Road 54 23/08/07

Glendyke Road 54 25/02/06

Glendyke Road 54 09/12/05

Glendyke Road 54 18/11/04

Glendyke Road 54 11/06/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Glendyke Road 54 54 Glendyke Road Allerton Liverpool Merseyside L18 9TH Lead Inspector Lynn Sharples Unannounced Inspection 23rd August 2006 09:30 DS0000057717.V298547.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000057717.V298547.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000057717.V298547.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Glendyke Road 54 Address 54 Glendyke Road Allerton Liverpool Merseyside L18 9TH 0151 420 3637 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) www.c-i-c.co.uk. Community Integrated Care Mrs June Dunne Care Home 3 Category(ies) of Learning disability (3) registration, with number of places DS0000057717.V298547.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th February 2006 Brief Description of the Service: 54 Glendyke Road is a care home registered with the CSCI to provide care for three adults with a Mental Health /learning disability. Community Integrated Care have been the registered provider for this service since December 2003. The home is situated in the Allerton area of Liverpool and is close to local amenities, bus and rail routes. The care home is a bungalow and all facilities for the service users and staff is situated on the ground floor. The home is accessible for wheelchair users and is generally well maintained. The fees for the home are £265.55 per week. DS0000057717.V298547.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home did not know about the visit and took five hours. The inspector spoke with the service users, staff on duty and the manager. The files relating to the service users and the home were read and the premises toured. What the service does well: What has improved since the last inspection? What they could do better: The care plans should be reviewed after consultation with the service user or representative. The home should enable service users to make decisions. The use of the wheelchairs should be risk assessed. The service users should visit a chiropodist. Discontinued medication should be disposed of. Complaints should be recorded and made available to appropriate parties if requested. The carpet in the lounge should be replaced. The aids in the bathroom should be safe and assessed by an appropriate professional. Each member of staff should have two references on file. The staff should receive regular recorded supervision. The fire extinguishers should be colour coded correctly. DS0000057717.V298547.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. DS0000057717.V298547.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000057717.V298547.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and Service User Guide provides sufficient information for prospective service users to be clear about the services the home provides to meet their needs. EVIDENCE: The statement of purpose and service user guide are well written documents with photographs of the staff to assist service users; as there has been a change in staff personnel the photographs will be updated. A copy of the service user guide is kept in the service users bedrooms. There have been no new admissions to the home. The current service users have been resident at the home since 1995/1997. Documentation indicates referral information is incorporated in the company’s assessment document. Information is gained from the service user and all other interested parties. A copy of the terms and conditions with the home are in service users care files and the service user guide. DS0000057717.V298547.R01.S.doc Version 5.2 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 Quality in this outcome is poor. This judgement has been made using available evidence including a visit to this service. The lack of the review of care plans and risk assessments leaves the service users unprotected from harm. EVIDENCE: The three service users all have care plans, one service users has an Essential Lifestyle Plan that was completed in December last year. The other two plans include details of personal hygiene and support needs, oral hygiene, mobility, finance and medication. The plans have not been reviewed for over twelve months. It is important that the plans are reviewed with the service user involving family, friends, advocates and significant professionals at least every six months and updated to reflect changing needs. None of the service users are able to verbally communicate their needs effectively and would benefit from having an advocate to assist with making decisions and choices. There is limited evidence that the staff record instances when the service users make decisions. They do choose what to eat each day. DS0000057717.V298547.R01.S.doc Version 5.2 Page 10 This could be greatly improved using a speech and language therapist to advise about the use of pictures to aid communication and choice. There was no record of the services users likes and dislikes. From discussions with the staff it is evident that service users are supported in terms of taking responsible risks. Where there are identified risk staff have acted appropriately to minimise the risk. Two of the service users use a wheelchair when going out, a risk assessment should be undertaken to include this activity, to ensure that they are safe. Also, one service user goes swimming, although they have not done so with the home for six months, if they are to go swimming again a risk assessment needs to be undertaken to ensure that they are safe. DS0000057717.V298547.R01.S.doc Version 5.2 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): 12,13,14,15,16,17 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. Service users engage in community and leisure activities appropriate to their age. This ensures that the service users lifestyle aspirations are addressed. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: DS0000057717.V298547.R01.S.doc Version 5.2 Page 12 One service user accesses a day centre three days per week and undertakes daily living skills. Service users are provided with opportunities to participate in various types of activities including trips out. On the day of the visit one service user went out shopping and an aromatherapist visited the other service users, an activity the service users appeared to enjoy. Discussions with staff on duty indicate that service users are provided with opportunities to be involved in the local and wider community. Service users have regular trips out to local cafes, eateries and pubs. Regular planned and unplanned trips are undertaken. Each service user has an activity plan in place and all the staff team have responsibility in relation to ensuring that service users have opportunities to undertake individual activities. Activities undertaken include: day centre, visits to the local shops, aromatherapy, occasional meals out, board games, music sessions and watching T.V. These are recorded in daily evaluation sheets. One service user has been on holiday this year and the other service users are going on holiday next month. Service users families can visit and if the service user wishes they can see them in the privacy of their own room. In one service users file it was recorded that they visit a friend regularly, the staff confirmed this. The staff team were observed to spend time interacting with service users and spending quality time with them. Staff did not speak exclusively to each other and the main topics of conversation focussed on the service users. Staff where observed to treat service users with respect and dignity throughout the visit. Service users have unrestricted access to all parts of the home including the garden area. Each bedroom has an over rideable lock although due to service users levels of understanding and dexterity they are unable to access this facility. A menu is maintained and indicates that service users are provided with a balanced and nutritious diet. Service users have individual needs and the food provided reflects these needs. It was evident that the service users eat different meals, as is their choice. At the weekend the service users have a brunch and a main meal, the manager explained that each night the service users have supper and this is not recorded. They agreed to include this in the menus to demonstrate that the service users are receiving a balanced diet. A pictorial representation of meals could help the service users to indicate a choice of preference each day. DS0000057717.V298547.R01.S.doc Version 5.2 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 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. The service users receive the appropriate personal support in the way they prefer and require. The service users have not visited a chiropodist and this means that their health needs are not met and could be at risk of harm or injury. EVIDENCE: All of the service users require full support in relation to personal support, although the staff team encourage independence where possible. It was observed during the visit that the support provided ensures service users privacy and dignity. A bath hoist is used to support service users according to individual service user’s needs. Service users are supported in choosing their clothes etc. and this is facilitated according to their personality and levels of communication. Service users receive specialist support from professionals according to assessed need. It is recorded in the individuals care plan the routines for getting up/going to bed, meals and these are flexible at the weekend. Each service user has a key worker and a co worker. The home fully supports each service user in relation to healthcare needs and arrangements are in DS0000057717.V298547.R01.S.doc Version 5.2 Page 14 place in order that service users receive dental, optical services and visit their doctors regularly. Good clear records are kept in relation to any health care intervention or contact with health care professionals. Specialist health care is sought where appropriate. In the risk assessments a visit to a chiropodist is highlighted as a need and there is no evidence of anyone visiting a chiropodist. The manager said that they had sent in a referral to a chiropodist and was aware of this issue. The home has a metal, lockable and secure medication storage facility bolted to the wall. A sample of medication administration records indicate that staff sign to indicate if medication has been administered to service users and there were no gaps apparent. The staff team have undertaken medication training this year. Two medications were found not to be use and it is recommended that these be returned to the pharmacist. A photograph of each service user is on file and a record of staff signatures is provided. DS0000057717.V298547.R01.S.doc Version 5.2 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): 22,23 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. The home has a documented complaints procedure to ensure service users views are listened to and acted upon. Systems are in place to ensure that service users are safeguarded from abuse and harm. EVIDENCE: The home has a detailed policy and procedure with regard to the protection of vulnerable adults and the procedure for whistle blowing by staff. There have been one complaint since the last inspection and the CSCI has not received any complaints. The home could not locate the complaint; the complaints received by the home should be documented and available to be read by the service users, their family and the CSCI. The staff demonstrated an awareness of how to ensure service users were protected from abuse and the staff team have received training in adult protection. DS0000057717.V298547.R01.S.doc Version 5.2 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): 24,26,27,29,30 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. The home is comfortable and creates a pleasing and pleasant environment for the service users to live in. The lack of risk assessment of some of the aids leaves service users at risk of harm. EVIDENCE: DS0000057717.V298547.R01.S.doc Version 5.2 Page 17 A re decoration programme within the home has been completed which includes service users bedrooms, kitchen, hallway and communal areas. The carpets have still not been replaced with a type of floor covering that colour co ordinates with the redecoration of the house. The carpet in the lounge needs replacing, it is threadbare in places and this could pose a risk to the service users. This was highlighted at the last visit. Each of the service user’s bedrooms is individually and tastefully decorated and furnished. None of the bedrooms has a hand wash facility. One service user has a new bed. The home provides toilet and assisted showering and bathing facilities. There are ongoing plans in place for the assisted bath to be replaced with a more appropriate type of assisted bath. A separate W.C facility is also provided that provides good wheelchair access. The toilet and bathroom has an over rideable lockable facility. The home provides a bath hoist to assist in the bathing of service users when necessary. There are plans to replace the bath hoist with a type of hoist that will further benefit the service users. There are aids at the side of the sink, which are kept in place by a plastic bottle, these are unsafe and could pose a risk to the service users, these aids should be risk assessed and involve other suitably qualified professionals to ensure that the service users are safe. The home provides domestic style programmable laundry facilities that are situated in the utility room and includes a separate washer and dryer. The utility room has adequate impermeable flooring. The home has a policy in relation to infection control. The home has adequate arrangements in place to ensure that clinical waste is adequately stored and disposed of. On the day of the visit the home was free from malodour and was clean. DS0000057717.V298547.R01.S.doc Version 5.2 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): 32,33,34,35,36 Quality in this outcome is poor. This judgement has been made using available evidence including a visit to this service. The lack of supervision and staff meetings leaves the staff without appropriate direction to provide effective support to the service users. EVIDENCE: There are five care staff and one manager at the home. Two staff have achieved the NVQ level 2 are three staff are waiting to start the programme. The staff were able to demonstrate an awareness of the specific conditions of the service users and were observed interacting appropriately with the service users. There have only been two recorded staff meetings this year. The home uses regular bank staff that know the service users well to cover for sickness and holidays. An examination of a sample of staff records indicated that the staff had two references, enhanced CRB checks, statements of terms and conditions on their personnel file. One member of staff did not have two references on their file and the manager agreed to address this. DS0000057717.V298547.R01.S.doc Version 5.2 Page 19 The staff team receive induction training as evidence in their personal files. The staff team have received training in adult protection, epilepsy, fire training, manual handling and medication. Staff spoken with indicated that they had received regular updated training this year. The staff have only received two or three recorded supervisions in the last year. The staff said that this has only started again recently and had long periods when they had not been formally supervised and welcomed the new supervisions. It is important that the staff have regular recorded supervision covering support and guidance and monitoring of work with individual service users. DS0000057717.V298547.R01.S.doc Version 5.2 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): 37,39,42 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. The record of self-review by the registered provider is good and provides the home with adequate quality assurance. EVIDENCE: The new manager has only been in post one week and is applying to the CSCI to register as the manager. The manager has been a team leader and a senior carer for three years, supervising staff. The manager is starting the NVQ 4 in management soon. The responsible individual visits monthly and writes a report and sends this to the CSCI office. It would be beneficial if the service users had access to an advocacy service, this could assist the service users give feedback to the home. DS0000057717.V298547.R01.S.doc Version 5.2 Page 21 Service users files were kept secure. A tour of the building confirmed that it was free from hazards. Risk assessments were in place and staff were aware of their responsibilities to maintain a safe environment. The staff team attend fire drills on a regular basis. Certificates of maintenance and worthiness for hoists, gas and electrical installations, fire equipment were evidenced on the day of the visit. All certificates were in date and valid. In one staff meeting in May 2006 it was recorded that the fire extinguishers colour coding was out of date; from discussions with the manager this has still not been addressed. DS0000057717.V298547.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 3 28 X 29 2 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 3 X 3 X X 2 X DS0000057717.V298547.R01.S.doc Version 5.2 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 YA6 Regulation 15 Requirement The registered person must ensure that the care plans are reviewed after consultation with the service user or representative. The registered person must ensure that they enable service users to make decisions. The registered person must ensure that the use of the wheelchairs is risk assessed. The registered person must ensure that the service users visit a chiropodist. The registered person must ensure that discontinued medication is disposed of. The registered person must ensure that complaints are recorded and made available to appropriate parties if requested. The registered person must ensure that the carpet in the lounge is replaced. The registered person must ensure that the aids in the bathroom are safe and are assessed by an appropriate professional. The registered person must DS0000057717.V298547.R01.S.doc Timescale for action 02/10/06 2 3 4 5 6 YA7 YA9 YA19 YA20 YA22 12 13 13 13 22 02/10/06 02/10/06 02/10/06 02/10/06 02/10/06 7 8 YA24 YA29 23 23 20/11/06 02/10/06 9 YA34 19 02/10/06 Page 24 Version 5.2 10 11 YA36 YA42 18 23 ensure that each member of staff has two references on file. The registered person must 20/11/06 ensure that the staff receive regular recorded supervision. The registered person must 02/10/06 ensure that the fire extinguishers are colour coded correctly. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA7 YA7 Good Practice Recommendations It is recommended that the service users have access to local independent advocacy services. It is recommended that service users be involved in making choices and record instances when others make decisions, and why. It is recommended that the bathroom/shower room furnishings and fittings be updated. It is recommended that the staff attend regular staff meetings (minimum six per year) and these are recorded and actioned. 3 4 YA27 YA33 DS0000057717.V298547.R01.S.doc Version 5.2 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. Extracts may not be used or reproduced without the express permission of CSCI DS0000057717.V298547.R01.S.doc Version 5.2 Page 26 - 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!