CARE HOME ADULTS 18-65
10 Glenside Allerton Liverpool Merseyside L18 9UJ Lead Inspector
Beate Roth Unannounced 13 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. 10 Glenside F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service 10 Glenside Address Allerton Liverpool L18 9UJ 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) 0151 724 5594 North West Community Services (Merseyside) Limited Mr Anthony Carroll Care Home 3 Category(ies) of LD - Learning Disability -3 registration, with number of places 10 Glenside F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 7 December 2004 Brief Description of the Service: 10 Glenside Close is registered to provide personal care to 3 people with learning disabilities. All rooms are at ground floor level. Service users have single bedrooms. There is a staff sleeping in room which is also used as a quiet area for service users and provides access to the garden. There is a large bathroom, a separate toilet, a large living room, kitchen and laundry room. There is parking space to the front of the premises and a small garden area. At the rear of the building there is a good sized private enclosed garden. Bathing aids, wheelchairs, hand rails and hoists are provided. The home is situated in a residential area of Mossley Hill and is close to the city centre. There are small shops in close proximity to the home and a good size shopping centre fairly close by. The service users have a minibus and several of the staff are designated drivers. There is access to train and bus services. 10 Glenside F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over a morning. During the inspection time was spent examining records and policies and procedures and talking to the manager. A tour of the home was undertaken. Staff were observed delivering care to service users. What the service does well: What has improved since the last inspection? What they could do better:
Further information needs to be made available to enable service users and/or their representatives to make an informed choice about the suitability of the home. The contracts/terms and conditions need to be factually accurate and provide clearer information about what the fees payable include. The involvement of family, friends/advocate in supporting service users when drawing up the contract/terms and conditions is recommended. The records of staff recruitment must contain all the required information in order to show that the staff working with service users are competent and suitable to care for
10 Glenside F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Version 1.40 Page 6 vulnerable adults. Service users would benefit from 50 of staff having completed a formal qualification in caring for adults with a learning disability. 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. 10 Glenside F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Version 1.40 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 10 Glenside F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Version 1.40 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 and 5 There is insufficient information available for prospective service users or their representatives to make a decision about whether the home is suitable. EVIDENCE: No new service users have come to live at the home since 1991. A service user guide was not available for inspection. The manager reported that this is currently being reviewed. The statement of purpose does not cover all of the required information as listed in Schedule 1 of The Care Homes Regulations 2001. Contracts between the service users and North West Community Services have been made available since the last inspection. These do not clearly identify what services are covered by the fees payable. All additional costs to service users are also not identified (for example, the contribution toward the cost and use of the home’s mini-bus). The support agreement that accompanies the contract refers to service users being able to choose to have support from North West Community Services and from an alternative care provider. It also states that ‘ your support is not a condition of your tenancy, you can choose to live somewhere else and still be supported by North West Community Services’. Glenside is registered with the Commission for Social care Inspection as a care home and does not provide supported living. This is not therefore factually accurate.
10 Glenside F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Version 1.40 Page 9 The contracts have not been signed. When drawing up the contract service users should be supported by family, friends/advocate as appropriate. 10 Glenside F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9 Service users needs are met by the care planning at the home that reflects the assessed and changing needs of service users. Further information is to be included in one risk assessment in order to better meet the needs of service users. EVIDENCE: A sample of service user care plans were seen. These provide a lot of detailed information on the needs of the service users and provide clear guidance to staff. The plans seen had had a recent review. It was recommended at the last inspection that the information that is hand written in the care plans and Essential Lifestyle Plans be typed. This is in the process of being addressed. Risk assessments are carried out for both personal and environmental risks. All risk assessments are reviewed regularly. Since the last inspection a risk assessment on the use of bed rails has been undertaken and agreement around the use of bed rails with the service users families has been recorded. A daily record is being made that the bed rails are safe for use. The risk assessment needs to include some further information. This needs to include whether there has been a change to the physical needs of the service users
10 Glenside F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Version 1.40 Page 11 that may effect the use of the bed rail and that all staff must report any difficulties with the bed rail immediately. 10 Glenside F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Version 1.40 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 13 and 15 Service users are provided with opportunities for personal development and appropriate activities that ensure they are part of the local community. The needs of service users are met by appropriate relationships being promoted. EVIDENCE: The records and a discussion with the acting manager indicated that service users are encouraged to develop independent life skills such as washing and dressing and choosing clothes. Evidence was also provided to indicate that service users make use of the local community by using shops and parks, local museums and local pubs and restaurants. There is a local bus link with facilities for the disabled and the home has it’s own mini-bus. Visitors are welcome at the home at any reasonable time and can either use the service users’ bedroom or the communal rooms such as the lounge or dining room. Visits are encouraged from other service users/staff from other homes in the area, and from family and friends. 10 Glenside F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Version 1.40 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 and 19 The health needs of service users are met and personal support is given that meets their identified preferences and promotes their wellbeing. EVIDENCE: Records show that staff are provided with guidance around providing appropriate personal care to service users. This includes the preferences of service users. Training records show that staff have received appropriate training in providing personal care with dignity and around PEG feeding. Records show that service users are supported to attend healthcare appointments and have access to health care services when they are needed. 10 Glenside F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Version 1.40 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 standard(s) 23 Staff training and policies and procedures are in place to ensure that service users are protected. EVIDENCE: There is a Whistle Blowing Policy and Liverpool City Council’s Adult Protection Procedures available. Staff are given training on induction on issues surrounding adult protection. Since the last inspection all staff have received formal training on recognising and reporting all forms of abuse. 10 Glenside F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Version 1.40 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 standard(s) 24 and 30 The home is clean and generally well presented and provides a comfortable and pleasant environment for service users. EVIDENCE: The home is generally decorated to a high standard and is comfortably furnished. Some minor attention is needed to the decoration in the bathroom. The manager reported that this room has been identified for redecoration. The progress of this will be assessed at the next inspection. A tour of the home showed that the home was clean. The home smelt fresh. It is clear the staff are working hard to ensure good standards of cleanliness are maintained throughout the home. There are procedures for staff to refer to about hygiene and infection control. 10 Glenside F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Version 1.40 Page 16 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 34 Service users are supported by the training staff have received, however, service users would benefit further if 50 of staff had completed formal training. The recruitment records do not demonstrate that service users are protected by the homes recruitment practices. EVIDENCE: The manager reported that since the last inspection a more structured induction programme is provided for staff. This covers training around manual handling, health and safety, food hygiene, first aid and the protection of vulnerable adults. Following this the staff files show that staff attend training courses relevant to the duties they perform at the home, such as training in PEG tube feeding, epilepsy management and medication management. Staff are then encouraged to undertake an NVQ in caring for adults with a learning disability. Steps are being taken to ensure that 50 of staff have undertaken this qualification. Four new members of staff have been employed since the last inspection. The records of recruitment were examined and did not contain all the required information. There was no documented evidence of the physical and mental suitability of the 4 staff to work at the care home. 2 references were not available for one staff member. A photograph was not available for 3 staff. It
10 Glenside F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Version 1.40 Page 17 was a requirement at the last inspection that all the information listed in Schedule II of the Care Homes Regulations is available at the home for all staff employed. 10 Glenside F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Version 1.40 Page 18 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 and 42 The quality assurance and the health and safety systems in operation at the home in general promote the wellbeing of service users. EVIDENCE: The home carries out regular quality assurance audits and the Service Manager visits the home monthly and also carries out a thorough audit of service users’ health and welfare, accidents, risk assessments both personal and environmental, and staffing levels. However copies of the audit report are not sent to the CSCI office as per regulations and a copy was not available at the home for inspection. A financial audit is conducted once a year by the parent company. The records of fire safety checks, gas supply and electricity were seen and were in order. Training records showed that staff are given appropriate training in safe working practices. A fire risk assessment was not available. 10 Glenside F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x 1 Standard No 22 23
ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 x x 2 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 x 3 x 3 x x Standard No 31 32 33 34 35 36 Score x 2 x 1 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
10 Glenside Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 2 x F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Version 1.40 Page 20 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 1 Regulation 4, 5 Requirement A service user guide must be available. The statement of purpose must cover all the matters listed in Schedule 1 of the Care Homes Regulations 2001. The contract/statement of terms and conditions between the home and the service user must accurately reflect the service provided, clearly state the facilites and services that are included in the fees payable and any additional costs to service users and what they are. The risk assessments around the use of bed rails must indicate whether there has been a change to the physical needs of the service users that may effect the use of the bed rail and that all staff must report any difficulties with the bed rail immediately. The records of recruitment must contain all the information detailed in Schedule 2 of The Care Homes Regulations 2001 (previous timescale not met). The registered person must ensure that the local CSCI office
F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Timescale for action 13/10/05 2. 5 5 13/10/05 3. 9 13 13/07/05 4. 34 17 13/07/05 5. 39 26 13/07/05
Page 21 10 Glenside Version 1.40 6. 42 23 receives copies of the monthly responsible individual’s representative reports on unannounced visits(previous timescale not met). A fire risk assessment is to be completed. 13/08/05 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. 2. 3. Refer to Standard 5 6 32 Good Practice Recommendations When drawing up the contract service users should be supported by family, friends/advocate as appropriate. All the hand written information on care planning should be typed. 50 of staff (including agency) are to hold an NVQ 2 or equivalent. 10 Glenside F52 F02 S0000025273 10 Glenside V238643 130705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 3rd Floor 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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