Inspection on 29/12/05 for Grandison Road (77)

This inspection was carried out on 29th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Grandison Road (77) 27/07/07

Grandison Road (77) 09/03/06

Grandison Road (77) 23/02/05

Grandison Road (77) 09/07/04

Grandison Road (77) 30/01/04

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 Grandison Road (77) 77 Grandison Road Walton Liverpool Merseyside L4 9SU Lead Inspector Karen Barry Announced Inspection 29th December 2005 09:45 Grandison Road (77) DS0000025275.V270592.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 Grandison Road (77) DS0000025275.V270592.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. Grandison Road (77) DS0000025275.V270592.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Grandison Road (77) Address 77 Grandison Road Walton Liverpool Merseyside L4 9SU 0151 270 1435 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 Mrs Helen Marsden Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Grandison Road (77) DS0000025275.V270592.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd February 2005 Brief Description of the Service: Grandison Road is a semi-detached home in Liverpool that offers two places for people with Aspergers Syndrome to reside. The home is run as a semiindependent unit in order to assist the service users towards long-term independence in the future. There is a communal kitchen, bathroom and living area that are shared by service users and staff, but each service user has their own single room decorated according to their own taste. Both service users are encouraged to fully access all local facilities and amenities, including college courses and employment. Grandison Road (77) DS0000025275.V270592.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector told the Registered manager that she would be visiting, before the inspection took place. This gave the registered manager time to prepare and to complete a questionnaire, which highlighted the various areas that inspector examined during the inspection, which lasted 5 hours. The inspector was welcomed to the house by a member of staff and the two service users prior to meeting the registered manager. Time was spent within the office examining and discussing records with the manager and support staff. The inspector was given a tour of the house by one of the service users who also shared her views and feelings regarding life in the house. What the service does well: What has improved since the last inspection? What they could do better: The registered person should continue to with planned improvements to the décor of the house ensuring it is maintained to a good standard of appearance. Grandison Road (77) DS0000025275.V270592.R01.S.doc Version 5.0 Page 6 Consideration should be given to reviewing paperwork used to record incidents that occur within the home as standard form does not presently include a space to date the recordings made. Consideration should be given to how staff within the house liaise with head office and vice versa, as at present there are no facilities to aid communication by fax. 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. Grandison Road (77) DS0000025275.V270592.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 Grandison Road (77) DS0000025275.V270592.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): 1,2,3,4 & 5 Grandison Rd ensures service users receive suitable information regarding services offered ensuring they are aware of how their needs could be met if they decided to live at the home. EVIDENCE: Grandison Rd has not had any admission for a number of years. Discussion relating to the process followed relating to the last service user admission highlighted that a multi-disciplinary assessment was undertaken and a number of visits to the home by the service user where undertaken before any formal decision was made by either party. Written evidence was seen to support the information given by both the service user and staff members. The homes statement of purpose confirms that prospective service users and their representatives are encouraged to visit the house to see the facilities offered at the care home for themselves. This also provides an opportunity for them to meet with the other service user and the staff, in order to establish working relationships. The service user guide appears to be regular updated to ensure service users are fully aware of what they can expect from the home and it’s staff members at any given time. Grandison Road (77) DS0000025275.V270592.R01.S.doc Version 5.0 Page 9 Copies of individualised contracts where seen upon service users files which confirmed the arrangements regarding services being offered. Grandison Road (77) DS0000025275.V270592.R01.S.doc Version 5.0 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 the following standard(s): 6,7,8,9 & 10 The individualised care plans used ensure each service has their needs and goals are met appropriately on a daily basis. EVIDENCE: Staff members have developed comprehensive Individual Personal Plan (IPP) together with detailed risk assessments with each of the services users. The IPP contains a ‘pen picture’, behavioural guidelines / strategies, healthcare, communications, individual living skills, leisure activities, mobility / transport needs and arrangements, specific risk assessments, care plan, daily activities and a timetable. Multi-disciplinary reviews meetings are held regularly. Staff members encourage service users to assist them in preparing a report, which highlights their achievements and changing care needs since the previous review. Observations during the inspection indicate staff support service users to make decisions over their daily lives. One of the service uses told the inspector that she felt her and her housemate where fully involved in how the house is run. Grandison Road (77) DS0000025275.V270592.R01.S.doc Version 5.0 Page 11 All care related documentation examined was found to be clear, concise and appeared accurate. It also showed that as far as possible service users are the fully involved in the planning and reviewing process. Full involvement of NHS and other healthcare professional agencies was clearly seen on all service user care plans examined. Family, friends and support networks also play a large part of the current service users’ lives. Grandison Road (77) DS0000025275.V270592.R01.S.doc Version 5.0 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 the following standard(s): 11,12,13,14,15,16 & 17 Family and friends are fully included in both service users lives, and participation within the local community is actively encouraged to ensure independence is promoted. EVIDENCE: Staff members where observed supporting service users preparing to go out independently during the day of the inspection. Service users Independent Living Skills (ILS) files seen clarified the various strategies and coping mechanisms that have been put in place to enable service users to undertake such tasks. One service user is presently being supported to achieve a set of goals that will hopefully prepare her for moving on to an independent living environment with the community. Discussion with the service users showed that they could access various community activities independently or with the support of their key worker if needed. Grandison Road (77) DS0000025275.V270592.R01.S.doc Version 5.0 Page 13 Both service users have very active social lives, and enjoy various leisure pursuits such as the attending the local gym, swimming, Aspergers Group one night per week (Thursday), local pubs, local college groups, shopping and what ever they choose, subject to their risk assessments. The home has an open visiting policy and service users are able to choose where to see their visitors. The staff have discussed issues around personal relationships with both service users and given advice and support as needed. Discussions indicated that both service users have formed and developed meaning-full personal relationships within the local community. Service users have been given their own keys to the house and can lock their bedroom doors in order to maintain their privacy. However as mentioned in the previous report the registered person must provide suitable locks to the service user bedroom doors, which can be overridden by staff in an emergency. The manager was informed that a requirement would be made regarding this issue. There is a generalised no-smoking policy in operation within the house, which service users respect by smoking by the back door area only. According to their agreed timetables both service users undertake various household tasks. This includes the planning purchasing and preparing of their on meals. The standard of record keeping in all areas was very good, and staff were able to demonstrate their specialist knowledge of the service users and their conditions. Grandison Road (77) DS0000025275.V270592.R01.S.doc Version 5.0 Page 14 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 &21 Continued independence with regards personal care is supported and promoted by the staff’s knowledge and experience of the individual service users. Polices and procedures followed ensure their mental and physical needs are met. EVIDENCE: The present service users do not require any assistance with personal care or with their mobility. Staff ensure both service users have full access to NHS screening and healthcare, i.e., well woman clinics, etc, and access their own GP independently. Service users chose whether or not they wish to be accompanied by staff when attending any health appointment. An information sheet is kept for guidance on medications, and policies, procedures and guidance was available to staff regarding the safe handling and administration of medications. Discussion with the registered manager indicated that the service users would be cared for at the care home if they became terminally ill or dying with the support of other health professionals. Grandison Road (77) DS0000025275.V270592.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Policies and procedures in place ensure services users views are listened to and acted upon appropriately. The homes approach to training helps protect the service users from abuse, neglect & self-harm. EVIDENCE: A clear complaints policy and procedure is available for both service users and their representatives. Records relating to a recent complaint made by one of the service users shows that staff members welcome their views and how they have worked with the service users to ensure compromises and improvements are made. Liverpool’s Inter-Agency policy and procedures for the protection of vulnerable adults is used within the home for guidance and advice regarding issues and concerns that may arise. Staff members appear to have gained sufficient knowledge from training provided to fully understand their roles and responsibilities of protecting service users from abuse. Training records indicate that staff members have undertaken training on Calm and Restraint. All monies belonging to service users are counted at the commencement of each shift with the service user, and when the service user goes out shopping, etc. Grandison Road (77) DS0000025275.V270592.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29 & 30 The house is comfortable, clean and tidy, however some redecoration is required to enhance the homely atmosphere provided within Grandison rd. EVIDENCE: The furnishings in the home are domestic in character and of a good quality. The inspector viewed one of the service users rooms during the inspection. One service users room was seen during the inspection. The room appeared to reflect her individual personality and preferences. The service user told the inspector “I’m planning to redecorate soon, I think I’ll keep the same colours its just that it needs freshening up” Further discussion indicated that where possible the service users are involved in choosing furniture and fitting and that they could be involved in undertaking some of the painting work themselves if they desired. The other bedroom was not seen on this occasions as information received indicated that the service users doesn’t really like people going into her room without her being present. Service users bedrooms are lockable, and staff only access with the service users permission. The registered person must however provide more suitable Grandison Road (77) DS0000025275.V270592.R01.S.doc Version 5.0 Page 17 locks to the bedroom doors, as presently these cannot be overridden by staff in the case of an emergency. One bathroom is provided in the home, and both service users and staff share this. The hot water temperatures are monitored on a regular basis, and records of this are kept. Staff are provided with a designated sleeping-in room, which also forms the homes office space. This room is locked when not is use. The home has well maintained gardens. Much of the work undertaken designing and maintaining the gardens is undertaken by one of the service users. A lounge, separate dining area and kitchen are also provided. Policies and procedures are available offering guidance in infection control and the maintenance of hygiene. Observation during the inspection showed a large crack leading from the bathroom along the landing and down the stairway. The manager explained that this has been reported and evidence suggests no major structural damage is present. Discussion with the manager also indicated that although the front door had been replaced water is still seeping in on occasions. The registered person must ensure that the building is maintained internally and externally and must provide the Commission for Social Care and Inspection (CSCI) with an action plan with timescales when these issues are to be rectified. Grandison Road (77) DS0000025275.V270592.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 & 36 There appears to be a good match of suitably qualified staff offering consistency of care to the service users within Grandison Rd. Recruitment polices and practices appear robust ensuring service users are protected via procedures followed. EVIDENCE: The home has an established staff group who appear fully aware of the needs of the service users. The low turnover and sickness levels of staff in the house alongside feedback from the service users demonstrates that staff have the necessary experience and personal skills to work with the service users. The inspector examined a number of staff files these confirmed that the home had obtained two written references, a Criminal Records Bureau check prior to staff starting work within the house. These files also confirmed that staff were issued with a written terms and conditions of employment and a job description. Discussion with staff indicated that they had a clear understanding of their roles and responsibilities and that they saw themselves as enables rather than carers. Before new staff are given a permanent contract of employment they the inspector was told that they have to complete all mandatory training plus five modules of specialist training. This covers fire, health & safety, food hygiene, Autistic spectrum disorders, first aid, epilepsy awareness, adult Grandison Road (77) DS0000025275.V270592.R01.S.doc Version 5.0 Page 19 protection, mental health, infection control and moving & handling. In addition to this most staff are either in process, or have completed their NVQ 2 in Care; and have the support of an external NVQ assessor. Staff training records seen showed they are clearly linked to the assessed needs of the service users. The registered manager provides supervision to all support workers and keeps a written record of issues discussed and an annual appraisal system is in place. Grandison Road (77) DS0000025275.V270592.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41,42 & 43 Grandison Rd appears to be a well run home with good leadership. Quality assurance process are in place to ensure the service user’s best interests are safeguarded and protected. EVIDENCE: The registered manager has many years experience within this specialized service user group, and was clearly able to demonstrate her knowledge. On the day of this inspection the home appeared very well organised. The Commission for Social Care and Inspection (CSCI) office has recently received notification that the present register manager is shortly due to leave the organisation, as a means of enhancing her career development. This matter was discussed in order to clarify what long and short term measures had been put into place to ensure the staff team and the service users continue to benefit from the ethos she has developed to ensure the home runs smoothly and in the best interests of the service users. Staff and services users spoken to indicated that the present manager would be greatly missed by them all but they understood why she had decided to pursue other options and they all wished her well in her new ventures. Grandison Road (77) DS0000025275.V270592.R01.S.doc Version 5.0 Page 21 Policies and procedures are reviewed reqularily by the quality assurance department at Autisms head office, to ensure they incorporate any recent developments in practice. Copies of all polices are fully accessible to staff and service users at any time. Quality assurance is undertaken in-house and via the company’s own audit process. Service user’s views and involvement is sought as far as possible, and the results of these audits are made available to interested parties, including the CSCI. Service users records are kept in a secure place, however when necessary service users can have access to these. As previously mentioned within this report all records seen where very well maintained. At the time of the inspection the home had a valid Public Liability Insurance certificate on display. All other necessary certificates such as gas, electric and risk assessments were up to date. Discussion with the manager confirmed that the home maintains a record of all financial transactions at the care home for accounting purposes. There are clear lines of accountability with the external management of the care home. Grandison Road (77) DS0000025275.V270592.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 2 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 2 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Grandison Road (77) Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 DS0000025275.V270592.R01.S.doc Version 5.0 Page 23 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 YA26YA16 Regulation 13 & 23 Requirement The registered person must install locks to the service users bedroom doors, which can be overridden by staff in an emergency. Previous time scale of 30/04/05 not met. The registered person must ensure that the building is adequately maintained internally and externally. The registered person must provide CSCI with an action plan with timescales detailing when identified maintenance issues in the report are to be reified. Timescale for action 01/03/06 2 YA24 23 01/03/06 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 Grandison Road (77) DS0000025275.V270592.R01.S.doc Version 5.0 Page 24 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 Grandison Road (77) DS0000025275.V270592.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. 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