Inspection on 09/03/06 for Grandison Road (77)

This inspection was carried out on 9th March 2006.

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 2 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) 29/12/05

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 Unannounced Inspection 9th March 2006 01:00 Grandison Road (77) DS0000025275.V286947.R01.S.doc Version 5.1 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.V286947.R01.S.doc Version 5.1 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.V286947.R01.S.doc Version 5.1 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) www.peterhouseschool.org Autism Initiatives Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Grandison Road (77) DS0000025275.V286947.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th December 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.V286947.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes second inspection, it took place without prior notice being given to the staff and service users. The inspector was welcomed into the house by one of the service users who was in the process of preparing her lunch after her morning at college. The inspector then met with a member of staff who was just commencing her duties. During the inspection time was spent sitting and chatting with service users and staff members. In addition service user files, records relating to every day operations and maintenance of the home were examined. As this inspection only looked at a limited number of standards the report should be read together with the previous report to gain a full picture of how the home is meeting the needs of the people living there. What the service does well: What has improved since the last inspection? One of the service users has recently been to view more suitable accommodation options, as with the appropriate support and guidance her goal of moving on to independent living is now felt to be achievable. “I’m really excited about moving on, the staff have helped so much over the years but I know now that I’m ready to live on my own. I just Grandison Road (77) DS0000025275.V286947.R01.S.doc Version 5.1 Page 6 wish they could give me actual times and dates for moving but they can’t yet.” The overall appearance of the house has been improved to ensure service users and staff members have a well-maintained, pleasant environment to live and work within. The following areas have received attention within the last 3 months; The hall and stairway has been painted and wallpapered. The bathroom has been decorated and new modern stainless steel fittings have been fitted. Net curtains throughout the house have been removed and replaced with blinds. One of the service users stated, “They make the house look much nicer inside and out. A new cooker has been purchased and fitted within the kitchen, service users and staff mentioned that although the previous one was still in good working order a lot of the enamel areas had become worn, which they felt not only gave an poor impression, but could reducing hygiene standards normal met within the home. The inspector was informed that estimates to replace the windows throughout the house with plastic framed double-glazing have recently been submitted to the estates department as a further means of improving the overall impression of the house whilst reducing a considerable amount of on going maintenance work A new lock has been fitted to one of the service users bedrooms door this ensures her rights to privacy is respected and maintained, whilst taking in to account that staff may need to override the lock in an emergency. What they could do better: The appointment of a suitable experienced qualified manager is required to ensure the staff team receives on going leadership support and direction to enable them to continue undertaking their duties to a high standard. As the organisation has recently changed its gas supplier it is imperative that an up to date certificate is obtained to confirm that the supply and equipment have been serviced and deemed safe. Please contact the provider for advice of actions taken in response to this Grandison Road (77) DS0000025275.V286947.R01.S.doc Version 5.1 Page 7 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.V286947.R01.S.doc Version 5.1 Page 8 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.V286947.R01.S.doc Version 5.1 Page 9 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): EVIDENCE: This area was not assessed on this occasion please see previous report for detailed information. Grandison Road (77) DS0000025275.V286947.R01.S.doc Version 5.1 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 Detailed person centred care and support plans devised through consultation with the service users ensures their individual needs and goals are met appropriately. EVIDENCE: The inspector examined support plans, comprehensive Individual Personal Plan (IPP) together with detailed risk assessments for both of the services users. All documentation seen clearly explain their individual needs and aspirations. 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. Discussion with one of the service users indicated that she had been fully involved in the devising of her plans, and that she felt that the staff gave her appropriate support and guidance as necessary. “I’m trying to cut down my smoking at the moment, the staff have been really good giving my support, guidance and loads of praise. I have one in the morning and then I’m trying not to have my next one till about 1 o’clock. Last week at college I started to get really anxious and upset all I could think about was have a cigarette. When I came Grandison Road (77) DS0000025275.V286947.R01.S.doc Version 5.1 Page 11 home and talked it all through with the staff they reminded me that I had been doing really well and that if I really felt I needed a cigarette then it was ok. They told me I know myself better then anyone else does and that I shouldn’t put too much pressure on myself. They’ve help me think of different ways of handling the symptoms of withdrawing from nicotine” Documentation seen confirmed that family, friends and support networks play a large part of the current service users’ lives and that they have regular access to relevant healthcare professionals to aid their physical and emotional well being. Records relating to regular multi-disciplinary reviews meetings indicate that staff members encourage service users to assist them in preparing a report, which highlights their achievements and changing care needs since the previous review. The other service user told the inspector that will the help and support she’d received at Grandison house she was now in the process of moving on to independent living “I’ve been to look at my new place and I can’t wait to move in, it will be strange at first not having the staff around and not having to think about ringing them to say when I’m on my way home etc but I know I’m ready now” 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. Service users records are held within office space this area is kept looked when not in use. Grandison Road (77) DS0000025275.V286947.R01.S.doc Version 5.1 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 Service users are enabled to pursue the lifestyles they desire with appropriate levels of support and guidance from knowledgeable staff members. Participation within the local community is actively promoted to ensure service users rights to independence is encouraged. EVIDENCE: Observations and discussion with the service users showed that they have been provided with a variety of opportunities to enable them to access various community activities independently or with the support of staff members thus enabling them to pursue a range of learning and leisure activities that reflect their preference of suitable life experience. 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 pursue such opportunities. Both service users have very active social lives, and enjoy various leisure pursuits such as the attending the local gym, swimming, Aspergers Group one Grandison Road (77) DS0000025275.V286947.R01.S.doc Version 5.1 Page 13 night per week (Thursday), local pubs, local college groups, shopping and what ever they choose, subject to their risk assessments. One service users is presently pursuing her chosen educational opportunities within the local college. Whilst the other service user has just commenced a new job on a voluntary basis. The home has an open visiting policy and service users are able to choose where to see their visitors. The inspector was told that staff members have discussed issues around personal relationships with both service users and given advice and support as deemed appropriate. Discussions indicated that both service users have formed and developed meaning-full personal relationships within the local community. Service users have their own keys to the house and can lock their bedroom doors in order to maintain their privacy if they chose. One of the service user has presently declined such an offered so a lock has not yet been fitted. A new lock has been fitted to the other service users door as requested within the previous inspection report as concern had been raised that staff may not have been able to over ride the lock in the case of an emergency. Individual menus set by the service users where seen by the inspector, these demonstrated that they are encouraged to maintain a well balanced varied diet. Staff and service users explained how shopping is undertaken on a regular basis by the service users to ensure they have access to the supplies they require to prepare and cook their own meals. Records relating to meals made and taken by service users are kept within the home. A varied supply of fresh food supplies where found to be stocked within the kitchen on the day of the inspection. Grandison Road (77) DS0000025275.V286947.R01.S.doc Version 5.1 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 Polices and procedures used within the home ensures the physical and emotional healthcare needs of the service users are recognised and addressed appropriately to promote and maintain health lifestyles. EVIDENCE: The service users living within Grandison Rd do not physically require any assistance with their personal care or with their mobility. However staff members are on hand to give advice and guidance as required to ensure service user continue to maintain their independence within these areas. Records seen by the inspector confirmed that 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. Grandison Road (77) DS0000025275.V286947.R01.S.doc Version 5.1 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): EVIDENCE: These standards were not assessed on this inspection please refer to previous report. Grandison Road (77) DS0000025275.V286947.R01.S.doc Version 5.1 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. Staff members have been working vary hard to enhance the homely atmosphere provided within Grandison rd. EVIDENCE: Since the previous inspection the overall appearance of the house has been improved to ensure service users and staff members have a well-maintained, pleasant environment to live and work within. The following areas have received attention within the last 3 months; The hall and stairway has been painted and wallpapered. The bathroom has been decorated and new modern stainless steel fittings have been fitted. Net curtains throughout the house have been removed and replaced with blinds. One of the service users stated, “They make the house look much nicer inside and out. A new cooker has been purchased and fitted within the kitchen, service users and staff mentioned that although the previous one was still in good working order a lot of the enamel areas had become worn, which they felt not only Grandison Road (77) DS0000025275.V286947.R01.S.doc Version 5.1 Page 17 gave an poor impression, but could reducing hygiene standards normal met within the home. The inspector was informed that estimates to replace the windows throughout the house with plastic framed double-glazing have recently been submitted to the estates department as a further means of improving the overall impression of the house whilst reducing a considerable amount of on going maintenance work Discussions with one service user and staff members indicated that where possible the service users are involved in choosing furniture, fitting and colour schemes used within the house. 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 regarding the designing and maintaining the gardens is undertaken by one of the service users. A lounge, separate dining area and kitchen are also provided. Service users have their own bedrooms which they have personalised to reflect their own personalities. Polices, procedures and systems are in place to ensure relevant legislation and guidance is followed to prevent any spread of infections and to ensure the health and safety of all concerned remains paramount. Grandison Road (77) DS0000025275.V286947.R01.S.doc Version 5.1 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 & 35 The service users living at Grandison Rd benefit from the support and guidance provided by an effective staff team who together have a wide range of skills and experience to meet their needs. EVIDENCE: An established core group of staff are in place within the home. The staff the inspector meet with demonstrated that they are fully aware of the needs of the service users. Records relating to 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. Discussion with staff indicated that they had a clear understanding of their roles and responsibilities and that they see themselves as enables rather than carers. During the previous inspection the inspector was informed that before any new staff members are given permanent contracts of employment 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 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. Grandison Road (77) DS0000025275.V286947.R01.S.doc Version 5.1 Page 19 Grandison Road (77) DS0000025275.V286947.R01.S.doc Version 5.1 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 The homes recording keeping, polices and procedures ensure practices promote and safeguard the health, safety and welfare of the service users. The staff group appear to be working very well together to ensure the home continues to run in the best interests of the service users whilst they await the appointment of a new manager. EVIDENCE: There has not been a registered manager in place since the previous manager took up a new appointment outside the organisation from January 2006. The organisation (Autism Initiatives) is reported to be processing suitable selection and recruitment procedures to address this significant shortfall. In the mean time arrangements have been made for a deputy manager from another home and the service manager to work closely with the staff team to ensure all managerial aspects of the home continue to be addressed and processed. The deputy manager was present for part of the inspection and was able to demonstrate how she has been managing her time between the two houses to ensure staff and service users continue to feel supported. Grandison Road (77) DS0000025275.V286947.R01.S.doc Version 5.1 Page 21 Policies and procedures used within the home 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. Fridge and freezer temperatures were monitored and recorded within the kitchen. Evidence was seen regarding the servicing of gas, electrical and fire equipment. However it was noted that since the gas supplier had recently changed to SWALEC no certificate confirming that the system remains in good working order has been received. The deputy manager agreed to highlight this issue with their estates department as a matter of urgency and understood why a requirement would need to be made. Fire log books confirm visual checks are made and that fire drills are undertaken on a weekly basis. It was suggested that the staff and service users could undertake fire safety refreshing sessions via the purchasing of a suitable fire safety training video, as this helps to raise the awareness of all concerned particularly when living and working in a smaller care home where more sophisticated fire detection and equipment is not present. Discussion with the deputy manager confirmed that the home maintains a record of all financial transactions at the care home for accounting purposes. Records seen by the inspector indicated how budgets where allocated and managed within the home. Records relating to various meetings undertaken within the home e.g. staff meetings, house meeting and key-worker meeting confirmed that various issues are regularly discussed and appropriate forms of actions agreed are taken to ensure the overall aim of the working practices used within the home benefit the service users. Grandison Road (77) DS0000025275.V286947.R01.S.doc Version 5.1 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 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 2 3 3 3 3 2 3 Grandison Road (77) DS0000025275.V286947.R01.S.doc Version 5.1 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 YA37 Regulation 8 Requirement The registered person must identify a suitable person to undertake the role of manager within the home and to ensure that once identified that an application is made to CSCI with regards to the formal registration process. The registered person is required to confirm in writing to the inspector that the home’s gas supply and equipment has been serviced and confirmed as being in good working order and safe. Timescale for action 01/07/06 2. YA42 13 & 23 01/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA42 Good Practice Recommendations The staff and service users should consider how they can ensure they maintain their awareness to the needs of fire prevention within the home. Grandison Road (77) DS0000025275.V286947.R01.S.doc Version 5.1 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.V286947.R01.S.doc Version 5.1 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. 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