Inspection on 15/08/06 for Greenheys (52)

This inspection was carried out on 15th August 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Greenheys (52) 19/02/09

Greenheys (52) 03/10/07

Greenheys (52) 08/03/06

Greenheys (52) 16/12/05

Greenheys (52) 20/10/04

Greenheys (52) 10/03/04

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 Greenheys (52) 52 Greenheys Road Wallasey Wirral CH44 5UP Lead Inspector Lynn Sharples Unannounced Inspection 15th August 2006 09:30 DS0000018890.V298603.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 DS0000018890.V298603.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. DS0000018890.V298603.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenheys (52) Address 52 Greenheys Road Wallasey Wirral CH44 5UP 0151 638 8248 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) Alternative Futures Limited Mrs Gail Alison Oxley-Pascall Care Home 5 Category(ies) of Learning disability (5) registration, with number of places DS0000018890.V298603.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th March 2006 Brief Description of the Service: 52 Greenheys Road is registered with the CSCI to provide care for up to 5 service users within the category of Learning Disability (LD). Alternative Futures Limited operates and manages the home, a registered charity operating in the North West with the premises being owned by Alternative Housing Association. The home is a purpose built detached bungalow with a large garden, close to Central Park Liscard Wirral and is within walking distance of local shops. There is car parking at the front of the home. Communal areas comprise a large lounge, with doors to the garden, and folding doors to the adjacent dining room. Well-planned domestic style kitchen and separate laundry facilities are provided. The home benefits from having a bathroom with W.C and separate shower room with W.C on the main corridor leading to the bedrooms; There is a separate toilet next to the lounge. There are five single bedrooms each with a wash hand basin. The fees for the home are £1112.48 per week. DS0000018890.V298603.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 that took four hours. The inspector spoke with the service users, the manager and care staff. 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 fees should reflect if a service user has not been on holiday. The care plans should be kept under review. Risk assessments should be reviewed regularly and incident relating to the service users recorded in the daily records. The healthcare needs of the service users should be met and recorded appropriately. There should be registered manager in post. DS0000018890.V298603.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. DS0000018890.V298603.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 DS0000018890.V298603.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 to assist service users. A copy of the service user guide is kept in the service users files and bedrooms. There have been no new admissions to the home and one service user has moved to another house. Documentation indicates referral information is incorporated in the company’s assessment document. Information is gained from the service user and all other interested parties. Service users have a statement of terms and conditions in their files. It was noted that holidays are included in the fees; however, one service user due to their physical and mental health worsening had not been on holiday. The home should ensure that either the service user goes on holiday, or regular day trips or has a refund in their fees. DS0000018890.V298603.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 adequate. 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 care files include a pen picture of the service user, the person centred plan, daily routines, what makes a good day for the service user, activity planner and a personal dictionary. The personal dictionary is a good tool to use when communicating with service users. Each service user has a separate file for daily records. Some of the service users are subject to the enhanced Care Programme Approach, this means they should have a review every six months and one service user had not had a review for ten months. One service user had not had a review of their care plan for 16 months. There was some evidence of the service users making decisions. It is recommended that the home expand this and use photographs to aid the decision making process, this was suggested at the last visit. One service user DS0000018890.V298603.R01.S.doc Version 5.2 Page 10 has an advocate, it would be helpful to the other service users if they had an advocate to assist with the decision making process. In the care plans there are risk assessments for each service users, some of these had not been reviewed for twelve months. In the accident/incident files, there were records of incidents but not all of these incidents were recorded in individuals’ daily records. DS0000018890.V298603.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 good. 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: One service user is a volunteer and helps out at a local gardening scheme. They said that they really enjoyed this and showed photographs of the tasks they undertake. They also attend college; the other service users do not attend college or day service. The home has a minibus and the service users go out regularly. Two of the service users enjoy going to the local town and shopping and going to a café. On the day of the visit one service user was out at the local supermarket, all the service users shop for their toiletries. The service users are provided with DS0000018890.V298603.R01.S.doc Version 5.2 Page 12 opportunities to be involved in community based activities. Three of the four service users have been on holiday this year. The home has a lounge/dining room with bedroom accommodation being single occupancy this offers service users the choice to receive visitors in private or in the communal lounge. Flexible routines are maintained to promote independence and choice. The staff were observed spending time with the service users, interacting appropriately. One service user assists with some of the domestic chores, it would be beneficial if the home would look at extending this to all service users, according to their capabilities. There is a four weekly menu, which is flexible and service users can choose alternatives. The menus were nutritious, varied and balanced. Meals are served within the communal dining room, although service users are able to dine alone according to their preferences and routines as observed on the day of the visit. One service users said that they enjoyed the food at the home. One service user sometimes helps with the preparation of the food; it would be useful if this were extended to include other service users. DS0000018890.V298603.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. Service users are protected by the home’s policies and procedures for handling and administrating medicines. EVIDENCE: Personal care tasks are undertaken gender appropriate where possible. There are appropriate arrangements in place to ensure that personal care tasks are undertaken with privacy and dignity. Care planning records and guidelines in place indicate that service users independence is promoted. Appointments to the dentist, optician and doctors are kept in the home’s diary and recorded in the daily records. It is difficult to evidence that all the service users have had access to all NHS healthcare facilities. There was evidence of service users visiting a consultant psychiatrist. The manager agreed with this and said that they are about to implement paperwork in the care files that will address this. One service user has recently been unwell and there was evidence that the appropriate professionals have been involved. DS0000018890.V298603.R01.S.doc Version 5.2 Page 14 None of the current service users are able to self medicate. On the day of the visit management and administration of medication was examined and found follow the correct protocol, the home has a policy regarding medication. The staff members who administer medication have all received training regarding medication. One of the prescribed medications is a controlled drug and there is no controlled drug register, this would be good practice. DS0000018890.V298603.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 no complaints since the last inspection and the CSCI has not received any complaints. One service users has an advocate. 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. The staff team on duty were able to demonstrate an understanding of physical and verbal aggression by the service users and that physical intervention is only used after distraction methods have failed. DS0000018890.V298603.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): 24,26,27,28,30 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. The home provides a safe well-maintained environment that meets service users needs and allows them to live in safe, comfortable surroundings. EVIDENCE: The home has been purpose built and adapted over the years to meet the needs of the service users. The home provides a comfortable environment and is overall well maintained and furnished. The dining room and one bedroom have been decorated. The bedrooms viewed were pleasantly decorated furnished and have been personalised. There is a bathroom, shower room and another separate toilet in the home. The home provides a secure, well-maintained and good size rear garden. One service user particularly enjoys spending time in the garden. The staff team now have a sleep in room and said that this has improved their working conditions. Areas of the home inspected during the visit were clean and tidy and free from offensive odours. Support workers carry out both domestic and catering duties DS0000018890.V298603.R01.S.doc Version 5.2 Page 17 as part of their role. There is a laundry room with a washing machine and drier and sluicing facilities. It would be useful for the service users if they were involved in this task to improve their development. DS0000018890.V298603.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 good. This judgement has been made using available evidence including a visit to this service. The recruitment practices are good and appropriate checks are carried out. This ensures that the service users are not put at risk. The staff training provided ensures that the staff team are well equipped to meet the needs of the service users. EVIDENCE: The service provides a high level of staff support. Generally three staff are on duty during the day, with two staff one waking and one sleep during the night time periods. The home has 10 care staff and one manager. Four of the care staff have completed the NVQ level 2 and four staff have started the NVQ level 2 and one is waiting to go on the course. There is a very low record of sick leave and the staff team attend regular staff meetings, which are recorded and actioned. The staff use Makaton (sign language) with one service user. An examination of a sample of staff records indicated that all staff had two references, enhanced CRB checks, statements of terms and conditions on their personnel file. DS0000018890.V298603.R01.S.doc Version 5.2 Page 19 All staff have a training and development plan. The staff spoken with said that they have received training in adult protection, food hygiene, health and safety and fire training. The staff records indicated that all staff had received at least five days paid training per year. The manager said that all the staff will have received at least six supervisions this year and the records indicated that all the staff have received at least three supervisions this year. The staff spoken with confirmed this. DS0000018890.V298603.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 manager has been in post for 10 months and has several years experience of working with adults with a learning disability. They have completed the Registered Managers Award and are completing the NVQ 4 in care and have applied to be the registered manager with the CSCI. The staff said that the manager was very approachable and supportive and they are regularly supervised by them. The responsible individual visits monthly and writes a report and sends this to the CSCI office. One service user has an advocate; it would be beneficial if this could be extended to all the service users. This could assist the service users give feedback to the home. DS0000018890.V298603.R01.S.doc Version 5.2 Page 21 Staff meetings are held regularly in the home, the meetings are minuted and actioned appropriately, as evidenced on the day of the visit. The staff are now regularly supervised and annual appraisals are held. Service users files were kept secure in accordance with the Data Protection Act 1998. 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 attend fire drills on a regular basis. DS0000018890.V298603.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 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 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 3 X 2 X 3 X X 3 X DS0000018890.V298603.R01.S.doc Version 5.2 Page 23 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 YA5 Regulation 5 Requirement The registered person must ensure that the fees reflect if a service user has not been on holiday The registered person must ensure that the care plans are kept under review. The registered person must ensure that risk assessments are reviewed regularly and incident relating to the service users recorded in the daily records. (This requirement remains unmet, timescale 06/04/06). The registered person must ensure that the healthcare needs of the service users are met and recorded appropriately. The registered person must ensure that there is a registered manager in post. (This requirement remains unmet, timescale 06/04/06). Timescale for action 19/09/06 2. 3. YA6 YA9 15 13 19/09/06 19/09/06 4. YA19 12 19/09/06 5. YA37 8 19/09/06 DS0000018890.V298603.R01.S.doc Version 5.2 Page 24 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 YA7 YA17 YA20 Good Practice Recommendations It is recommended that all the service users have the opportunity to have an advocate to help with the decision making process. It is recommended that service users have the opportunity to be involved in preparing meals. It is recommended that controlled drugs be recorded in a register. 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