Inspection on 06/11/06 for Helen House

This inspection was carried out on 6th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Helen House 24/02/06

Helen House 21/06/05

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 09/07/2008.

CARE HOME ADULTS 18-65 Helen House Helen House Raby Hall Raby Hall Road Bromborough Wirral CH63 0NN Lead Inspector June Beaver Key Unannounced Inspection 30th November 2006 11 am Helen House DS0000060941.V312321.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 Helen House DS0000060941.V312321.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. Helen House DS0000060941.V312321.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Helen House Address 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) Helen House Raby Hall Raby Hall Road Bromborough Wirral CH63 0NN 0151 334 7510 Wirral Autistic Society John Alkins Care Home 20 Category(ies) of Learning disability (20) registration, with number of places Helen House DS0000060941.V312321.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th February 2006 Brief Description of the Service: Helen House was previously registered as part of the Raby Hall registration but is now registered separately and runs as an independent unit. The home provides accommodation and care for up to twenty adults who have a learning disability, specifically, autistic spectrum disorders. The home provides accommodation in single bedrooms, with three service users having individual flatlets with their own bedroom, lounge, kitchen and bathroom. The home is on two floors and all service users accommodated on the first floor are fully mobile and able to access this area via the stairs. The home provides a large lounge / dining room with an additional seating area in the foyer. All service users are given the opportunity to learn and develop new skills through the day services. Some facilities for day services are within the Raby Hall complex but some are at the Industrial Training Units at Grisedale Road. Transport is provided to the day services. The home is set in extensive, well maintained grounds. Helen House DS0000060941.V312321.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced site visit to the premises which lasted approximately 5 hours and was part of a key inspection. During the visit the two service users were addressed to as well as two members of staff. The Manager prior to the visit completed a pre-inspection questionnaire and the information it contained was verified on the day by looking at the records and documentation available at the home. There were some requirements and recommendations made during this visit which relate to documentation and medication at this visit. What the service does well: What has improved since the last inspection? What they could do better: The care plans for the service users cases tracked on the day of the visit were not complete and needed updating. Medication practices were also in need of improvement as the stock did not balance and recording was not accurate. There were two environmental issues, one relating to the provision of a suitable bed for a service user and the other relating to the storage of medicines. Helen House DS0000060941.V312321.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. Helen House DS0000060941.V312321.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 Helen House DS0000060941.V312321.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): 1,2,3,4 and 5 Quality in this outcome area is good. This judgement has been made using all available evidence including a visit to the service. The Statement of Purpose and service user guide contained sufficient information to enable service users and their families to make an informed choice regarding the suitability of the service. EVIDENCE: The Statement of Purpose and Service User Guide is very detailed and informative and gives prospective service users and/or their relatives an indication of what the home provides by way of the accommodation, the staff and qualifications, the meals, social activities, contact numbers for the registered owners and what to do if there are any concerns/complaints about the service. Prior to admission the prospective service user or their representative will be required to complete an application form with details of health and personal care needs. When there is a vacancy a senior member of staff will carry out a pre-admission assessment to make sure the home can meet the prospective service user’s needs in full. The preadmission information is used to form an initial care plan which is reviewed shortly after admission. Admission is needs led and both parties are given time to settle and adjust before making any commitment. Service users are offered the opportunity of test driving the Helen House DS0000060941.V312321.R01.S.doc Version 5.2 Page 9 home prior to commitment and can visit the service as often as they need before making up their mind whether it is the right place for them or not. Helen House DS0000060941.V312321.R01.S.doc Version 5.2 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 and 9. Quality in this outcome area is adequate. This judgement has been made using all available evidence including a visit to the service. EVIDENCE: Two service users care files were case tracked, one of which contained enough information to help staff meet the service users physical health and social care needs, however the other file was missing specific information about aspects of care. All files should contain relevant and updated information which is reviewed regularly to ensure all health and welfare needs are met and service users are not put at risk. Some of the information on file was old and no longer relevant and it is recommended that any resolved health or welfare care plans that are no longer required are discontinued. Daily records and risk assessments are kept for each service user which include any specific issues such as accidents or incidents and any visits from GPs or specialist nurses. Helen House DS0000060941.V312321.R01.S.doc Version 5.2 Page 11 Helen House DS0000060941.V312321.R01.S.doc Version 5.2 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): 12,13,15,16 and 17. Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. Service users are encouraged to make choices and decisions for themselves and are able to enjoy a stimulating lifestyle with a variety of activities. Service users are encouraged to use local amenities and services and are provided with the opportunity to engage in leisure activities outside the home. EVIDENCE: The service users attend the Wirral Autistic Society’s day centres between 9.30am and 4pm Monday to Friday. There is a range of activities they can pursue either educational, physical or leisure and service users are able to follow their own individual hobbies during the evenings as well as weekends. Service users accompanied by staff use the local community services such as local clubs and pubs, shops, restaurants and walking trails. There are also a range of indoor activities arranged by the home such as reiki, table top games, Helen House DS0000060941.V312321.R01.S.doc Version 5.2 Page 13 listening to music or watching television. Service users are encourage to develop lifestyle/domestic skills and this was evident on the day of the visit as one of the service user’s cleaned and vacuumed his room and another went with a member of staff for some shopping. Family visits are encouraged and some of the service users often go home for weekends or holidays. There are regular holidays and outings arranged by the service either at home or abroad. They have recently returned from a trip to Euro Disney and have had a camping trip this summer. The Wirral Autistic Society have two large holiday lodges in Wales which enables the service to take bigger groups of service users together. The Manager stated that the bigger groups work well as the “service users get on well together”. None of the current service users are currently involved in any spiritual groups however the Manager stated that there were good links with several church groups in the area if needed. Whilst the meals were not directly observed during the visit, the menus were available and they indicated that a healthy and varied diet is provided. There is also a “picture board” available at the serving hatch for service users who have communication difficulties. Helen House DS0000060941.V312321.R01.S.doc Version 5.2 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 and 20. Quality outcome in this area is poor. This judgement has been made using all the available evidence including a visit to the service. The medication procedures at the home are not sufficiently robust to ensure medication is given safely and the recording practices need improving. EVIDENCE: Through discussion with the Manager and by looking at some of the care files it was clear that service users are supported by staff in a positive way and in a manner that allows them to make choices about their health and welfare. The Manager stated that all staff have been given crisis intervention and challenging behaviour training and are experienced in handling differences of opinion that occur from time to time. The medication practices at the home need improving. A stock balance check revealed that some of the service users tablets could not be accounted for. It was difficult to conduct a full audit trail due to the way medication administration was recorded. The “take home medication” was also poorly recorded and difficult to monitor. The service must revise the way it receives Helen House DS0000060941.V312321.R01.S.doc Version 5.2 Page 15 and records all medication and develop an improved monitoring system to enable a full audit of medication brought into and taken out of the home to be Carried out at any time. The medication storage room is very small allowing only one person to be in there comfortably at any one time. There is another storage room next to it which the Manager hopes can be used to make one big room. It is strongly recommended that this conversion is done as quickly as possible so that staff can work in the room in safety and comfort. Helen House DS0000060941.V312321.R01.S.doc Version 5.2 Page 16 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 and 23. Quality in this outcome area is good. This judgement has been made using all available evidence including a visit to the service. There is a robust complaints procedure in operation, which ensures that service users and their families’ complaints, or concerns are listened to. The home provides staff with training in adult protection procedures to make sure service users are not put at risk of harm or abuse. EVIDENCE: There is a comprehensive complaints procedure in operation at the home so that service users and their families can feel confident that there concerns will be listened to and staff will try and resolve matters. Through discussion with staff and reviewing the pre-inspection questionnaire it was evident that all concerns and complaints are treated seriously and responded to either in writing or verbally to both parties satisfaction. There had been five complaints made since the last visit all of which had been concluded and a record kept for audit purposes. . Staff are provided with training in adult protection procedures so that they can alert the appropriate authorities should they need to. They have also been given training in “breakaway techniques” to enable them to intervene in any crisis behaviour situations if necessary in a safe way to prevent any injury to service users or themselves. Helen House DS0000060941.V312321.R01.S.doc Version 5.2 Page 17 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 and 30 Quality in this outcome area is good. This judgement has been made using all available evidence including a visit to the service. The service users live in comfortable clean surroundings. The home is modern and bright, accessible to local amenities and equipped with aid and adaptations to support each service users needs. EVIDENCE: The service provides a range of furniture and furnishings that create a modern and homely environment. There is a communal lounge that is bright and nicely decorated with photographs of service users enjoying nights out and holidays. There is a well equipped dining room off the lounge which has a large service hatch as access to the kitchen is restricted due to health and safety reasons. The service users bedrooms were personalised and furnished with modern furniture and furnishings. All rooms were lockable and most service users had their own key. One service user’s bed was not fit for purpose and needs replacing. Helen House DS0000060941.V312321.R01.S.doc Version 5.2 Page 18 The bathrooms and toilets were very plain and would benefit from upgrading as the fixtures and fittings were showing signs of age. The hot water temperature from the hand basins in the communal areas was hand tested and found to be satisfactory and the home was adequately heated on the day of the visit. Helen House DS0000060941.V312321.R01.S.doc Version 5.2 Page 19 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): 32,34 and 35. Quality outcome in this area is good. This judgement has been made using all available evidence including a visit to the service. The service employs sufficient numbers of staff to ensure the service users health and welfare needs are met in a safe manner. EVIDENCE: An inspection of the rota indicated that there is a steady stable workforce with no vacancies.. The present staffing levels ensure service user needs are met and that their lifestyles and social activities are promoted. The home provides staff with a wide range of appropriate training which includes NVQ training (National Vocational Qualification) to level 2 & 3. and the pre-inspection questionnaire completed by the manager stated that Helen House staff have 201 attendances at the Wirral Autistic Society’s in house staff development programme. Courses include :Breakaway & Supportive holds - 6 attendances. Non violent crisis intervention - 19 attendances. Food hygiene training - 11 attendances First aid training - 6 attendances. Drug administration - 9 attendances. Epilepsy and Stesolid training - 19 attendances. Helen House DS0000060941.V312321.R01.S.doc Version 5.2 Page 20 Other training includes Introduction to Autism, fire awareness, report writing, equal opportunities, managing behaviour, triad of impairments, communication and prevention of abuse. Helen House DS0000060941.V312321.R01.S.doc Version 5.2 Page 21 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 and 42. Quality in this outcome area is good. This judgement has been made using all available evidence and by visiting the service. The Manager is competent and has the skills necessary to manage the home in an efficient manner whilst developing good working relationships with staff, visitors and the service users. EVIDENCE: The Manager has worked for the Wirral Autistic Society for twenty two years and has been registered as Manager with the Commission for Social Care Inspection since February 2005 when Helen House registered as a service in its own right. (It was previously part of the Raby Hall registration). He has a lot of experience in managing the client group and demonstrated a good understanding of autism and related conditions. The Manager stated that he hopes to have completed an NVQ 4 in care by the end of the year and provided evidence of regular updates and training. He has completed an extensive first aid training course and an Autistic Accreditation Service course. He also likes to work shifts at the home so that he is accessible if needed to the night staff. Helen House DS0000060941.V312321.R01.S.doc Version 5.2 Page 22 There did not appear to be any supervision notes available during the visit and it is strongly recommended that all staff are given the opportunity of one to one supervision at least six times a year. The policies and procedures reviewed during the visit appeared up to date and offered useful reference type information for staff. The certificates of worthiness for gas, electricity and all other appliances were available and up to date. Helen House DS0000060941.V312321.R01.S.doc Version 5.2 Page 23 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 3 4 3 5 3 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 2 26 x 27 2 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 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 3 2 x 3 x 3 x x 3 x Helen House DS0000060941.V312321.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15(2)(b) Requirement Timescale for action 14/01/07 2. YA20 13 3 YA25 23 The registered person shall keep the clients plan of care under review. This requirement was also made at the last inspection The registered person must 31/12/06 ensure that there is robust medication practices at the home and that all medication can be accounted for and recorded appropriately. The registered person must 31/01/07 ensure that a suitable bed is provided to meet service user needs 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 YA36 Good Practice Recommendations It is strongly recommended that all staff receive regular one to one supervision which is documented and signed for by both parties. Helen House DS0000060941.V312321.R01.S.doc Version 5.2 Page 25 2. YA27 It is recommended that the communal bathrooms and toilets be upgraded and refurbished as they look dated and in need of decoration. Helen House DS0000060941.V312321.R01.S.doc Version 5.2 Page 26 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 Helen House DS0000060941.V312321.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!