Inspection on 02/05/06 for Huntsmans Wood (8)

This inspection was carried out on 2nd May 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Huntsmans Wood (8) 07/12/05

Huntsmans Wood (8) 04/07/05

Huntsmans Wood (8) 09/12/04

Huntsmans Wood (8) 05/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 28/10/2008.

CARE HOME ADULTS 18-65 Huntsmans Wood (8) 8 Huntsmans Wood Croxteth Park Liverpool Merseyside L12 0HY Lead Inspector Peter Cresswell Key Unannounced Inspection 2nd May 2006 09:30 Huntsmans Wood (8) DS0000025286.V288540.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 Huntsmans Wood (8) DS0000025286.V288540.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. Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Huntsmans Wood (8) Address 8 Huntsmans Wood Croxteth Park Liverpool Merseyside L12 0HY 0151 259 3152 9999 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.c-i-c.co.uk. Community Integrated Care Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th December 2005 Brief Description of the Service: 8 Huntsmans Wood is home for up to three adults with learning disabilities. Only two people live there at the moment but preparations are being made to admit a third person. Both of the current service users also have physical disabilities. The home, a spacious bungalow in a residential area of Croxteth Park, is run by Community Integrated Care (CIC), a large not-for-profit organisation, and owned by Maritime Housing. The home has three bedrooms, a large lounge and a back garden. The home is not far from bus routes and local shops. The home has a newly appointed manager who is not yet registered. She has applied for registration and her application is under consideration by the Commission for Social Care Inspection. Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. No written notice had been given of this visit but the inspector had telephoned a few days before arriving in order to make sure that someone would be in the house. The inspector spoke to one of the service users, a support worker and the manager. The other service user was in hospital at the time of the inspection. The inspector toured the home and examined records including care plans, risk assessments, medication, fire safety, staffing, training and menus. The visit lasted four hours. A week before the site visit the manager completed and returned a pre inspection questionnaire. The inspector sent survey forms to several of the service users’ relatives and one was returned shortly after the site visit. What the service does well: What has improved since the last inspection? What they could do better: 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. Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 6 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 Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 7 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. Quality in this outcome area is good. Material is available to ensure that prospective service users, where possible, have information about the home. People are thoroughly assessed and gradually introduced to the home before admission, ensuring that the home can meet their needs. EVIDENCE: Huntsman’s Wood has a service user guide and a Statement of Purpose available. The service user guide contains a section that is intended to be accessible to people with learning difficulties. The two existing residents have been in the home for some time and the owners are now proposing to admit a third resident. The interests of the existing service users are a key element in this procedure and great care is being taken to make sure that the new person will be compatible with them. The proposed new service user is currently in a nursing home and the manager needs to make sure that her suitability for an establishment which does not provide nursing care has been fully assessed. No documentation on the proposed new service user was available in the home. She has been visiting the home once a week for some months and this is due to be increased in the near future to twice a week. The reaction of the service users is being carefully monitored and had been discussed in team meetings. Copies of service user contracts were available in the home. Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 8 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. Quality in this outcome area is good. Care plans provide staff with the information they need to care for the service users. Service users are involved as far as possible in every aspect of the home’s life. EVIDENCE: One of the service users was staying in hospital when the inspector visited the home. The manager said that his case file and care plans were with him so that staff from the home could consult them at any time and keep them up to date. The file for the one service user who was in the home was comprehensive. It included a full pen picture and a detailed care plan that is reviewed every three months. Relatives and other professionals are involved in the major annual reviews. The reviews are recorded and if any changes are agreed then the plan is changed. As the plans are handwritten it can be a bit cumbersome to make the amendments and it would be helpful if the care plans could be prepared on a computer. Risk assessments have been updated and detailed risk assessments now cover all potential risks faced by the service users. It has been made clear that service users cannot be left alone in the vehicle under any circumstances. The risk assessments are signed by all staff. The service users have limited communication but the staff make every effort to involve them in decision making by finding out what they want to do. The Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 9 essential lifestyle plans contain a lot of information about how the service users communicate and their likes and dislikes. The service users also sit in, for instance, on staff meetings. Documentation is securely stored in the office. Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 10 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 area is good. Support staff help service users to take part in appropriate activities that they enjoy. Meals meet the individual tastes and needs of the service users. EVIDENCE: The service users’ likes and dislikes are set out in some detail in their case files. Both service users have limited means of communication but are sometimes able to express their views about things they have experienced or which staff suggest to them. A recent house meeting, for instance, had suggested a visit to Knowsley Safari Park – both service users had seemed keen on this and the subsequent visit proved to be a great success. The sole service user in the home went out to the shops with a member of staff during the site visit. The support worker said that the service user enjoys this sort of trip, which is typical of the kind of everyday activities that the service users enjoy. The Essential Lifestyle plan listed shopping, one-to-one time with staff and going to the pictures amongst the service user’s likes. She also attends a sensory room in a day centre and enjoys this very much. Families are closely involved with the service users and are always made welcome in the home. One of the service users goes to stay with the family Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 11 for two days of every week. Comment cards were sent to relatives and one was returned. The relative had no concerns about the home and was always made welcome when visiting. The service users can have whichever food they choose and the staff have established by trial and error the things that they most enjoy. Most of their food needs to be liquidised and the manager said that if they eat out most cafes and restaurants are happy to help to prepare the food in this way. The kitchen was well stocked with a variety of food and the menu showed that the meals the service users eat are varied and nutritious. Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 12 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 area is good. Staffing arrangements during a hospital stay ensure that the service user is cared for by people with whom he is familiar. Medication is properly administered, ensuring the service users’ safety, but any alterations must be clearly made and signed to ensure that the record is complete and accurate. EVIDENCE: One of the service users was in hospital at the time of the site visit. His care plans had been taken to the hospital and staff from the home were staying with him in the hospital throughout the day. This was helping to provide a familiar, supportive environment for the service user during what might have been a difficult time for him. Staff were observed treating the service users with respect, dignity and friendship. Service users have a Health Action Plan on file and are seen regularly by a General Practitioner. Files also recorded regular check ups by an optician, chiropodist and dentist. Medication is kept in a secure, locked cupboard that is fixed to a wall. The community pharmacist is now providing printed Medication Administration Record (MAR) sheets on which staff record all medication. Those medicines that can be dispensed in blister packs are in a Monitored Dosage system but this does not, as it happens, apply to most of the drugs in question. The pharmacist delivers the medication to the home. The medication for the one Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 13 service user in the home at the time of the site visit was accurately recorded. Some incorrect entries on the MAR sheet had been Tippexed out. These particular marks did not affect the legibility of the record but Tippex or similar correction fluids must not be used in any circumstances on MAR sheets. Any changes should be clearly identified and signed by the person making the alterations. Paracetamol has been prescribed for one service user and the service user’s GP has signed forms to advise which homely remedies can be used and in what circumstances. Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is good. Huntsman’s Wood has satisfactory complaints and adult abuse procedures to protect the interests of the service users. One element of transport finance still has to be sorted out to protect the financial interests of all the service users. EVIDENCE: No complaints have been made since the last inspection. The home has a suitable complaints procedure but the copy displayed in the home refers to the now abolished National Care Standards Commission. This has been changed to the Commission for Social Care Inspection in the file copy and the copy on display needs to be replaced. Staff are trained in adult protection issues and the home has a copy of the Liverpool multi-agency adult protection protocol. The vehicle used by the home is funded by one of the service users and at the last inspection the costs were not shared proportionately. This situation is likely to become more complex with the addition of a third service user. The manager said that the Registered Person is taking action to remedy the situation and evidence of this needs to be forwarded to the Commission for Social Care Inspection when it has been done. Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30. Quality in this outcome area is good. The home is clean, well maintained, and on the whole well decorated, providing a homely environment for the people who live there, though some minor work is needed on the kitchen. EVIDENCE: 8 Huntsman’s Wood is a bungalow in a quiet residential area of the Croxteth Park estate in north Liverpool. The bungalow is clean, well maintained, odour free, and well decorated. The bathroom has specialist equipment to enable service users to bathe with dignity and there is lifting equipment to meet the needs of the service users. Each service user has their own spacious and comfortable bedroom. The bedroom for the proposed new service user will be furnished with her own furniture from her current home, including an adjustable bed. The service users are able to move around freely in their wheelchairs, as the home is quite spacious and uncluttered. Patio doors lead from the lounge on to the large back garden. Unlike the rest of the home, the kitchen has still not been redecorated. Although it is clean and well maintained, the kitchen- – especially the tiling - now looks rather dull and old fashioned, quite out of keeping with the rest of the bungalow. Many of the tiles have been damaged over the years by drill holes for since replaced equipment. The housing association which owns the building has declined to replace the Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 16 tiling and the Registered Person should approach them to explain that few people in the community would choose to retain such décor. Several of the kitchen doors and units were slightly damaged and must be repaired. Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 17 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, 35, 36. Quality in this outcome area is good. Staff recruitment and training procedures help to ensure that well trained staff are available to meet the needs of the service users. EVIDENCE: Six support staff, including the manager, work at Huntsman’s Wood. There is one vacancy and where necessary any gaps in the rota are being covered by an agency worker. The manager uses the same agency worker when cover is needed so that the service users do not have to get used to a new person. Two new members of staff have started since the last inspection and they are both former CIC employees who used to work with the manager. There was evidence in the home that all of the proper checks had been carried out on the staff before they were employed. The Registered Person makes sure that all appropriate checks re carried out on agency staff who work in the home, though this evidence was not in the home. The rota provided for two members of staff at all times during the day, with one member of staff on duty at night. The rota will have to be reviewed if the new service user is admitted whilst another is still in hospital. Four of the staff have NVQ2 or above, so the home meets the standard for 50 of staff to have this qualification. Two of those without NVQ have been put forward for training by the manager but are not yet on a course. Recent training has included budgeting, leadership (management courses), Induction and Foundation training. Training planned for the immediate future includes Basic Food Hygiene, the Protection of Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 18 Vulnerable Adults and First Aid. The manager is a moving and handling trainer. It is important that the impetus of training is maintained and that all staff get the opportunity to obtain NVQs. Staff receive regular supervision in one to one sessions with the manager and these sessions are recorded. Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 19 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, 41, 42. Quality in this outcome area is good. Up to date safety procedures help to maintain a safe environment for the service users. EVIDENCE: The new manager has applied for registration and a date for a fit person interview has now been set. The manager has previously been a registered manager at another of the owner’s homes. She was recently asked to help at another home which was experiencing short term difficulties but this has now finished. The Registered Person should be cautious about using the manager in such a capacity in another home prior to registration and she should continue to work a full working week at Huntsman’s Wood. Regular audits of policies and procedures are carried out as part of a rolling programme of quality assurance. The service manager carries out regular visits in accordance with Regulation 26. Annual questionnaires are sent out to relatives and the results are compiled on a national basis. It would be helpful if the manager were given the results of any questionnaires concerning Huntsman’s Wood so that the feedback can be built into reviews of how the home is operating. Fire safety records were up to date and up to date gas and electrical Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 20 safety certificates were in place. Accidents are recorded in an Accident Book and details are then removed and kept in individual service user’s files, meeting the requirements of the Data Protection Act. Fridge and freezer temperatures are checked and recorded twice a day, ensuring that fresh and frozen food is stored safely. Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 21 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 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 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 4 3 2 X 3 3 3 X 3 3 X Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 22 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 YA24 Regulation 23(2) Requirement The Registered Person must ensure that all parts of the home are reasonably decorated and must therefore arrange for damaged kitchen units to be repaired or replaced. Timescale for action 01/07/06 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. 2. 3. Refer to Standard YA24 YA20 YA23 Good Practice Recommendations It is recommended that the kitchen tiling is replaced to bring it up to the same standard as the rest of the home. Corrections to Medication Administration Record sheets should be clearly initialled and correction fluids should not be used. The Registered Person should complete the review of the arrangements for meeting the running costs of the vehicle to ensure that they are met proportionately. Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 23 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 Huntsmans Wood (8) DS0000025286.V288540.R01.S.doc Version 5.1 Page 24 - 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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