Inspection on 07/12/05 for Huntsmans Wood (8)

This inspection was carried out on 7th December 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Huntsmans Wood (8) 02/05/06

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 Unannounced Inspection 11:00 7 and 8 December 2005 th th Huntsmans Wood (8) DS0000025286.V271377.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Huntsmans Wood (8) DS0000025286.V271377.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Huntsmans Wood (8) DS0000025286.V271377.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Huntsmans Wood (8) Address 8 Huntsmans Wood Croxteth Park Liverpool Merseyside L12 0HY 0151 259 3152 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) Community Integrated Care Limited Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Huntsmans Wood (8) DS0000025286.V271377.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th July 2005 Brief Description of the Service: 8 Huntsmans Wood is home for up to three adults with learning disabilities, though only two people live there at the moment. 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 large, well maintained back garden. The home is not far from bus routes and local shops and the service users have the use of a suitably adapted vehicle that is owned by the company. The home has a newly appointed manager who is not yet registered. Huntsmans Wood (8) DS0000025286.V271377.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. On the first day of this unannounced inspection the inspector spoke to two members of staff, both service users and (very briefly) to a relative of one service user. He visited again the following day in order to speak to the new manager. He looked at all areas of the home and inspected records including care files, staff information, and safety records. 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.V271377.R01.S.doc Version 5.0 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.V271377.R01.S.doc Version 5.0 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): 2 and 4. New service users are appropriately admitted to the home, ensuring that the interests of the existing service users are fully considered and protected. EVIDENCE: The two present service users have lived at Huntsman’s Wood since 1990. The third room has been vacant for some time and was most recently used for respite care for one individual. The manager said that a possible candidate has been identified for the vacancy but the process of assessing suitability for the placement – in particular the issue of compatibility with the existing service users - would be conducted with great care and would not be rushed. The service users are tenants of Maritime Housing – a housing association - which owns the property. Huntsmans Wood (8) DS0000025286.V271377.R01.S.doc Version 5.0 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. Care planning is good and provides 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: There are detailed care plans and Essential Life Style plans in place for both service users. The new manager revised the care plans shortly after her appointment in late November to ensure that they cover all areas of the care that is necessary. It would be sensible to extend this to the field of skin integrity to ensure that staff have a guide as to how to ensure that the service users do not get pressure sores, especially as one has had a pressure sore in the past. The plans provide a wealth of relevant information on the needs, interests and personalities of the service users. The manager said that she plans to review the plans every three months and in addition there is a major annual review, to which other professionals and relatives are invited. Huntsman’s Wood now has a computer but it is not yet fully operational. When it is, it could be used to make care plans easier to amend. Some of the documentation was out of date; the last ‘six monthly’ dental review for one service user was recorded as being in April 2004. The manager said that the service user in question had been to the dentist since then but the records were out of date and one of her priorities was to improve record keeping. Staff Huntsmans Wood (8) DS0000025286.V271377.R01.S.doc Version 5.0 Page 9 talk to the service users about the decisions that affect them and they are able to make their views known in different ways. The risk assessment in respect of whether a service user could be left in the home’s vehicle was out of date and positively misleading. Fortunately the staff on duty were all able to describe how they would appropriately handle such situations. The manager said that she was aware of the discrepancy and said that she was in the process of updating the risk assessments. Documentation is stored securely in the office. Huntsmans Wood (8) DS0000025286.V271377.R01.S.doc Version 5.0 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. Staff support service users in appropriate activities to meet their needs and preferences. Meals meet the individual tastes of the service users. EVIDENCE: The care plans set out in some detail the activities that the service users enjoy. These are everyday activities in the community and include shopping, trips out, eating out, watching football in the pub and visiting the cinema. The home has a vehicle that can accommodate both of the service users and their wheelchairs. Family and friends are welcome to come to the home whenever they and the service users choose, and one of the service users spends several days a week at home with her family. One relative visited the home during the inspection and spoke highly of the care provided for her relative. The service users have holiday plans for next year and one of them will be going abroad with staff. The service users go shopping with staff and indicate the kind of food that they prefer. A record is kept of what the service users eat. Huntsmans Wood (8) DS0000025286.V271377.R01.S.doc Version 5.0 Page 11 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. Staff have a clear understanding of the service users’ needs and provide care and support accordingly. Medication is properly administered, ensuring the service users’ safety, but some minor amendments to the procedure are advisable. EVIDENCE: Staff were seen to treat the service users with respect, dignity and friendship. The service users have access to all necessary community and specialist health care services. A local pharmacist dispenses medication in monitored dosage blister packs but does not provide printed Medication Administration Record (MAR) sheets, so the home creates its own. Handwritten MAR sheet transcriptions should be signed by the member of staff making the entry and countersigned by another member of staff. Medication is checked when it is received from the pharmacist but a minor error made by the pharmacist had not been identified at that stage. This had not affected the medication actually administered. Apart from this the records checked during the inspection were found to be accurate. It would be helpful to include advice on the circumstances in which medication prescribed as PRN (as required) is to be administered, given the communication needs of the service users. Huntsmans Wood (8) DS0000025286.V271377.R01.S.doc Version 5.0 Page 12 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. Huntsman’s Wood has satisfactory complaints and adult abuse procedures to protect the interests of the service users. EVIDENCE: CIC has an appropriate complaints policy and no complaints have been received since the last inspection. Staff are trained in adult protection issues and the home has a copy of the Liverpool multi-agency adult protection protocol. It is not evident that the running costs of the vehicle used by the home are met proportionately by both service users. The Registered Person needs to review this arrangement and advise the Commission for Social Care Inspection of the outcome. Huntsmans Wood (8) DS0000025286.V271377.R01.S.doc Version 5.0 Page 13 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 home is clean, well decorated and well maintained, providing a homely environment for the people who live there. EVIDENCE: 8 Huntsman’s Wood is a bungalow in a quiet residential area of the Croxteth Park estate in north Liverpool. It is clean, well maintained, odour free, and has recently been almost completely redecorated. 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 bedrooms and the lounge are big enough to enable the service users to move around freely in their wheelchairs. Patio doors lead from the lounge on to the large, well-maintained garden. Unlike the rest of the home, the kitchen has not been redecorated. Although it is clean and well maintained, the kitchen now looks rather dull and old fashioned, quite out of keeping with the rest of the bungalow. Huntsmans Wood (8) DS0000025286.V271377.R01.S.doc Version 5.0 Page 14 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. Thorough staff recruitment and training procedures help to ensure that well trained staff are available to meet the needs of the service users. EVIDENCE: Several new staff have started since the last inspection as well as a new manager but those who spoke to the inspector said that they had settled in quickly and were seen to get on well with the service users. Six care staff work at the home in addition to the manager. Two staff are on duty throughout the day, with one on waking duty at night time. Senior CIC staff are on call in the evenings, weekends and on public holidays. Three care staff have NVQ2 and two others have applied for courses leading to the qualification. CIC has a wide-ranging training programme and staff are encouraged to apply for courses that interest them and will benefit the care of the service users. New staff are only employed subject to satisfactory CRB and POVA clearance. The recruitment file of the latest recruit contained evidence of all the necessary checks, including references. The manager said that she will be carrying out a programme of staff supervision, to take place six times a year. Huntsmans Wood (8) DS0000025286.V271377.R01.S.doc Version 5.0 Page 15 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, 41, 42. The home is effectively managed, with up to date fire and health and safety procedures, ensuring a safe environment for the service users. EVIDENCE: The Registered Manager has left since the last inspection. Her replacement was appointed in November and has completed her NVQ4 though she does not yet have her certificate of qualification. The owners, CIC, have informed the Commission for Social Care Inspection of the appointment but have not yet forwarded her application to register as manager to the Commission and this needs to be done as soon as possible. The manager has previously been registered by the Commission to manage a different home. Regular audits of policies and procedures are carried out as part of a rolling programme of quality assurance. Annual questionnaires are sent out to relatives and the results are compiled on a national basis. These were not scrutinised during this inspection. Fire safety and training records were up to date and an electrical safety certificate was in place. The manager was unable to locate a gas safety certificate but at the last inspection the certificate was valid until February 2006. The standard of record keeping in the home is generally high Huntsmans Wood (8) DS0000025286.V271377.R01.S.doc Version 5.0 Page 16 and records are stored securely in a filing cabinet in the office. Fridge and freezer temperatures are monitored twice daily. Accidents are recorded in an Accident Book designed by the owners. The book is very unwieldy and does not comply with the Data Protection Act. It would be advisable for the owners to obtain an Accident Book with removable pages that can be filed separately. Huntsmans Wood (8) DS0000025286.V271377.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Huntsmans Wood (8) Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 X X X 3 3 x DS0000025286.V271377.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? NO 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 and 9 Requirement The Registered Person must submit an application for the registration of a manager. Timescale for action 01/01/06 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. Refer to Standard YA9 YA20 Good Practice Recommendations The Registered Manager should continue to update risk assessment to ensure that they reflect the needs of the service users. Staff should sign handwritten entries on Medication Administration sheets; incoming medication should be checked and any errors reported to the dispensing pharmacist. The Registered Person should review the arrangements for meeting the running costs of the vehicle to ensure that they are met proportionately. It is recommended that the kitchen is redecorated to bring it up to the same standard as the rest of the home. Accidents should e recorded in a format which complies with the Data Protection Act. 2. 3. 4. YA23 YA24 YA42 Huntsmans Wood (8) DS0000025286.V271377.R01.S.doc Version 5.0 Page 19 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. 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