Inspection on 15/03/07 for Ivyhurst Close (4)

This inspection was carried out on 15th March 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ivyhurst Close (4) 10/12/08

Ivyhurst Close (4) 21/07/05

Ivyhurst Close (4) 13/01/05

Ivyhurst Close (4) 07/12/04

Ivyhurst Close (4) 28/06/04

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 09/07/2008.

CARE HOME ADULTS 18-65 Ivyhurst Close (4) 4 Ivyhurst Close Aigburth Liverpool Merseyside L19 3PJ Lead Inspector Les Hill Key Unannounced Inspection 15th March 2007 09:30 Ivyhurst Close (4) DS0000025287.V321813.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 Ivyhurst Close (4) DS0000025287.V321813.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. Ivyhurst Close (4) DS0000025287.V321813.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ivyhurst Close (4) Address 4 Ivyhurst Close Aigburth Liverpool Merseyside L19 3PJ 0151 427 7927 0151 427 7927 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 Miss Winifred Austin Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Ivyhurst Close (4) DS0000025287.V321813.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st July 2005 Brief Description of the Service: 4 Ivyhurst Close is a bungalow property in a quiet cul-de-sac in the Aigburth area of Liverpool. It provides accommodation and personal support for two younger adults in single bedrooms. The home is supported with two members of staff throughout the day and one sleep-in member of staff at night. A number of aids are provided to meet the individual needs of residents and to promote their safety and comfort. The home is easily accessible by public transport and a mini bus is available to enable the residents to access community facilities. There is a large garden area to the rear of the property. The home is in good decorative order. Routine maintenance is carried out by the housing association that owns the property. Fees for accommodation at the home are agreed by the placing authority and are dependent upon a range of factors including the levels of need presented by individual residents. Ivyhurst Close (4) DS0000025287.V321813.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This “Key” inspection of Ivyhurst Close was carried out on Tuesday March 13th 2007 over a period of 1.5 hours. It involved the examination of some records, meeting with the homes manager, a member of the care staff, the two residents, and a tour of the building. The manager had submitted a completed questionnaire that gave essential information about the current operation of the home and was contacted on the day prior to the visit to ensure someone would be available. The inspection was undertaken as part of the Commission’s responsibility to visit and report on all registered care homes. What the service does well: What has improved since the last inspection? What they could do better: No requirements or recommendations have been made as a result of this inspection. Ivyhurst Close (4) DS0000025287.V321813.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. The summary of this inspection report can be made available in other formats on request. Ivyhurst Close (4) DS0000025287.V321813.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 Ivyhurst Close (4) DS0000025287.V321813.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Detailed and comprehensive assessments are in place to record the needs of individual residents. EVIDENCE: The homes statement of purpose and service user guide were seen during the CSCI inspection in January 2006 and found to be in good order. There have been no significant changes to the operation of the service since that time. Care files for the two residents living at Ivyhurst Close were seen during the visit. Each contained a comprehensive assessment of their needs that was clearly presented and was based on both the experience of current carers and a previous history in the health care services. Additionally the manager had prepared an individual profile on each of the residents, written in the first person style, that gave a complete pen picture of their needs, their likes and dislikes and the ways in which they should be supported. The documents are a useful aid to any new or agency staff who might be used at the home from time to time. Both of the residents have lived at the home since it was opened approximately 15 years ago, and are well settled. Ivyhurst Close (4) DS0000025287.V321813.R01.S.doc Version 5.2 Page 9 Ivyhurst Close is managed by Community Integrated Care (CIC) and they have polices and procedures in place that require any new resident to be admitted to their homes through a process of assessment and gradual introduction. Each of the residents has a contract/terms and conditions of residence with the housing association that owns the property and the care provider. Ivyhurst Close (4) DS0000025287.V321813.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are supported through clear and detailed care plans and risk assessments that are reviewed on a regular basis. EVIDENCE: Detailed care plans are in place to identify particular areas of need and the ways in which staff should provide support. The care plans are dated and signed each month to identify that they have been reviewed. A separate monthly review form is completed that identifies and reviews activities provided and activities for the next month. The ones in Ivyhurst Close also identify any matters affecting the ongoing care and support of the individual resident. Both residents have severe communication difficulties but staff have learned to understand movements and gestures from each of them that indicate what they want and details of these are included in the care plans. Ivyhurst Close (4) DS0000025287.V321813.R01.S.doc Version 5.2 Page 11 It was clear from observing staff with the residents, from discussions with the manager and from reading care files, that residents are consulted routinely about what they want and how their support should be provided. Risk assessments were evidenced on separate files. Again they are detailed and well prepared and are reviewed on a monthly basis. The organisation has policies and procedures in place that require staff to maintain the confidence of information held about residents and their families. Ivyhurst Close (4) DS0000025287.V321813.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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are supported to engage in community activities and to use public transport to further develop their experiences of ordinary living. EVIDENCE: Despite the severe disability of both residents it was clear that staff create opportunities for regular access to the wider community and encourage residents to follow their own interests. The home has its own minibus but staff also use public transport (good wheelchair access) and regularly take residents on buses for local journeys and trips into the city centre. Both residents attend special needs courses in a city centre college and are supported in doing so by staff from the home. They also go to the theatre, to the pictures and to concerts. One of the residents often attends major football matches. Meals out are arranged at local pubs and restaurants and visits to Ivyhurst Close (4) DS0000025287.V321813.R01.S.doc Version 5.2 Page 13 places of interest are organised. Annual holidays are taken to suit the needs of the residents. Contact with family is encouraged and supported. Staff ensure that residents can provide family members with cards and gifts at appropriate times and that events such as Mothers Day are celebrated with flowers. Staff recently supported one resident to make regular visits to their mother who had to spend some time in hospital. The two residents have lived together for 15 years. Reports from staff and written records show that they get on well. However staff recognise that the residents may wish to spend some time on their own and will arrange for them to do so in the home and will take them out separately. One of the resident is fed through a “PEG” system and the other has swallowing difficulties that requires food to be blended and drinks to be thickened. Ongoing observations of dietary intake are noted and following this visit staff were meeting with a nutritionist to discuss future feeding arrangements. Ivyhurst Close (4) DS0000025287.V321813.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Resident’s health and personal care needs are met through appropriate arrangements with health care professionals and others who are skilled in the support of disabled people. EVIDENCE: Personal care and support are essential for both residents living in the home. Individual bedrooms are provided with special electric beds, mattresses and with bedrails. Personal care is always provided in the privacy of the resident’s bedroom or in the homes bathroom. Links are maintained with the residents GP and with district nurses when necessary. Routine dental checks are carried out six-monthly and eye tests are done annually. Treatments are carried out more frequently if required. Support is also provided by, the dietician by the speech therapist and by the chiropodist. Neither resident is able to manage their own medicines. The local pharmacist supports staff with regular monthly prescriptions. The arrangements for managing medicines in the home were checked and found to conform to good Ivyhurst Close (4) DS0000025287.V321813.R01.S.doc Version 5.2 Page 15 practice guidance. However, instructions on one of the medicines said it was not to be chewed but the pharmacist had advised staff to crush the tablet and to dilute it with water so it can be fed through the “PEG” tube. The manager was advised to ask the pharmacist to confirm the instructions on the next batch of this medicine. Ivyhurst Close (4) DS0000025287.V321813.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. 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 available evidence including a visit to this service. Residents are protected from abuse by the homes procedures around complaints and adult protection. EVIDENCE: The home has a complaints procedure in place but no formal complaints have been made to the home or to CSCI in the past twelve months. CIC’s polices and procedures are in place to advise staff if they have concerns that residents may have been abused and a copy of Liverpool City Council’s procedures is also available in the home. Training in the protection of vulnerable adults has been provided to all staff by CIC. CIC acts as appointee for both residents and manages personal money on their behalf. The manager said that she requests small amounts from savings for each of the residents’ as they need it but is careful not to spend money for spending sake. Regular audits of the individual accounts are undertaken by CIC and a statement of balances is produced on a regular basis. Interest on any savings is paid directly to the residents account. Ivyhurst Close (4) DS0000025287.V321813.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents live in a warm and comfortable home that is maintained to a good standard. EVIDENCE: 4 Ivyhurst Close is a detached bungalow set in a small cul-de-sac of similar properties in the residential area of Aigburth. Shops and access to public transport are close by. The home is of a good construction and is well maintained both internally and externally. Resident’s bedrooms have been personalised to reflect their interests and are of a good size. Specialist equipment is provided as necessary and each of the residents has their own television and radio/music systems. There is one bathroom in the home that has been developed as a “wet” room to more comfortably provide accessible showering facilities for residents. Ivyhurst Close (4) DS0000025287.V321813.R01.S.doc Version 5.2 Page 18 The lounge area is well presented with domestic style furniture and the kitchen is suitably equipped to deal with the catering needs of two residents and staff. Gardens are well laid out and the manager said that they are accessible to residents in their wheelchairs and are used extensively in the warmer summer months. All areas of the home are well decorated and on the day of this visit were clean and free of any unpleasant odours. Specialist equipment to support the residents is provided and maintained through appropriate contracts. Ivyhurst Close (4) DS0000025287.V321813.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are supported by a staff team that is selected through appropriate procedures and supported with essential training. EVIDENCE: Staff recruitment and selection procedures for CIC have been reviewed on numerous occasions by CSCI and are generally in good order. Only one new member of staff has been appointed to work at the home since the CSCI inspection in January 2006 and the manager confirmed that all of the necessary checks had been undertaken, including Protection of Vulnerable Adult (POVA) and Criminal Records Bureau (CRB) clearances. CIC update CRB clearances for staff on a regular basis. All staff are provided with a job description and have a contract of employment. The care staff team at Ivyhurst (with the exception of the latest appointment) have been in post for some considerable time and the manager said that they work well together. Rotas allow for two care staff to be on duty throughout the waking day and for one member of staff to “sleep in” in the home at night. Ivyhurst Close (4) DS0000025287.V321813.R01.S.doc Version 5.2 Page 20 More recently, and because of sickness, the home has needed a more regular use of “bank” and agency workers but the manager said that they usually have the same people who know the residents well and there is always a permanent member of the staff team on duty. Four of the five permanent care staff (this number excludes the manager) have an award at NVQ level 2 or above in care. Induction training is provided for all new members of staff and routine updating of skills in first aid, manual handling, food hygiene, fire awareness and POVA is arranged. The manager said that additional training to support staff in meeting the specific needs of residents is provided as necessary. The manager said that she provides one-to-one supervision for staff every 2-3 months and makes a record of what has been discussed. No concerns have been raised about the staffing arrangements at the home. Ivyhurst Close (4) DS0000025287.V321813.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 and 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Resident’s benefit from a well run home. EVIDENCE: The homes manager has worked at Ivyhurst for some considerable time both as a support worker and as its manager. She has an award at NVQ level 4 in management. The longevity of placement for the two residents, the stability of the staff team and the quality of information kept in the home would indicate that it has strong leadership and commitment. Discussions and records examined during the visit also confirmed that residents are central to the running of the home and their needs and wishes take priority in day-to-day events. Ivyhurst Close (4) DS0000025287.V321813.R01.S.doc Version 5.2 Page 22 Policies and procedures for the management and day-to-day operation of care homes are prepared by CIC and are regularly reviewed. Experience of the organisation has indicated that they support the needs and best interests of residents. Records seen during the visit were comprehensive and clear and gave a good picture of both the resident’s needs and the ways in which the home is run. Health and safety matters are given appropriate priority. The manager confirmed in her pre inspection questionnaire that fire equipment was last checked in February 2006; that the fire alarm system is tested weekly; that gas installations were checked in April 2006 and that an electrical wiring safety certificate was issued in February 2003. Ivyhurst Close (4) DS0000025287.V321813.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 4 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 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 4 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 4 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 3 3 3 3 Ivyhurst Close (4) DS0000025287.V321813.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ivyhurst Close (4) DS0000025287.V321813.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Ivyhurst Close (4) DS0000025287.V321813.R01.S.doc Version 5.2 Page 26 - 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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