Inspection on 17/02/06 for James Phoenix House

This inspection was carried out on 17th February 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

James Phoenix House 31/08/06

James Phoenix House 21/07/05

James Phoenix House 15/02/05

James Phoenix House 25/11/04

James Phoenix House 16/02/04

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 James Phoenix House Hilden Road Padgate Warrington Cheshire WA2 0JP Lead Inspector Judith Morton Unannounced Inspection 07:30 17 February 2006 th James Phoenix House DS0000036270.V264830.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 James Phoenix House DS0000036270.V264830.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. James Phoenix House DS0000036270.V264830.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service James Phoenix House Address Hilden Road Padgate Warrington Cheshire WA2 0JP 01925 815586 01925 826387 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) Warrington Borough Council Benjamin John Challinor Care Home 10 Category(ies) of Learning disability (10) registration, with number of places James Phoenix House DS0000036270.V264830.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home is registered for a maximum of ten (10) service users in the category of LD (Learning disability) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The registered provider must provide staff to meet the dependency needs of the service users at all times and shall comply with any guidelines which may be issued through the Commission for Social Care Inspection 21st July 2005 3. Date of last inspection Brief Description of the Service: James Phoenix House is owned and managed by Warrington Borough Council and is part of the Social Services Special needs and Disability Division. The premises, a two storey building with garden and parking areas, are situated in the Padgate area of Warrington. The service provides short-term care for adults who have a learning disability and live within the Borough of Warrington. Although the home is registered for ten service users, only seven are accommodated for short-term care at any one time. An eighth bed is kept for emergency admissions. James Phoenix House DS0000036270.V264830.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Throughout this report the service users/ residents will be referred to as guests as this is the term used by the home. This unannounced inspection took place from 8:00am so that the inspector was able to talk with the guests, observe the morning routine and the interaction between the staff and guests. The inspection concentrated on the requirements made at the last inspection and the standards that had not been checked previously, therefore, this report should be read alongside the first report. Three of the guests who were staying at James Phoenix House were spoken with. Two of the guests’ files were checked, together with three staff files. 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. James Phoenix House DS0000036270.V264830.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 James Phoenix House DS0000036270.V264830.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): 1 There is ample information available, in various formats, which would give parents, carers and prospective guests an understanding of the type of service James Phoenix House could offer them. EVIDENCE: The Statement of Purpose and Service User Guide has been sent out to all guests and their families who use the service. The Service User Guide has been produced using photographs and symbols so that it would help more of the guests to understand it. Advice was sought from the speech and language department of the Local Authority to make sure that it would be understood by the young people it was to be given to. The Service User Guide had first been sent out to a number of local day centres so that they could give their comments on whether the information would be easy to understand. James Phoenix House DS0000036270.V264830.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, 9 & 10 There was improvement in the daily recordings being made by the staff. Greater care is needed in providing accurate and consistent information for staff. EVIDENCE: There was a very clear and detailed plan on each of the two files checked. The files included a health needs profile, speech and language therapy reports, either for communication purposes or eating and drinking guidance, moving and handling assessments and guidelines on the use of specific equipment. One of the guests had diabetes and there was specific guidance relating to this. The plan stated that Weetabix MUST be given each evening for supper. However, in the guidelines for drinks, meals and snacks this had not been identified and needed adding so that all staff would know that this was to happen. Additionally, under the review section headed medication, it stated that there was no change and this was signed and dated 24th June. It did not say which year this referred to and had not been completed since. It should state how often this review was to happen and the full date must be written. James Phoenix House DS0000036270.V264830.R01.S.doc Version 5.0 Page 9 Senior staff must ensure that accurate and consistent information is available for the support staff in order that specific needs are met appropriately. (See requirement 1) Risk assessments had been completed and were being reviewed and guidelines on how to use a hoist were on file in photographic form. The last local authority review on one file was from February 2001. The manager explained that they do not always get invited to the reviews but staff do go if they are aware that they are taking place. The manager should evidence the attempts made to get information about each of the guest’s review date and if this has passed a copy of the review must be obtained. (See recommendation 1) One of the guests required two members of staff with him in order that his needs can be met. It was recorded that staff were not to use the word “no” as this would raise his anxiety. In the emotional support requirements it said that staff were to try to reassure him. This should be extended to give examples of what staff can say or do that will do this and what they should avoid doing so that they don’t make the situation worse. (See recommendation 2) Many of the guests are unaware, due to the level of disability, that the staff record information about them in a file, some of the guests would be aware that they have a link book between their home, day service and James Phoenix House, whilst others would not. The parents and carers have however, been involved in the assessment and planning and are aware that a file is held securely by the home. James Phoenix House DS0000036270.V264830.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 & 17 Greater effort is being made to provide suitable community based experiences and to record the activities that each person participates in throughout their stay. EVIDENCE: The guests have been involved in an increased number of activities, which were now being recorded clearly in the daily records. Additionally there was an activities file, which identified the activity and who participated. Community based activities included, line dancing, walks, visits to the park, pub meals out and, on occasion, football matches. The manager may consider providing a link book for parents detailing the activities, both indoors and in the community that their son/daughter has been involved in during their stay. (See recommendation 3) There had been a number of new members to the steering group and efforts to fund raise for a mini bus and its upkeep were being made. James Phoenix House DS0000036270.V264830.R01.S.doc Version 5.0 Page 11 Some of the guests stayed at James Phoenix House at the same time as their friends from their day service. This was not always possible if their parents had requested specific dates to fit in with a booked holiday. Staff were observed to speak to and treat the guests in a respectful manner. Guests who were mobile were able to spend time in whichever room they chose unless a risk was identified on their care plan that they needed support to do so. One guest wanted to go into the kitchen to help himself to drinks and snacks. This was particularly dangerous when the meals were being prepared. A member of staff suggested that a small fridge in the dining area that contained drinks and snacks that he liked would resolve this difficulty. This suggestion was under consideration. At the last inspection it had been identified that the meals of the guests who needed assistance or who were slow at eating, would go cold before they were finished, particularly if they required liquidizing. The manager and cook had purchased a number of different specialist dishes that keep food warmer longer. They had also purchased specialist cutlery to assist guests who were working towards independence. James Phoenix House DS0000036270.V264830.R01.S.doc Version 5.0 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 & 21 The staff and guests are less at risk of injury because of the provision of appropriate equipment and guidance available for the staff on its use. EVIDENCE: There were risk assessments available for the safe use of various pieces of equipment, including hoists and bed rails. There were also handling assessments completed for each of the guests who use the home. These detailed the level of potential risk when staff were transferring a resident from bed to chair, chair to bath or shower etc and how the risk could be minimised by the correct use of equipment. Risk assessments were being reviewed regularly. The staff provide care and activities appropriate to the age and needs of the guests. Guests who become ill during their stay may continue to be cared for at James Phoenix House depending on their illness. However, parents would be contacted and informed so that the decision for them to remain or return home is made jointly. The young person’s GP details are also recorded on their file and they would be contacted if required. James Phoenix House DS0000036270.V264830.R01.S.doc Version 5.0 Page 13 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 Some additional headings in the complaint book would enable complaints to be tracked through to completion. EVIDENCE: There is a complaints book held at James Phoenix House, however, it does not contain headings that would enable complaints to be tracked through to completion, show the investigation process, outcome and whether the complainant was satisfied with the outcome. Additionally it did not enable the manager to see if there were any patterns forming and regular complaints being made regarding the same issues or member of staff. (See recommendation 4) James Phoenix House DS0000036270.V264830.R01.S.doc Version 5.0 Page 14 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 Some additional safety measures would further protect the guests staying at James Phoenix House. EVIDENCE: Since the last inspection the carpet had been replaced on the corridor outside bedroom 4 has now been replaced. A system has been devised for the easy opening of the bathroom door locks from the outside in an emergency and symbols have been added to some of the toilet/bathroom doors where it was felt to be appropriate. Window restrictors need to be fitted to the right hand window in the upstairs lounge/kitchen. This window leads directly out to a flat roof. There was a football on the roof at the time of inspection and some guests may be tempted to climb out to retrieve it. Additionally, there was equipment such as a ladder, lampshade etc being stored in the same lounge area. This must be removed and stored appropriately. James Phoenix House DS0000036270.V264830.R01.S.doc Version 5.0 Page 15 The net curtains had been removed for replacement or cleaning. The wires with the hooks attached were left on each of the windowsills. The wires must be hooked back in place until the curtains are ready to be hung. The chairs in the manager’s office were broken and one in particular was dangerous, having both arms broken. These should be disposed of and replaced as a matter of priority. (See requirement 2) James Phoenix House DS0000036270.V264830.R01.S.doc Version 5.0 Page 16 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): 34 Guests would be further protected if the recruitment procedure was followed for all members of staff. EVIDENCE: Two staff files were checked, a further was requested but was not in existence. Two were full time, permanent staff. Both of these contained all of the information and documentation required to fully protect the guests. However, one member of staff worked part time and had a learning disability. A recruitment file could not be produced and it was not clear whether a criminal record bureau (CRB) check had been made before this person started working at James Phoenix House. The manager was unsure whether the person’s own Social Worker would have done any checks that were necessary. Any person being employed must have had a CRB and protection of vulnerable adult check (POVA) made before they commence employment. The manager must have seen evidence of this and the recruitment procedure followed for any employee, including the making up and keeping of a personnel file. (See requirement 3) James Phoenix House DS0000036270.V264830.R01.S.doc Version 5.0 Page 17 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, 41 & 42 Appropriate safety checks are being made to ensure the safety of the guests staying at James Phoenix House. EVIDENCE: The manager has been registered with the Commission for Social Care Inspection since the last inspection. He has worked in care services for many years and has the necessary experience to run the home effectively. The staff appear happy in their work and there is a good atmosphere within the home. There is a clear line of accountability and staff meetings are held regularly to ensure all staff are kept up to date with current issues. Questionnaires are sent out to all of the families of guests who use the service and to those guests who would be able to contribute to answering the questions. The results seen so far were very positive with only one or two concerns or queries being made. The manager may consider keeping a comments book in the same way that a complaints book is kept so that it is clear what action has been taken to James Phoenix House DS0000036270.V264830.R01.S.doc Version 5.0 Page 18 resolve any issues identified in the returned questionnaires. It should also record whether the person concerned is satisfied with any changes that have been made. (See recommendation 5) The manager may consider providing staff and professionals with a similar questionnaire so that their views are also sought. (See recommendation 6) The fire safety checks are being made on a regular basis. The last fire evacuation exercise took place on 12/02/06 and an evacuation plan is in place. The fire alarm system is checked weekly, the last being 15/02/06. Fire safety training for staff is under review to ensure that all staff have received adequate and appropriate instruction. (See recommendation) James Phoenix House DS0000036270.V264830.R01.S.doc Version 5.0 Page 19 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 3 X X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X X 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 X X 2 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 James Phoenix House Score 3 X X X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X 3 3 x DS0000036270.V264830.R01.S.doc Version 5.0 Page 20 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 Requirement Senior staff must ensure that accurate and consistent information is available for the support staff in order that specific needs are met appropriately. A window restrictor is required in the upstairs lounge/kitchen. The two office chairs must be replaced. Net curtain wires must be hung up until the nets are ready. Any unused equipment/furniture and fittings must be stored appropriately. The recruitment procedure must be followed for all staff. Timescale for action 01/08/06 2 YA24 13 01/08/06 3 YA34 19 01/08/06 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 Refer to Standard YA6 Good Practice Recommendations Involvement in, or information from Local Authority reviews should be sought. DS0000036270.V264830.R01.S.doc Version 5.0 Page 21 James Phoenix House 2 3 4 5 6 YA9 YA14 YA22 YA39 YA39 More detail and guidance should be given to staff as to what they should do/say to reduce risk from challenging behaviour. The manager may consider providing a link book for parents, detailing activities that were experienced at each stay. Additional headings should be added to the complaints book A comments book should be produced along the same lines as the complaints book. A questionnaire for staff and professionals should be produced. James Phoenix House DS0000036270.V264830.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 James Phoenix House DS0000036270.V264830.R01.S.doc Version 5.0 Page 23 - 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. 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