Inspection on 31/08/06 for James Phoenix House

This inspection was carried out on 31st August 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 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

James Phoenix House 17/02/06

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 Key Unannounced Inspection 31st August 2006 10:00 James Phoenix House DS0000036270.V309864.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 James Phoenix House DS0000036270.V309864.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. James Phoenix House DS0000036270.V309864.R01.S.doc Version 5.2 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.V309864.R01.S.doc Version 5.2 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 17th February 2006 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.V309864.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit, part of the key inspection for this service, took place over 5 hours on 31st August 2006. The registered manager had left the service since the last inspection visit so the team manager assisted the inspector during this visit. A tour of the premises was made, three members of staff were spoken with and documentation, including two staff files and two guests’ files were checked. A Social worker and a visitor were also spoken with during the visit. There were no guests present during the site visit as they were out at their day service. 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.V309864.R01.S.doc Version 5.2 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.V309864.R01.S.doc Version 5.2 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 & 4 Quality in this outcome area is good. This judgement has been made using available evidence and a visit to the service. The information available for residents, together with the detailed assessment, would give the residents confidence that their needs could be met at James Phoenix House. EVIDENCE: The statement of purpose and service user guide uses photographs and symbols so that it would help more of the guests to understand it. This is given to all guests and their families. There were assessments available on both of the files checked. The local authority had provided an initial assessment and the staff at James Phoenix House had completed their own assessment. Although there was a guest profile held on the files, a more detailed history, including a more detailed account of the guest’s method of communication, might give the staff a greater understanding of the guest. During the visit, the parent of a prospective guest and the social worker had come to view James Phoenix House. They were shown around, given the documentation and the opportunity to ask any questions. The staff member conducting the visit explained the introductory process to the parent and explained that it would be done at a pace agreed by all parties. James Phoenix House DS0000036270.V309864.R01.S.doc Version 5.2 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, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence and a visit to the service. The level of support provided to the residents, dependent on their assessment of need, enables all of the residents to participate in daily life as independently as they are able. EVIDENCE: The care plan on each of the two files was checked. The files included a health needs profile, speech and language therapy reports, moving and handling assessments and guidelines on the use of specific equipment. As needs had changed updated information had been inserted into one guest’s profile. The information had not been dated so it difficult to know when the change took place and whether it would still apply. Consideration should be given to developing a system by which all staff could be made aware when guests’ needs change. James Phoenix House DS0000036270.V309864.R01.S.doc Version 5.2 Page 9 The last local authority review on one file was from February 2001. There were no reviews held on the other guest’s file. Efforts had been made to obtain dates of future reviews so staff from James Phoenix could attend. In the meantime, a copy of the last review should be obtained and held on each guest’s file while waiting for the next annual review in case there had been any changes of need that staff at James Phoenix had not been informed about. The daily recordings made by staff had improved considerably but this was not consistent across the team. For example, on one file, there had not been an entry made for the whole of one day (11/06/06) of a person’s stay. Another entry made reference to the guest having gone home with a note about a problem that occurred whilst they were staying at James Phoenix but there was nothing recorded during the whole of the person’s stay to show that there had been a problem. Consistency of recording in detail, including the guest’s view, where possible, and ensuring an entry is made at each shift should be pursued. The guests were able to make some decisions about their lives, depending on their level of ability. Guests can choose what they want to wear each day; some are able to choose when they wish to go to bed and when they wish to get up, particularly if their stay is at a weekend. Guests are also able to decide where, within James Phoenix House, they would like to spend their time and who with. The manager said that very often the guests would choose to socialise downstairs in the main lounge all together even though the upstairs lounge, sensory room and games room were all available to them. The guests are encouraged to participate in all aspects of life in, and outside of James Phoenix House, dependent on their ability and risk assessment. Many of the guests are not able to understand that staff record information about them; in these cases, the parents and carers have been involved in the assessment and planning and are aware that a file is held securely by the home. James Phoenix House DS0000036270.V309864.R01.S.doc Version 5.2 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, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence and a visit to the service. The increase in the number of community-based activities, together with the wholesome, balanced diet offered, ensures that the guests’ lead healthy lifestyles while staying at James Phoenix House. EVIDENCE: The guests have been involved in an increased number of activities, which were being recorded in a file that identified the activity and who participated. Community based activities for August included walks, shopping trips, local church clubs, visits to the park, pub meals out, a trip to Chester Zoo and a trip to the Blue Planet Aquarium. 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. The parents’ committee had successfully raised the funds to buy and maintain a minibus for the home. Since then, a minibus that is already owned by the James Phoenix House DS0000036270.V309864.R01.S.doc Version 5.2 Page 11 local authority will be provided to James Phoenix House in January 2007 so the funds raised will now be used to buy equipment for the home. Since the retirement of the previous cook, a new cook has been employed at the home and was observed to be ordering fresh food to be delivered to the home, including fresh fruit and vegetables. Fresh fruit was available for the guests to help themselves from a fruit bowl in the dining room. Water was always available from the water cooler, which was in the corner of the dining room. The idea of providing a menu with photographs was discussed in order to help guests understand and make their choices of meals. James Phoenix House DS0000036270.V309864.R01.S.doc Version 5.2 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. This judgement has been made using available evidence and a visit to the service. The risk assessments carried out, particularly in the administration of medication, would mean that the guests were given the appropriate amount of support for their safety and protection. 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. The staff provide care and activities appropriate to the age and needs of the guests. Guests’ healthcare needs are met appropriately and parents are involved in any decisions about treatment that might become necessary when guests are staying at the home. Details of the guests’ GPs are kept on file and there was evidence that staff at the home provided appropriate emotional support to guests. Due to the varying complexity of the residents’ learning disability none of the residents administered their own medication. The medication was stored appropriately in a locked cabinet in the manager’s office. None of the medication was out of date. James Phoenix House DS0000036270.V309864.R01.S.doc Version 5.2 Page 13 The medication administration records, (MAR), were also checked and were being completed appropriately with the correct code being used if medication had been refused or destroyed. James Phoenix House DS0000036270.V309864.R01.S.doc Version 5.2 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. This judgement has been made using available evidence and a visit to the service. The staff’s level of knowledge ensures that the guests receive appropriate support with communication so they can make their feelings known. EVIDENCE: There is a complaints file held at James Phoenix House but its layout does not enable complaints to be tracked through to completion, showing the investigation process, identifying the outcome and whether the complainant was satisfied with the outcome. Many of the guests are unable to verbalise their concerns or complaints and, therefore, could be very vulnerable. Very often their behaviour is the only form of communication that can indicate how they are feeling. The staff spoken with know the guests well and recognise and record any change in their manner. Improvement in this area could be achieved if a more detailed communication profile was recorded on each file. The staff at James Phoenix House have received adult abuse awareness training to ensure they recognise the various forms that abuse can take. There are policies and procedures on dealing with allegations or instances of abuse available to the staff in the home. Other professionals, who are involved with those guests who need additional support, work closely with staff at the home and the person’s day centre. James Phoenix House DS0000036270.V309864.R01.S.doc Version 5.2 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence and a visit to the service. The environment is homely, clean, comfortable so guests have a safe and pleasant place in which to stay. EVIDENCE: A tour of the building was made, which included all of the bathrooms and toilet areas, many of the bedrooms and all communal areas. James Phoenix House was clean and tidy and there were no offensive odours in any part of the building. All of the requirements regarding the environment made at the previous inspection had been met. The manager informed the inspector that the kitchen was to be upgraded with the provision of a new cooking range and the disposal of the deep fat fryer, as James Phoenix House strives to provide the guests with a wholesome and healthy diet. James Phoenix House DS0000036270.V309864.R01.S.doc Version 5.2 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): 32, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence and a visit to the service. Staff work well, with good management support and training, so that residents have stability, continuity and confidence in the support they receive. EVIDENCE: The staff team at James Phoenix House have worked there for many years. This means that staff know the residents well and gives the guests stability and continuity each time they come to stay. New staff receive a two week induction training course with Warrington Borough Council before beginning work at James Phoenix House. This includes disability awareness training. Foundation training courses are provided after this and are specific to disability issues. The cook confirmed that she had attended induction training. New staff have weekly supervision for the first couple of months after starting at the home. After this monthly supervision is provided and recorded. There was a record of supervision having been conducted on the newest member of staff’s file. Two staff files were checked. Both contained evidence that the full range of recruitment checks had been carried out. Staff meetings are held regularly and any issues of poor practice are brought up in general to all staff. James Phoenix House DS0000036270.V309864.R01.S.doc Version 5.2 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 40 & 42 Quality in this outcome area is good. This judgement has been made using available evidence and a visit to the service. The level of consultation with the residents, via their families, ensures they continue to be involved in decision making within the home and therefore the continual development of the service. EVIDENCE: The previous manager has left James phoenix House since the last inspection visit. The team manager who has managed the home in the past is currently managing it again, temporarily. Questionnaires are sent out from James Phoenix House 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 were very positive with only one or two concerns or queries being made. James Phoenix House DS0000036270.V309864.R01.S.doc Version 5.2 Page 18 There are two files in which all of the departments’ policies and procedures are held for staff to read whenever they wish. The staff cover some of the main policies and procedures in induction training and supervision. They have to sign to say they have been read and understood. However, a number of the policies and procedures were old and needed updating to reflect any policy changes that might have been made. For example, complaint procedure 1998, bullying and harassment 2001, diversity 2001, restraint 2003 and safer handling 2003. The manager said that the policies and procedures were to be reviewed and brought up to date in the near future. Health and safety checks have been carried out at the agreed time scales at James Phoenix House. Written evidence was available to show that the fire alarm was being tested and recorded weekly, the emergency lights were being checked, water temperatures, fridge and freezer temperature, food temperature and the temperature probe had also been checked for accuracy on a regular basis. James Phoenix House DS0000036270.V309864.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 X 4 X 5 X 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 X 26 X 27 X 28 X 29 X 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 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 3 X 3 X James Phoenix House DS0000036270.V309864.R01.S.doc Version 5.2 Page 20 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. 1 Refer to Standard YA2 Good Practice Recommendations Consideration should be given to developing a more detailed guest profile, to include life history and communication methods, for each guest to help staff further improve the care provided. A system to ensure that staff are made aware of any changes to guests’ care plans should be developed. Involvement in, or information from Local Authority reviews should be sought. Consistency of recording in detail, including the guest’s view, where possible, and ensuring an entry is made at each shift should be pursued. Consideration should be given to providing a link book for parents, to show the activities that their son/daughter took part in whilst staying at the home. Consideration should be given to producing a menu in the form of photographs to enable all guests to make their own choices of what they would like to eat. Consideration should be given to developing the layout of the complaints log so that all the appropriate information DS0000036270.V309864.R01.S.doc Version 5.2 Page 21 2 3 4 5 6 7 YA6 YA6 YA6 YA12 YA17 YA22 James Phoenix House 8 YA42 is recorded to enable a complaint to be tracked to its outcome. Policies and procedures should be reviewed and updated. 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