Inspection on 16/12/05 for Kenneth House

This inspection was carried out on 16th 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

Kenneth House 16/02/07

Kenneth House 15/08/05

Kenneth House 27/01/05

Kenneth House 12/08/04

Kenneth House 27/02/04

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 Kenneth House 121 Raeburn Avenue Eastham Wirral CH62 8BD Lead Inspector Beate Roth Unannounced Inspection 16th December 2005 16:15 Kenneth House DS0000018903.V273118.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 Kenneth House DS0000018903.V273118.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. Kenneth House DS0000018903.V273118.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kenneth House Address 121 Raeburn Avenue Eastham Wirral CH62 8BD 0151 327 3680 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) angie.kemp@wirral.autistic.org Wirral Autistic Society Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Kenneth House DS0000018903.V273118.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th August 2005 Brief Description of the Service: Kenneth House is registered to provide personal care for four adults with a learning disability and provides a service for adults with autism. The home is a two storey semi-detached property located in a residential area. On the ground floor there is a lounge with patio doors leading to a large garden, dining room, kitchen and a toilet. On the first floor there are four single bedrooms, an office/staff sleep in room, and two bathrooms. Parking is available on the main road. Kenneth House is close to local shops and to public transport services. The home is run by Wirral Autistic Society who have several care homes for adults with a learning disability in the area. Wirral Autistic Society provides a range of services and facilities, which are fully utilised by the service users, accommodated at Kenneth House. Kenneth House DS0000018903.V273118.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during an evening. During the inspection time was spent in the office examining records and policies and procedures. A service user and staff were spoken with. A tour of the home was undertaken. Staff were observed delivering care to service users. 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. Kenneth House DS0000018903.V273118.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 Kenneth House DS0000018903.V273118.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, 2 and 5 A full assessment would take place to ensure that a service user’s needs could be met. The contracts/terms and conditions could better support the interests of service users. EVIDENCE: A statement of purpose and a service user guide are available. Both documents cover the required information. Consideration should be given to making the service user guide more suited to the needs of the service users who live at the home. There have been no new service users admitted to the home since the last inspection. New service users would be assessed by the manager for the home and by a representative from day services. The manager would visit a prospective service user where they are living. Information would be gathered from the service users’ carers, social worker and any other relevant agencies. An examination of an initial assessment pro forma at a previous inspection indicated that all the information recommended in this standard is available. An assessment would be made if a service user moved to the home from another home within the Society. This information would be recorded. Kenneth House DS0000018903.V273118.R01.S.doc Version 5.0 Page 8 The contracts/terms and conditions between the home and the service user are in the process of being reviewed. At the last inspection it was recommended that service users be supported by family, friends and/or advocate, as appropriate when drawing up the contract and that clear information around any costs a service user has when they go out with staff is provided. Kenneth House DS0000018903.V273118.R01.S.doc Version 5.0 Page 9 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): 7, 8 and 9 The service users need for independence is balanced with any risks to their wellbeing. Consultation takes place with service users to ensure their views are as far as possible obtained. EVIDENCE: An examination of the service user plan indicated that service users’ rights to live as independently as possible, in accordance with their abilities, is promoted by the home. Risk assessments are available which indicate why service users’ rights need to be limited in order to safeguard their wellbeing. There is evidence that agreement is reached with the service user, family and the funding authority with regard to any restrictions placed on a service users day-to-day life. Reactive plans, which detail behaviour management strategies are also available. These are appropriate and indicate that minimum physical intervention strategies would be used. Service users are encouraged to contribute towards the running of the household. There is a housework rota, which details each service users’ responsibilities in accordance with their abilities. Residents’ meetings are held. Kenneth House DS0000018903.V273118.R01.S.doc Version 5.0 Page 10 Minutes from these meetings are taken. Service users’ views are obtained through their individual key workers. Service users are able to make their views known about the day care services offered at a service user run advocacy group, which meets every week. Some of the policies and procedures have been made available in formats that make them more accessible to some service users. It is recommended that where possible, further policies and procedures, the service users guide and service user plans are made available in forms suitable for the people for whom the home is intended. Kenneth House DS0000018903.V273118.R01.S.doc Version 5.0 Page 11 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): 11, 12 and 17 Service users are able to take part in appropriate activities that provide opportunities for their educational, social and personal development. Service users enjoy their meals and have a variety of meals provided. EVIDENCE: Service users attend day services from Monday to Friday, where they are provided with opportunities for social, educational and communication support and development. Daily living skills are taught at day services by appropriately trained staff, and by care staff within the home on a daily basis. Staff give encouragement and support within a risk management framework. The home accesses Speech and Language Therapy services. The home uses a picture system to communicate with service users as appropriate for those who do not have verbal communication skills. Service users have the opportunity to demonstrate individual preferences for a range of activities within day services subject to risk assessments. Some of the opportunities available are horticulture, craftwork, community work experience, drama and physical education. Service users are provided with work experience opportunities and attend local Kenneth House DS0000018903.V273118.R01.S.doc Version 5.0 Page 12 college courses in accordance with their wishes and abilities. An examination of the menu record indicated that varied foods are provided that would provide for a balanced diet. A service user spoken with said the food is “good.” Care plans indicate the dietary requirements of service users. Advice is obtained from a dietician if this is required. Kenneth House DS0000018903.V273118.R01.S.doc Version 5.0 Page 13 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 and 20 The personal care and health needs of service users are well met. Service users are not fully safeguarded by the practices around the administration of medication. EVIDENCE: Records detail the personal care needs of service users to be met by staff. Observations indicated that staff promote the privacy and dignity of service users. Consistency and continuity of support for service users is provided through the key worker system. Staff receive training on promoting privacy and dignity during their induction. Records indicate that service users have access to medical/health care professionals as needed. Service users are supported to attend health care appointments. A revised medication procedure is available which provides clear guidance. Observations of staff administering medication indicated that they are not following this procedure. Staff were observed to dispense medication in the office into their hand and then to take this to each service user in turn. Service users where downstairs. The medication was signed for before service users had taken it. In order to avoid medicines being incorrectly administered, medicines should be taken to the service user together with the medication Kenneth House DS0000018903.V273118.R01.S.doc Version 5.0 Page 14 administration sheets. Dispensed into an appropriate container and signed for when the service user has taken the medication. This is indicated in the medication administration procedure for the home. Medication is stored securely. Members of staff interviewed reported that they have been trained in the administration of medication. A selection of medication administration record sheets and corresponding medication were inspected and found to be in order. Any service users who self – administer their own medication do so in accordance with a risk assessment. Kenneth House DS0000018903.V273118.R01.S.doc Version 5.0 Page 15 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 and 23 The policies and procedures and practices at the home ensure that the wellbeing of the service user is safeguarded. EVIDENCE: There is a complaint procedure available that includes the timescales for dealing with each stage of a complaint. The complaint procedure is displayed on the service users’ notice boards. The procedure is available in different formats to reflect the abilities of service users. No complaints have been made to the home or about the home to CSCI since the last inspection. A record would be kept of any complaints made. A copy of Wirral Borough Council’s adult protection procedure was available at the home. A shorter and more accessible version of the adult protection procedure has been made available by Wirral Borough Council and was at the home for staff to refer to. Staff have received training in the adult protection procedures. From discussion with a member of staff and from an examination of the financial records, the home’s policies and practices with regards to service users’ money and financial affairs safeguard service users. The personal allowance records for two service users were inspected and found to be in order. A member of staff said that keeping the receipts for personal allowances spent by or on behalf of service users is to stop, it is recommended that receipts continue to be retained in order to demonstrate that a service users money is being appropriately managed. Kenneth House DS0000018903.V273118.R01.S.doc Version 5.0 Page 16 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 and 30 The home in general provides a safe, comfortable and pleasant environment for service users. EVIDENCE: The premises provide a comfortable environment for service users and are satisfactorily maintained. The home was clean and odour free at the time of the inspection. Since the last inspection the lounge and dining room have been redecorated. Maintenance works have also been undertaken to improve the appearance of the home. The bathrooms at the home would benefit from redecoration as the decoration is looking worn. The kitchen flooring is also looking worn and this room would be enhanced if the flooring were replaced. At present a request is made to Wirral Autistic Society’s maintenance department for decorative work to be undertaken when it is considered necessary rather than there being a planned maintenance and renewal programme for the decoration of the premises. Consideration should be given to putting this in place. Thermostatic mixing valves with lockable temperature controls are fitted to the bath and bathroom sink. A risk assessment of the risks presented by radiators that are not temperature controlled has taken place and appropriate measures Kenneth House DS0000018903.V273118.R01.S.doc Version 5.0 Page 17 taken. It continues to be recommended that design solutions that control the risk from all radiators that can exceed 43 degrees centigrade be provided to all radiators. Window restrictors are fitted and regularly checked. A sample of fire safety check and inspection records were examined and found to be in order. Kenneth House DS0000018903.V273118.R01.S.doc Version 5.0 Page 18 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): 33 and 35 Service users are supported and protected by the number and skills of staff available. EVIDENCE: Kenneth House DS0000018903.V273118.R01.S.doc Version 5.0 Page 19 There is generally two members of staff on duty at all times. At the weekends there are periods where there is only one member of staff on duty. Staff spoken with said that given the needs of one service user it would be beneficial to have two staff on duty throughout the weekends. The acting manager has reviewed the staffing arrangements at the home and is to continue to keep this matter under close review. There is a network of support provided by Wirral Autistic Society for lone workers. Lone worker risk assessments are available. There are currently four permanent staff working at the home with absences being covered by permanent or bank staff. Bank staff have been recruited to work for Wirral Autistic Society to cover absences in the homes if needed or to provide support within the day care service. A comprehensive induction and foundation training programme is provided to staff. The induction and foundation training programmes have been developed in accordance with the National Training Organisation training targets. Training needs are identified through supervision and appraisals. Training is provided to staff around equal opportunities. Kenneth House DS0000018903.V273118.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38 and 39 The quality assurance systems promote the wellbeing of service users. EVIDENCE: Since the last inspection a new manager has been appointed and an application to register the new manager has been made to CSCI. The manager of the home has had several years experience of management in a care setting. The manager has an NVQ Level 4 in care and management and other relevant qualifications. The manager has undertaken periodic training to maintain and update her knowledge skills and competence. The staff interviewed reported that they consider their views regarding the running of the home are sought and listened to. A clear complaint procedure is available. Staff meetings are held every month. There are a range of quality assurance systems in place. Wirral Autistic Society is accredited by the National Autistic Society which carries out an inspection of services provided. Wirral Autistic Society conducts an internal audit of the society as a whole on an annual basis. The views of service users Kenneth House DS0000018903.V273118.R01.S.doc Version 5.0 Page 21 are obtained by key workers and the manager. The day service also provides a forum for service users to give their views on the services provided there. The views of GP’s are obtained regarding the provision of health care at the Wirral Autistic Society’s homes. Visits to the home by the representative of the registered provider are made. Kenneth House DS0000018903.V273118.R01.S.doc Version 5.0 Page 22 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 3 X X 2 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 3 12 3 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 3 X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Kenneth House Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X X X DS0000018903.V273118.R01.S.doc Version 5.0 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13 Requirement The registered person must ensure that staff follow the medication procedure for the home in order to fully safeguard service users. Timescale for action 16/12/05 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 YA1YA8 Good Practice Recommendations It is recommended that where possible, further policies and procedures and the service users guide be made available in formats that are more suitable for the people for whom the home is intended. It is recommended that service users be supported by family, friends and/or an advocate, as appropriate when drawing up the contract. The service user guide/contract should provide clearer information on the costs service users may have to meet when going out with staff. It is recommended that the receipts of personal allowances spent by or on behalf of service users continue to be retained. It is recommended that design solutions that control the risk from radiators that can exceed 43 degrees centigrade DS0000018903.V273118.R01.S.doc Version 5.0 Page 24 2. YA5 3. 4. YA23 YA24 Kenneth House 5. 6. YA24 YA24 be provided. It is recommended that a planned maintenance and renewal programme for decoration of the premises be put in place. Attention should be given to the decoration in the bathrooms. 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