CARE HOME ADULTS 18-65
Knowsley Road, 246 246 Knowsley Road Bootle Liverpool Merseyside L20 5DQ Lead Inspector
Mrs Julie Garrity Unannounced Inspection 29th November 2005 09:00 Knowsley Road, 246 DS0000005246.V269905.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 Knowsley Road, 246 DS0000005246.V269905.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. Knowsley Road, 246 DS0000005246.V269905.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Knowsley Road, 246 Address 246 Knowsley Road Bootle Liverpool Merseyside L20 5DQ 0151 922 6607 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) Expect Limited Ms Kathleen Sanderson Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Knowsley Road, 246 DS0000005246.V269905.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users to include up to 3 LD. Date of last inspection Brief Description of the Service: 246 Knowsley Road is registered as a care home for three people with a learning disability. The service provider for the home is Expect Limited. Expect Limited provides and manages a number of care homes within the Sefton area. The home is located in a residential area of Bootle and is in keeping with other properties in the area. It is indistinguishable as a residential care home and lends itself to the principles of ordinary community living. There is a small backyard at the rear of the building that leads to a communal alleyway. 246 Knowsley Road has limited parking, as it is located on a busy main road. A lounge/ diner is available at the front of the building for the residents. The Home has limited access to individuals with disabilities. The home is located on a busy main road and does not have separate parking facilities. Local facilities include easy access to rail and bus services, there is a bus stop directly outside the home. There area a number of local shops within the area that are approximately a five-minute walk. Pierhead Housing owns the property a local housing association, which is separate to Sefton Support Services. Knowsley Road, 246 DS0000005246.V269905.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 over 2 and half hours. It was a routine unannounced inspection. All residents and three care staff member were spoken with. A tour of the premises was undertaken and cares plans, risk assessments, policies, procedures, financial records, medication records and storage of the medications were reviewed. What the service does well: What has improved since the last inspection? What they could do better:
A number of improvements in the management have impacted positively for the residents and the staff. The service users would benefit from clear instructions to the staff in the usage of as needed medications, a clear maintenance plan that details for the service users when redecoration or refurbishment will occur, information for the manager on new staff. The head office of Expect was contacted regarding these areas on the day of inspection. The registered provider detailed that redecoration needs would be undertaken within the week and a long term plan would be developed with the Pier head Housing Association, staff would be supported to give out medications on a “as needed basis” and dependency needs would be monitored. A requirement to complete these plans has been included in the report.
Knowsley Road, 246 DS0000005246.V269905.R01.S.doc Version 5.0 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. Knowsley Road, 246 DS0000005246.V269905.R01.S.doc Version 5.0 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 Knowsley Road, 246 DS0000005246.V269905.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the standards in this area were reviewed. EVIDENCE: There have been no new admittances to the home for over 3 years, a procedure is in place to help support any new service users. Knowsley Road, 246 DS0000005246.V269905.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): 6 Individual plans have improved and are reflective of the service users needs. They fully explore the actions need to take in order for staff to appropriately support the service users. EVIDENCE: The manager has looked at the individual plans and has included information about service users chooses, medical needs and risk taking. This has provided staff and in particular new staff with clear guidance on how to support the service users. The home remains unable to meet the needs of one service user, who is no longer able to leave the home. This is an issue that causes distress to the service user and they “ not happy” that they cannot go out. The restriction on the residents leaving the building are clearly documented, risk assessed and the home has consulted with Social Services, advocacy services, Pierhead Housing and CSCI in order to resolve the situation. Expect limited has started its own discharge policies and informed Social Services about this. Despite the management and staff’s best abilities the situation remains unresolved. Knowsley Road, 246 DS0000005246.V269905.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): 13 Service users are supported to be part of the community in the way that they would wish. The restrictions for one service user are fully explored and explained with their individual plan. EVIDENCE: On the day of the inspection one service user had gone out for the morning and arrangements were in place for another service user to go out. Holidays for the service users have not taken place for sometime however plans are in place to have a weekend away in the spring of next year. One service user will not be able to participate in this and the reasons for this area detailed clearly in the records within the home. As detailed in other parts of this report the home has tried to resolve this situation and has done all that it can do in order to meet all the needs of the service user. Knowsley Road, 246 DS0000005246.V269905.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 20 The support needs of service users are clearly written in the individual plans. Clear actions detailed to staff help them support service users in the way that the service users would prefer. Medications are appropriately, stored, received and returned from the Home. Staff need written instructions on giving out medications that are not given out regularly. EVIDENCE: Plans are updated and contain good, useful information that details how staff are to support the service users. A service user spoken with said that her needs are supported “as I like help” and in a “kind, nice way”. Medication records are clear however medications that are to be given when needed do not have clear instructions. Without proper instructions staff are not able to make a proper decision as to when to give the medication. Expect ltd detailed that this would be actioned and the details as to when the medications was to be given and in what circumstances will be written down. Knowsley Road, 246 DS0000005246.V269905.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Service users views are listened to and acted on as fully as possible by the home. EVIDENCE: The home has a complaints procedure available. However it is not in format that is suitable to the residents needs. Advocacy services have been used to help resolve any concerns that service users or staff may have. One service expressed concerns regarding accessing the community. The home is aware of this and has tried their best to resolve this situation. Assistance from external agencies such as social services will be needed by the home in order to fully resolve the situation. Knowsley Road, 246 DS0000005246.V269905.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the standards in this area were fully reviewed. EVIDENCE: The home has been redecorated in the main hall landing and stairs. There were plans to replace the carpets within the week of the inspection. Tiling in the bathroom and kitchen was in need of re-grouting or steam cleaning. Expect ltd management detailed that this would be undertaken within the week. Knowsley Road, 246 DS0000005246.V269905.R01.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the standards were fully reviewed in this area. EVIDENCE: A new member of staff has recently started in the home and bank staff are occasionally used. The recruitment and training information for these staff had not been forwarded to the manager. Expect ltd stated that arrangements will be made to make sure that the manager has this information. Staff say that training is planned for the future and this will included training specific to service users needs such as epilepsy. Knowsley Road, 246 DS0000005246.V269905.R01.S.doc Version 5.0 Page 15 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the standards in this area were fully reviewed. EVIDENCE: The home has a manager that is registered with CSCI. It was evident on the day of inspection that the manager and the staff team are striving to deliver a quality service. Information within the Home has improved. The manager and Expect ltd have made good efforts to resolve the Health and Safety issues regarding the needs of service user. Full risk assessments have been put in place. Advice and support has been requested from Social Services and Pierhead Housing. Knowsley Road, 246 DS0000005246.V269905.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X X X Standard No 24 25 26 27 28 29 30
STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Knowsley Road, 246 Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000005246.V269905.R01.S.doc Version 5.0 Page 17 Yes 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 YA24 Regulation Requirement Timescale for action 01/03/06 2. *RQN 23(1a,2a&b) A maintenance plan must be developed that includes recarpeting, replacing worn furniture, repainting and redecoration of the hall, stairs, landing kitchen, lounge and bedroom on the ground floor. Provision must be made in the ground floor bedroom for storage of clothing and personal items. This plan must be shared with the residents. (OUTSTANDING FROM PREVIOUS REPORT) 16 (1) The actions agreed with Expect ltd and detailed in this report must be put into place and monitored by the manager to make sure that they are completed. 01/03/06 Knowsley Road, 246 DS0000005246.V269905.R01.S.doc Version 5.0 Page 18 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA8 YA24 YA24 Good Practice Recommendations The home should produce information in a service user accessible format whenever possible The occupational health recommendations should be put into place. Further support should be sought from both Pierhead Housing and Social Services. Adaptations to the home should be made to enable access to shower/bathing facilities for one resident whose bedroom has been relocated. Further support should be sought from both Pierhead Housing and Social Services. Resident’s dependency needs should be monitored and appropriate staffing levels in place. In particular for the resident who may need additional support not detailed in the original agreement with Social Services. The manager should be included in the formation of budgets in the Home. 4. YA33 5. YA39 Knowsley Road, 246 DS0000005246.V269905.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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