Inspection on 23/05/07 for Liam House

This inspection was carried out on 23rd May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Liam House 26/02/07

Liam House 23/05/06

Liam House 05/12/05

Liam House 10/05/05

Liam House 22/11/04

Liam House 02/06/04

Liam House 01/03/04

Liam House 03/11/03

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Liam House 13 Spencer Road Bournemouth Dorset BH1 3TE Lead Inspector Tracey Cockburn Key Unannounced Inspection 23 & 26th May 2007 9:50 rd Liam House DS0000003956.V337839.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 Liam House DS0000003956.V337839.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. Liam House DS0000003956.V337839.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Liam House Address 13 Spencer Road Bournemouth Dorset BH1 3TE 01202 294148 01202 789983 liamhouse007@aol.com 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) Mr Marvin Charles Stephens Vacant Care Home 11 Category(ies) of Learning disability (11), Learning disability over registration, with number 65 years of age (11) of places Liam House DS0000003956.V337839.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th February 2007 Brief Description of the Service: Liam House is a home for adults of both sexes who have a learning disability. It is a large, semi-detached house situated in a central area of Bournemouth close to Boscombe and Bournemouth town centres. The home is conveniently located near shops and facilities and is not far from the sea. It has good access to public transport. Residents accommodation is provided in 7 single and 2 double bedrooms. Seven bedrooms are located on the first floor and two on the ground. The first floor also has 2 bathrooms with WCs and a separate WC. The ground floor has one bathroom with a WC. The communal space is located on the ground floor and consists of a lounge, separate dining room and kitchen. There is a small locked office where all the records are kept. Outside there is a small garden at the rear of the property that has a large storage shed, which contains the laundry facilities and 2 large freezers. The front of the property provides offroad parking. The home is staffed 24 hours a day, with 2 sleeping in staff at nights. Most residents attend day activities organised by different agencies outside the home although this is flexible and residents are also supported to spend time at the home. Current fees provided on 14/03/07 range from £450 to £1000 per week; dependent on individual care needs and if the provision of day care is necessary. Fees do not include personal items such as toiletries, hairdressing, cigarettes and sweets. For further information on fee levels and fair terms of contracts you are advised to refer to the Office of Fair Trading website: www.oft.gov.uk. The home keeps copies of all inspection reports that are available in the office and can be seen by service users, relatives and professionals at their request. Liam House DS0000003956.V337839.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection, which began on the morning of the 23rd May 2007 and was completed on Saturday 26th May 2007. This inspection was spread over 2 days to ensure that, as many people who use the service were able to express their opinion about the home. During the course of the inspection on the first day; the manager, care staff and 1 person who lives in the home were talked to. A tour of the premises took place including all communal areas and the laundry room, which is a shed outside the main building. Various record and documents including: care files; staff files, policies and procedures were viewed. On the second visit only people who live in the home and care staff were talked to. This inspection assessed all the key National Minimum Standards for care homes for adults (18-65) Since the inspection the manager of the service has submitted his application to be registered. What the service does well: People who live in the home have their needs and aspirations assessed. This means that the care staff have the information they need to support each resident individually with detailed care plans. The people who use they service tell us that they are able to make decisions about their lives. The home works hard to address risk and support the people who use the service to live the lives they want to. People who live in the home are part of the community and take part in activities they enjoy with people they like to be with. The people who live at Liam House decide the food they eat and the daily routines they have. They are supported the way they prefer and their physical and emotional needs met by staff that understand them well. The home’s policy and procedure on medication supports and protects the people in the home. People living in the home say they are listened to and know who to talk to if they are worried. Staff receive the training they need to protect the people they support from harm. People at Liam House live in a nice home, which is clean and safe. Liam House DS0000003956.V337839.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Liam House DS0000003956.V337839.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Liam House DS0000003956.V337839.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Prior to admission individual needs and aspirations are assessed. This means that people who are considering moving into the home can be assured their needs and aspirations will be met. EVIDENCE: There have been no new admissions to the home since the last inspection. There is evidence in previous inspections that indicate clear admission processes are in place. Including care management assessments and visits to the home. There are individual care plans in place for all residents. A random selection of 2 personal files were looked at. The manager explained that the contract for each resident ahs been written in a more user-friendly format and that this was taken to the residents meeting for their views. Liam House DS0000003956.V337839.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in this home have individual care plans, which reflect their needs, goals and risks. This means they are able to have the lifestyle they want and are supported to make decisions. EVIDENCE: In the 2 files looked at both contained a service user plan. These plans both contained detailed information on how each person needs and likes to be supported both with their personal care needs as well as day-to-day support. 1 care plan stated it is important for all staff to ensure that the person wears a peaked cap when out in bright sunlight due to their eye condition. There is very clear instruction for staff to follow and understand why this is so important. The care plans seen were also very clear on the communication needs of these two people. There is also evidence that care plans are also being writing in a more accessible format for the individual. The manager Liam House DS0000003956.V337839.R01.S.doc Version 5.2 Page 10 explained that the home operates a link /key worker system and several of the people living in the home said that they had chosen who their link worker was. A member of staff said she had recently become the link worker for someone else in the home at the request of the person she used to be the key worker for because the resident had wanted a change. Both care plans seen on the day of the inspection had been reviewed at the end of March 2007. Both care plans contained clear information on the communication needs, health, mobility, likes and dislikes and interests. The manager was able to demonstrate and the residents confirmed that they are able to make decisions in their daily lives. This includes staff working during the day to enable residents to be flexible in what they want to do. At the time of the inspection 1 resident was on their way to a dental appointment and another was going shopping for personal items. Several people who live in the home are members of Bournemouth forum, which is a speaking up group. There was also information on advocacy services on the notice board in the dining room. All the people who live in the home have their own bank accounts and this is well managed by the manager who audits each bank statement on a monthly basis against the receipts. Individual risk assessments have been updated and are more specific on how each risk should be managed. The manager has put considerable work into these documents. Liam House DS0000003956.V337839.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in this service are able to live the life they want, have relationships, be respected and be part of the community. EVIDENCE: The manager explained that there are 2 residents who attend college courses. He is also looking into a work experience for another residents. This resident is very excited about the prospect of a work placement. Daytime activities are recorded on the files looked at. These include day centres, college course and work placements. At the time of the inspection there was 1 resident who was at home, another who was on their way to a day centre and another who was off for a health appointment. Liam House DS0000003956.V337839.R01.S.doc Version 5.2 Page 12 On the second visit to the home to speak to the people who live there spoke about the activities they take part in such as visits to the cinema, trips to the shopping centre, meals out. The manager has a record of all the activities, which take place both in the home such as making eater cards and out of the home such as a trip in April to the Oceanarium, pub lunches and a picnic in the gardens. 1 resident said that they go out with their friends. This resident also had his or her own front door key and bedroom key. Another resident said that the staff encourage him with his hobby. During the inspection on both days, residents were seen to move freely about their home. 1 member of staff said that the kitchen is where many of the residents choose to spend some time, as there is a large kitchen table where they can drink, eat and discuss their day with each other and staff. This was observed both visits to the home. 1 resident said that they do all their own laundry and help out around the home. There is a chart on the kitchen wall with different chores for each resident. The manager has introduced a suggestion box but he said that so far this idea has not gone down as well as others. 1 resident said he would raise any issues at the resident meeting, which is chaired by 1 of the people who live in the home. Minutes of the meeting are taken and posted on the notice board in the dining room. Residents said that they have a say in the food they eat and are able to make choices if they do not want something. People who live in the service are able to make themselves drinks; some are able to assist with preparation. People who live in the home said that they enjoyed the food. Liam House DS0000003956.V337839.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in this service are supported the way they prefer. Their physical and emotional needs are met and the home has robust procedures in place to ensure they are protected. EVIDENCE: The 2 care plans examined at the time of the inspection clearly document the personal care needs of the residents. The information details assistance with teeth brushing, dressing, and support with continence, eye care and hair care. The people who live in the service said they feel supported by staff, 1 resident said, “staff are lovely”. Care plans detail evidence of staff encouraging residents to take responsibility themselves for aspects of their care such as ensuring that new batteries are ordered for their hearing aids. The manager has experience of supported living environments and brings that encouragement of support to the service. Residents said they are able to make choices about their clothes and appearance. The manager said that he is in the process of ordering a wheelchair for 1 resident who has also had an occupational therapy Liam House DS0000003956.V337839.R01.S.doc Version 5.2 Page 14 assessment because of changes to their mobility. Files contain evidence of advice being sought from a variety of health care professionals including psychologists. Care staff receive clear guidance on what signs to look for if someone might be depressed. Files contained information about healthcare appointments such as hearing, dental and eyesight. Staff support residents to attend health care appointments. The manager is in the process of reviewing transport for these appointments. Both files looked at contained the individual’s personal health record. Staff spoken to had a very good understanding of the individual needs and methods of communication of each resident. Staff were also observed using a variety of communication methods such as makaton, sign language and interpreting other more subtle signs such as facial expression. The home uses a monitored dosage system and medication is stored in a locked cupboard in the office. The records were checked and were up to date and accurate. None of the residents manage their own medication. The manager has completed risk assessments for each resident. A few residents take responsibility for their medication when they are out at their daytime activities. This has been risk assessed. Liam House DS0000003956.V337839.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in this service feel listened to and are protected from abuse. EVIDENCE: There have been no complaints logged since the last inspection. Several people who live in the home were asked whom they would talk to if they had concerns. They said they would either talk to their key worker or the manager. The complaints procedure is on the notice board in the dining room and is in an accessible format. Those residents who were able to speak said they could also speak to their social worker if they had concerns. The home has an adult protection policy and procedure in place. Staff have undertaken training. The manager said that he has a good relationship with a day centre which many of the residents attend. He felt this was an important link as communication was important. There have been no adult protection referrals since the last inspection. All residents have access to their own money. Liam House DS0000003956.V337839.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in this service are in a homely, comfortable and safe place, which is clean and has procedures in place to ensure it is hygienic. EVIDENCE: The homes statement of purpose details the number and size of rooms. 1 bedroom is shared. There is access to the local community as the home s is situated in a quiet residential street close to the centre of Bournemouth. The home is clean and airy. On the day of the inspection decorating was taking place in the lounge. Residents who were at home were either in the kitchen or the dining room. The door to the garden was open. The lighting in the home is domestic in character and the furnishings comfortable. There are 2 sofas in the lounge and a large screen TV. The laundry is in a shed in the garden. The flooring is impermeable. There are policies and procedures in place for the control of infection. Liam House DS0000003956.V337839.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use this service are supported by competent and qualified staff that are supervised and properly recruited and trained. EVIDENCE: The home employs 8 care staff who all have either NVQ 2 or 3. The manager explained that he is currently seeking some specialist training for staff around mental health issues. All the residents spoken to say the care staff were approachable. During the inspection care staff were observed with residents and were seen to be comfortable with them and listening to what they had to say. They were also able to communicate using the residents preferred method of communication. Staff were enthusiastic about their role and committed. The file of a member of staff was reviewed. This contained all the appropriate documentation. There were 2 written references and the POVA 1st check and CRB disclosure had been returned before they commenced employment. There Liam House DS0000003956.V337839.R01.S.doc Version 5.2 Page 18 was no evidence that residents are involved in recruitment and selection however a visit to the home is part of the process. The manager said that this member of staff had the correct documentation to work in this country as he had seen it however this documentation was not on the file. The manager is continuing to address shortfalls in training, which he outlined in the previous inspection. Staff have completed all mandatory training courses and the manager is now looking at specialist courses such as mental health, diabetes and total communication. The manager has started supervision and was able to demonstrate this by showing the details of recorded sessions. Staff also said that they have supervision dates. Liam House DS0000003956.V337839.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. This home is well run, people have their views listened to and acted upon and the health, welfare and safety of the people who live there are promoted and protected. EVIDENCE: The manager has been in post 8 months. At the time of the inspection the application had not been submitted to the Regional Registration team. The application is complete and the CRB disclosure has recently been returned. The manager and the registered provider gave assurances that the application would be submitted to the commission. The application was received by the commission in early June. Liam House DS0000003956.V337839.R01.S.doc Version 5.2 Page 20 The manager is continuing to work on the annual development plan for the home; he has taken on board suggestions made at the last inspection and has a more detailed plan, which is still in draft. The manager has set up a 6 monthly system for monitoring the care provided as part of the homes quality assurance process. Each week the manager undertakes an audit of the environment, which includes checks on water temperatures, fire extinguishers, fridge and freezer temperature and a check on the building itself. A record of fire drills and fire training are kept. The homes insurance certificate and registration certificate were on display. Liam House DS0000003956.V337839.R01.S.doc Version 5.2 Page 21 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 X 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 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X 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 X X 3 X Liam House DS0000003956.V337839.R01.S.doc Version 5.2 Page 22 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 YA34 Regulation 19(1) (b) Requirement The registered person must make sure that the documentation required in paragraph 3 of schedule 2 of the National Minimum Standards is up to date. This includes information on the documentation needed to work in this country legally. Timescale for action 30/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Liam House DS0000003956.V337839.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Liam House DS0000003956.V337839.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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