Inspection on 14/07/05 for Liverpool Grove, 26

This inspection was carried out on 14th July 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Liverpool Grove, 26 26/07/07

Liverpool Grove, 26 16/11/06

Liverpool Grove, 26 05/01/06

Liverpool Grove, 26 11/01/05

Liverpool Grove, 26 07/09/04

Liverpool Grove, 26 02/10/03

Liverpool Grove, 26 25/04/03

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

CARE HOME ADULTS 18-65 26 Liverpool Grove 26 Liverpool Grove London SE17 2HJ Lead Inspector Mark Stroud Unannounced 14 July 2005, 10:00 th 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 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 Stationary 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. 26 Liverpool Grove G52-G02 7089 Liverpool Grove 231652 140705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 26 Liverpool Grove Address 26 Liverpool Grove , London, SE17 2HJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Category(ies) of registration, with number of places 020 7703 1935 LINC, 6 Belmont Hill , Lewisham, SE13 5BD Ms Teresa Lipski CRH Care Home 5 26 Liverpool Grove G52-G02 7089 Liverpool Grove 231652 140705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11.01.05 Brief Description of the Service: Liverpool Road is a Care Home providing personal care and accommodation for four people with a learning disability. The home is managed by LINC, a voluntary organisation. LINC is in the process of merging with another organisation to become Providence and LINC United Services (PLUS). The home is located in Camberwell, close to bus routes, shops, post office, pubs, and most amenities. The home consists of two floors, two bedrooms on the ground floor, one bedroom and an independent flat situated on the first floor. There is no passenger lift, the ground floor designed to be wheelchair accessible. 26 Liverpool Grove G52-G02 7089 Liverpool Grove 231652 140705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was made in the afternoon. Three service users were seen, two new and two established staff spoken to, as well as the new manager (previous manager promoted). 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. 26 Liverpool Grove G52-G02 7089 Liverpool Grove 231652 140705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 26 Liverpool Grove G52-G02 7089 Liverpool Grove 231652 140705 Stage 4.doc Version 1.30 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 standard(s) 1 & 2 Service users are supported to make decisions about where they live and have their needs fully assessed by a qualified person unconnected with the home. EVIDENCE: The complaints procedure is included in the Service User Guide. The guide is not currently of use directly to service users. The home use a variety of methods to support service users to understand the Service User Guide, so that they understand how the home is run and can change this if it doesn’t meet their needs. Service users receive direct staff support with specialist communication, visual prompts and with support from outside professionals. This means that service users continue to make a positive choice to live at the home. Service users’ needs are also reviewed by social workers representing the authority that arranged for them to live at the home, so that their needs are regularly reassessed, at least every year. 26 Liverpool Grove G52-G02 7089 Liverpool Grove 231652 140705 Stage 4.doc Version 1.30 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 standard(s) 6, 7,& 9 Service users are supported to do the things they want to, and take managed risks when they want to. EVIDENCE: Service users have plans to try and ensure they get all the support they need. These contain goals to aim for, and when things should be done by. Service users are helped to plan by trying out new activities to see if they like them, and for instance when is the best time to go. The staff also use team meetings to discuss what service users need and like, and share ideas for plans. Staff are aware of the wishes and feelings of service users, for instance whether they like crowds or not, and whether they enjoy their own company, and when. The manager understands that service users need support to get more confident and familiar with making their own choices and this is included in their plans. Service users are supported safely, ensuring risks are assessed and reviewed, and plans recorded to minimise them. 26 Liverpool Grove G52-G02 7089 Liverpool Grove 231652 140705 Stage 4.doc Version 1.30 Page 9 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 standard(s) 17 12,13,15,16 & Service users are supported to participate and try out new leisure activities in the local community. Service users are supported to continue established relationships with family and friends, but need more support to decide if they want to make contact if this has not happened previously. Service users are supported to eat a healthy diet. EVIDENCE: During this visit service users were being supported to go swimming, and use the local park. In the home, staff provide individual activities and support, one service user relaxing in the garden. The home needs to provide support to one service user so that they can decide whether to make contact with their family. Service users do receive support to entertain and visit family and friends. Service users are supported to eat well, one service user showing increasing independence when eating. The home need to see if other equipment or ideas might make the service user even more independent in this area by referring to an Occupational Therapist who could give specialist advice. The manager clarified that one service user is supported to eat out, but does sometimes fail to finish meals, and this has led staff to question whether the service user wanted the food, or enjoys eating out. 26 Liverpool Grove G52-G02 7089 Liverpool Grove 231652 140705 Stage 4.doc Version 1.30 Page 10 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 standard(s) 18, 20 & 21 Service users are supported according to their wishes by staff who are confident and knowledgeable about their needs. EVIDENCE: One service user is supported around the home by staff, who allow the service user plenty of time to move, provide reassurance, and follow clear guidance to keep the service user safe. The communication needs of service users have been assessed by health professionals, and staff have been supported to know these needs better. The home has written guidance. Information about communication needs is displayed on the wall, which may infringe privacy and confidentiality, and is not in itself effective in supporting staff, or service users. Information and resources should be used in supervision and training, discussion at team meetings, so that all staff receive support to understand service users needs and how these should be met. Staff are confident and clear when communicating with service users. New staff are given guidance and information about the communication needs of service users, and are given feedback about how to improve their skills. Staff are assessed to make sure they can support service users with their medication safely. The home has been advised to put different labels on dossette boxes after a pharmacist did an audit of medication recently. The homes chemist felt this was not necessary, and the home needs to clarify this with the Primary Care Trust. The wishes of service users regarding death and dying have been discussed at reviews of serviced users support, and suggestions recorded for preferred 26 Liverpool Grove G52-G02 7089 Liverpool Grove 231652 140705 Stage 4.doc Version 1.30 Page 11 music and other arrangements. This work needs to be continued, and plans kept up to date. The home also need to consider any further support, such as the drawing up of a will, to ensure the wishes of service users are protected. 26 Liverpool Grove G52-G02 7089 Liverpool Grove 231652 140705 Stage 4.doc Version 1.30 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 standard(s) 22 & 23 Service users are supported to change agreements where these no longer meet their needs, and are supported to complain should they wish to. EVIDENCE: The complaints procedure is included in the Service User Guide. The vehicle belonging to some of the service users is being reviewed by the organisation with the funding authority for the service users, London Borough of Southwark. The transport needs of service users are being reviewed and a new plan put in place, involving the sale of the vehicle, and possible compensation to service users. This process it is hoped will be complete within two months. Service users may then lease vehicles individually if required, or use public transport, or other available community transport. Service users will be able to spend benefits designed to support them getting around the community in a way that meets their specific needs. The organisation has a Protection of Vulnerable Adults policy, and new staff are supported to understand this, and what their responsibilities are if they have concerns. This will minimise the risk of abuse happening, or going unnoticed. 26 Liverpool Grove G52-G02 7089 Liverpool Grove 231652 140705 Stage 4.doc Version 1.30 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 standard(s) 24, 29 & 30 The home is in a good state of repair, clean, and meets the needs of service users. EVIDENCE: The home provides good individual and communal accommodation to service users. One service user needs black out blinds to use sensory equipment, for which they have been assessed by a health professional. The kitchen worktop around the sink is damaged and needs to be replaced. Otherwise the home is well maintained. 26 Liverpool Grove G52-G02 7089 Liverpool Grove 231652 140705 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 34, 33 & 35 Service users are supported by trained staff who provide one to one support in the community when they need it. EVIDENCE: Two new staff have started working at the home and demonstrated qualities and attitudes that reflected the needs of service users. The manager was involved in their recruitment, but service users are not. The manager said that staff are observed to see how they interact with service users when they start work. This does not allow service users to meet staff before appointment. The two new staff had spent time at another home before starting at this home. The manager explained that this allowed staff skills to be assessed and matched to service users needs. Staff qualities include good listening skills, a calm and confident manner, and a good grasp of the basic areas of need they needed to meet, including communication. Staff receive induction training before starting work, including instruction and assessment to keep service users safe, and first steps to awards as part of the Learning Disability Award Framework, nationally recognised training for staff working with people who have a learning disability. One staff member has an NVQ Level 3, a National Vocational Qualification for senior staff, and other staff are following NVQ qualification at Level 2. Service users have enough staff for them to follow individual planned activities in and out of the home, and for their basic needs to be met. 26 Liverpool Grove G52-G02 7089 Liverpool Grove 231652 140705 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 & 39 Service users know the home is well managed and planned, but need to be more involved. EVIDENCE: The previous manager was promoted, a new manager now in place. The new manager is working towards an NVQ Level 4 Registered Managers Award, a nationally recognised qualification for home managers Registered with CSCI (Commission for Social Care Inspection). The manager has overseen an improvement in the quality of care since the last inspection, reflected in improved record keeping, and activity levels for service users. The organisation has a business plan, and supports service users from other homes to comment on the way the organisation is run and what they want changed. Service users were supported in this way to participate in discussions about the recent merger of this organisation with another large provider of social care. This particular home does not have an annual development plan, that would plan for general changes in the type of service provided, taking into account the changing needs of service users, while also reflecting the improvement in the quality of care provided. 26 Liverpool Grove G52-G02 7089 Liverpool Grove 231652 140705 Stage 4.doc Version 1.30 Page 16 26 Liverpool Grove G52-G02 7089 Liverpool Grove 231652 140705 Stage 4.doc Version 1.30 Page 17 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 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 2 3 2 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 26 Liverpool Grove Score 3 x 3 3 Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x x x G52-G02 7089 Liverpool Grove 231652 140705 Stage 4.doc Version 1.30 Page 18 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 15 Regulation 12(2) Requirement Timescale for action 31.12.05 2. 17 12(3) 3. 20 13(2) 4. 24 & 29 23 The Registered Person must ensure that the service user discussed recieves suitable supprot to ensure they can decide whether to make contact with their family, and any goals inlcuded in the Service Users Plan. The Registered Person must 30.11.05 ensure that service users are supported to make informed choices regarding food, providing appropriate planning for them to experience different foods, appropriate to their needs, at home and in the community, including this in their Service User Plan. The Registered Person must 31.10.05 consult with the Primary Care Trust regarding the labelling of dossette boxes to resolve the contradictory advice from a pharmacist, and the supplying chemist. The Registered Person must 31.10.05 ensure that the service user discussed is supported to obtain suitable window covering, following guidance form the Occupational Therapist, and that Version 1.30 26 Liverpool Grove G52-G02 7089 Liverpool Grove 231652 140705 Stage 4.doc Page 19 the kitchen work top is replaced. 5. 39 24 The registered provider must 31.12.05 ensure the home has effective quality assurance and monitoring systems, based on seeking the views of service users and their advocates. The systems should be in place to measure how far the home is meeting the aims and objectives and statement of purpose (timescale of 30.04.05 not met). 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 1 Good Practice Recommendations The home should continue to look at ways to make the Service User Guide and complaints procedure easier to understand for service users, so that they need less staff support. The home should refer the service user discussed to an Occupational Therapist or similarly qualified professional to advise regarding any further adaptations or support that would make the service user more independent. The home need to consider whether sevice users need support to make a will, and ensure plans regarding death and dying are kept up to date. Infomration about the communication needs of service users should not be displayed, instead used in supervision of staff, staff meetings, handover, key work sessions, and other meetings where all staff are supproted appropriate to their needs, information is effectively shared, and service users are supproted according to their needs. 2. 17 3. 4. 21 18 26 Liverpool Grove G52-G02 7089 Liverpool Grove 231652 140705 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 46 Loman Street Southwark SE1 0EH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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