Inspection on 17/10/05 for Old Racecourse Road, 6a

This inspection was carried out on 17th October 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Old Racecourse Road, 6a 06/09/07

Old Racecourse Road, 6a 19/01/06

Old Racecourse Road, 6a 09/02/05

Old Racecourse Road, 6a 29/06/04

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 Old Racecourse Road, 6a 6a Old Racecourse Road Maghull Liverpool Merseyside L31 8AN Lead Inspector Debbie Corcoran Unannounced Inspection 17th October 2005 11:00 Old Racecourse Road, 6a DS0000005426.V261395.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 Old Racecourse Road, 6a DS0000005426.V261395.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. Old Racecourse Road, 6a DS0000005426.V261395.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Old Racecourse Road, 6a Address 6a Old Racecourse Road Maghull Liverpool Merseyside L31 8AN 0151 531 6154 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 Mrs Eleanor Dowling Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Old Racecourse Road, 6a DS0000005426.V261395.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: 6A Old Racecourse Road is registered as a care home for three people with a learning disability. The service provider for the home is Expect Ltd. This organisation is in the voluntary sector and is a registered charity. The registered Landlord for the property is Liverpool Housing Trust. The property is a five bed roomed dormer bungalow. The home is located in a residential area in Maghull. It is in keeping with other properties in the area and is indistinguishable as a residential care home. The home is located approximately one mile from local shops and is a fifteen minute walk from the nearest train station. Old Racecourse Road, 6a DS0000005426.V261395.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over a half day. During the visit all three of the service users were present and both members of staff on duty were spoken with. A tour of the home was carried out. Service user plans, health and safety records, medication administration records, staff records, staff rotas, menus and other relevant records were examined in some detail. What the service does well: What has improved since the last inspection? Each member of staff now has an individual training file. These provide a clear record as to the training staff have been provided with and identifies future training needs. Old Racecourse Road, 6a DS0000005426.V261395.R01.S.doc Version 5.0 Page 6 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. Old Racecourse Road, 6a DS0000005426.V261395.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 Old Racecourse Road, 6a DS0000005426.V261395.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): 1, 2, 5 A statement of purpose and service user guide is available to provide service users and their representatives with information on the home. Each of the service users has a contract with the home. EVIDENCE: The home has a good information pack which includes information on the philosophy of care and aims and objectives of the home, the services and facilities provided, a policy on the rights of service users, a complaints notice and leaflet, information on advocacy services. Expect Ltd are reported to be developing relevant information in service user appropriate formats. This should include the service user guide. The service users have been living at the home for a number of years and therefore standard 2 regarding attaining an assessment of needs could not be practically evidenced. The home does have a referral and admissions policy and procedure. Each of the service users has a contract statement. The contracts are signed and dated and a copy is kept in service user’s personal file. As with other relevant information the format of the contract should be made as service user accessible as possible. Old Racecourse Road, 6a DS0000005426.V261395.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, 9, 10 Each of the service users has a plan of care which includes a good level of information on their needs and the plans are reviewed and updated regularly. When service users are involved in an activity which involves taking risks the risk is assessed and plans are put in place to manage the risk. Personal and confidential information is handled appropriately. EVIDENCE: Old Racecourse Road, 6a DS0000005426.V261395.R01.S.doc Version 5.0 Page 10 Each of the people living at the home has a care plan. The plans are of a good standard and include information on the individual’s daily routines, likes and dislikes, skills and needs, targets for personal development, a health action plan, weekly activity plan, finance action plan and some very good detailed information on the service user’s needs in relation to their health and diet and specific health conditions. The plans are monitored monthly and reviewed every six months. Reviews can take different forms but the manager should ensure that some of the reviews are a holistic review of a person’s support and not just an update of their care plans. The manager reported that new care plans are going to be introduced which are referred to as ‘person centred plans’. The manager has been provided with training in this type of care planning and service users will have the opportunity of a new plan in the near future. When a service user is thought to be at risk then a risk assessment is carried out and plans are put in place to manage the risk. The risk assessments are comprehensive and have been reviewed and updated since the previous inspection. The home has a risk assessment policy. It was evidenced that all confidential information in the home is maintained securely. The home has a confidentiality policy and staff are aware of their responsibilities in maintaining confidentiality. Old Racecourse Road, 6a DS0000005426.V261395.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, 13, 14, 17 Service users are supported with their personal development. Service users are not involved in a great variety of leisure activities or community access. There is a good level of information on the service user’s likes, dislikes and needs with their diet. However, there is clear room for improvement in the variety and quality of food available at the home and in how food is stored. EVIDENCE: Old Racecourse Road, 6a DS0000005426.V261395.R01.S.doc Version 5.0 Page 12 Service user’s plans have a section which includes goals for their personal development. The goals are realistic and achievable and reflect the needs of the service users. Staffing levels are good and this enables staff to provide a significant amount of one to one support to service users in promoting independent living skills. Daily records were examined to assess the frequency of leisure opportunities and community access for one of the service users over the past two months. This showed that there are occasions when the service user has been going out on a regular basis and other occasions when the service users might not go out for a relatively long period of time. The records also indicate that the service user isn’t being offered a great variety of activities with the vast majority of outings being for shopping purposes. This might suite some service users and be in line with their needs but the manager should review the current needs of the service users with regards to community access and leisure. The manager stated that the service users may have a greater level of community access than is reflected in the daily records. The home does have menus which are used as a guide. However service users have the option to choose what to eat on a daily basis and this is then recorded. Service user’s records include a good amount of information on the special dietary requirements of the service users when appropriate. There wasn’t a great variety of food available at the time of the inspection and little evidence of fresh food. The manager should review the arrangements for shopping and ensure a supply of fresh food is available at all times. Some food was found to be stored inappropriately and would have been dangerous if eaten. The manager and staff team must be provided with further training in food hygiene and be aware of the policy and procedure on this and ensure this is adopted at all times. Old Racecourse Road, 6a DS0000005426.V261395.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, 20 The service user’s strengths and needs with personal support are well documented and the service users are supported by a small staff team who know their personal care needs and preferences well. The service users are well supported to remain healthy. Medication is handled safely and in accordance with policies and procedures. EVIDENCE: Service user’s care plans include guidelines for supporting the service user with personal care tasks and with moving and handling tasks. The plans include a good level of information on the individual’s likes and dislikes and preferred routines. There was a good level of evidence to indicate that the service users are supported to remain healthy. Service user’s records include a good level of information on the health related needs of the service user and records also evidenced regular G.P, occupational therapy, community nurse involvement and hospital appointments. Each service user has a health action plan and these include a record of target and actual dates for all health checks. Old Racecourse Road, 6a DS0000005426.V261395.R01.S.doc Version 5.0 Page 14 The home maintains a record of all medication received, administered and stock checked. Medication storage and administration records were examined and found to be appropriate. All of the staff team have undertaken a medication awareness course. The home has a medication policy. Old Racecourse Road, 6a DS0000005426.V261395.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): Policies, procedures and practices are in place to deal with complaints and to prevent and respond to abusive, neglectful or issue self harm from occurring. Service users are restricted in access to their money and records regarding service user’s money are not appropriately maintained. EVIDENCE: The home has a complaints procedure which is time scaled appropriately and includes details of the Commission. A comments, complaints and suggestions notice is also available in the home along with a complaints leaflet. There have been no complaints made to the home since the previous inspection. Any complaints made are recorded and forwarded to the head office of the organisation. The complaints procedure should also be produced in a more service user friendly format although it has been reported that this has been explained to service users. Old Racecourse Road, 6a DS0000005426.V261395.R01.S.doc Version 5.0 Page 16 The home has a protection of service users policy and an abuse policy and a copy of Sefton Borough Council’s adult protection procedures. Staff have been provided with protection of vulnerable adults training. The home has a policy and procedure for the management of service user’s money and financial affairs. When a service user needs access to their money, other than their personal allowance, the staff send a request form into the head office of the organisation and the money is released approximately one week later. This does not fit in with the principles of ordinary living. The organisation should address this issue and enable service users to have access to their own money as and when they require. Current financial records for service users do not include up to date information on all service user’s incoming and outgoing monies or include a current balance. This is an issue which needs to be addressed and is outstanding from previous inspections. It is recommended that each of the service users has a bank account in their own name. Old Racecourse Road, 6a DS0000005426.V261395.R01.S.doc Version 5.0 Page 17 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, 29, 30 The service user lives in a home which is spacious, generally well presented, homely and comfortable. The home is presented as clean and hygienic and staff have relevant training in health and safety topics. Specialist equipment is in place and this is serviced regularly. Old Racecourse Road, 6a DS0000005426.V261395.R01.S.doc Version 5.0 Page 18 EVIDENCE: The home is a five-bedroom dormer bungalow. It is fully accessible and fitted with aids and adaptations to meet the needs of the service users. The house is homely and well maintained. Furnishings, fittings and décor are generally of a good standard. However one of the service user’s bedrooms and the kitchen are in need of redecoration. The home easily meets the standard for shared living space. A ramp is in situ at the rear of the house to ensure service users have full access to the garden. The house has gardens at the front and rear. These are of a good size and well maintained. The home is equipped with aids and adaptations to meet the needs of the service users and there was evidence that this equipment has been serviced regularly. The amount of this equipment is appropriate to the service users needs and is not too obtrusive within the home. Staff have been provided with training in moving and handling. The home was presented as clean and hygienic on the day of inspection. One area of concern was the storage of food. This was discussed with the manager and has been reported on page 13 of this report. Policies and procedures are in place in relation to; health and safety, control of infection, food safety and hygiene, food safety and nutrition and staff have been provided with training in a number of core health and safety related topics. Old Racecourse Road, 6a DS0000005426.V261395.R01.S.doc Version 5.0 Page 19 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): 31, 34, 35, 36 Staff have clear roles and responsibilities. The staff recruitment procedures are thorough and aim to protect service users. Staff training opportunities are good and in line with the needs of the service users. Staff have the opportunity to meet one to one with their manager and to meet as a team on a regular basis. EVIDENCE: Old Racecourse Road, 6a DS0000005426.V261395.R01.S.doc Version 5.0 Page 20 Staff have job descriptions which are clearly defined and include supporting service users to achieve aims. There was evidence in service users files that staff have appropriately referred for specialist support and advice to meet individuals needs. Expect Ltd has a staff recruitment and selection policy and an equal opportunities policy. Files were examined for two new members of staff who have started work at the home since the previous inspection. The files included evidence of pre employment references having been attained and a Criminal Records Bureau Disclosure number to show that a disclosure had been attained. The actual disclosures were not available on file. Service users are reported to be involved in a second stage of interviewing staff however there was no evidence of the outcome of these interviews at the home on this occasion. New staff are subject to a six month probationary period which can be extended if necessary. Each member of staff has a training file. Staff training records indicate that most staff have undertaken core skills training, for example food hygiene, fire safety, first aid, moving and handling. Staff have also been provided with training in issues such as diabetes, medication, the role of a support worker, adult protection. Training is identified in staff supervision and appraisals and each member of staff has an individual training and development plan. The training and development budget and programme is managed centrally. Staff are receiving regular and recorded supervision and staff team meetings are taking place regularly. Staff also undergo an annual appraisal. Old Racecourse Road, 6a DS0000005426.V261395.R01.S.doc Version 5.0 Page 21 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): 40, 41, 42 Service user’s rights are safeguarded by the safe keeping and security of records and all records are up to date and maintained appropriately. Policies, procedures and practices are in place which aim to safeguard and protect the health and safety and well being of service users and staff. EVIDENCE: The home has a large number of policies and procedures which have been produced by Crones. These cover all of the policy and procedure requirements of the National Minimum Standards. Relevant policies and procedures should be produced in a service user friendly format. The policies and procedures are kept at the home and are fully accessible to all staff. All records in the home were evidenced to be maintained securely. The records kept at the home are in good order and up to date. The home maintains a record of all accidents, injuries or incidents. Old Racecourse Road, 6a DS0000005426.V261395.R01.S.doc Version 5.0 Page 22 The home has a number of policies and procedures which aim to ensure the health and safety of service users and staff and these include policies on health and safety, first aid, fire safety, food safety, medication, COSHH, control of infection. Health and safety records were examined and found to be up to date. The records examined included fire procedures, gas and electricity safety certificates and a water temperatures log. The home has a risk assessment for safe working practices and this has been reviewed since the previous inspection. Old Racecourse Road, 6a DS0000005426.V261395.R01.S.doc Version 5.0 Page 23 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 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x x 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x 3 3 LIFESTYLES Standard No Score 11 3 12 x 13 2 14 2 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score 3 x x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Old Racecourse Road, 6a Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x 3 3 3 x DS0000005426.V261395.R01.S.doc Version 5.0 Page 24 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 2 Standard YA42 YA17 Regulation 18 (1) (c )(i) 16 (2) (i) Requirement All staff must be provided with training in food hygiene. The manager must ensure that a good variety of nutritious food is available for the service user’s choice. The manager must ensure that food is stored safely and hygienically. The kitchen and one of the service user’s bedrooms must be redecorated. Records relating to all of the service user’s money should be maintained at the care home. Timescale for action 13/01/06 18/10/05 3 YA30 13 (3) 18/10/05 4 YA24 23 (2) (d) 13/03/06 5 YA23 17 (2) Schedule 4 16/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Old Racecourse Road, 6a DS0000005426.V261395.R01.S.doc Version 5.0 Page 25 No. 1 2 3 Refer to Standard YA23 YA8 YA6 Good Practice Recommendations Service users should have access to their own money as required. The home should ensure that information provided to service users is in appropriate formats and accessible. Consideration should be given to develop the review process. Old Racecourse Road, 6a DS0000005426.V261395.R01.S.doc Version 5.0 Page 26 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 © 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 Old Racecourse Road, 6a DS0000005426.V261395.R01.S.doc Version 5.0 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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