Inspection on 06/10/05 for Outreach Community & Residential Services 17 York Avenue

This inspection was carried out on 6th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Outreach Community & Residential... 20/02/07

Outreach Community & Residential... 07/03/06

Outreach Community & Residential... 29/03/05

Outreach Community & Residential... 27/07/04

Outreach Community & Residential... 04/03/04

Similar services:

Whitewalls

Home Farm

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

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

CARE HOME ADULTS 18-65 Outreach Community & Residential Services 17 York Avenue 17 York Avenue Prestwich Manchester M25 0FZ Lead Inspector Sarah Tomlinson Unannounced Inspection 6th October 2005 12.30p Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.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 Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.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. Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Outreach Community & Residential Services 17 York Avenue 17 York Avenue Prestwich Manchester M25 0FZ 0161 773 5053 0161 740 5678 Address 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) Outreach Community & Residential Services Anita Florence Taylor Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 4 service users to include: up to 4 service users in the category of LD (Learning Disabilities under 65 years of age) The service should employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection. 29th March 2005 Date of last inspection Brief Description of the Service: 17 York Avenue is a small care home providing long-term support for four people with a learning disability. It is part of a group of homes managed by Outreach Community & Residential Services, a charitable organisation, which has nine other homes in the south Bury/north Manchester area. The homes are predominantly for Jewish people, although care is also offered for nonJewish residents. 17 York Avenue is an end terrace house in a residential area of Prestwich. There are three single bedrooms on the first floor and one on the ground floor. The home has a small, enclosed lawned area at the rear and on street parking outside. There are shops within close walking distance and public transport is available nearby. Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 5 and 3/4 hours. The inspector met all four service users and was able to spend time talking with three of them. Time was also spent talking with the manager and a support worker, looking at paperwork and at parts of the building. What the service does well: What has improved since the last inspection? Maintenance work had been carried out to the outside of the home (repainting doors and windows, and rebuilding the garden wall). The safety of the bedroom door locks had also been improved. A staff appraisal system was being introduced, helping staff get feedback about their work and advice about developing their roles/careers. The manager had gained her Registered Managers Award qualification. Ways of checking on the quality of the service provided had improved; with internal monitoring visits now taking place each month, plus a new system for asking those people involved with the home, for their views about it. Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.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. Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.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 Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.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): 2, 3, 4 and 5 York Avenue provided a stable home environment, where service users’ care and support needs were being met. A gradual, flexible and individualised ‘settling in’ process ensured that prospective service users were given time to make an informed decision about moving in. EVIDENCE: One new service user had moved in since the last inspection. This person had been living at another Outreach house and although it had been proposed that they may wish to move to York Avenue, the actual move had been unplanned and had happened at very short notice. Consequently, following a recent review, their place at York Avenue was in the process of now being confirmed as permanent. The initial, temporary move had been for several days of respite care and had been extended at the request of the service user. The manager had subsequently completed assessment and care planning documentation, with a community care assessment also requested (with regard to funding). Good practice was noted, as prior to the move, the service user had been coming to York Avenue on a flexible, informal basis (as part of a gradual, individually tailored series of introductory visits). The new service user had received a contract for York Avenue and a copy of the complaints procedure. Although they knew the home, the benefits of them also receiving a Service Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 9 Users’ Guide was discussed (regarding the opportunity to give feedback on its content/style/layout). From speaking with service users about the support they received; observing staff and service users together; and from speaking with staff about their work and the training they had received, service users’ needs were being met. Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 10 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, 7, 8 and 9 Staff worked in positive and enabling ways with service users; maintaining service users’ safety, whilst also supporting them to be responsible and independent individuals. The introduction of a new care planning system should hopefully further improve the information that staff have to guide them in their work. EVIDENCE: Information in care records and risk assessments was extensive, personalised and up to date, with service users closely involved in their initial development and subsequent review. Outreach was in the process of introducing new care paperwork (combining the existing ‘Individual Personal Plans’ with ‘Health Plans’), with the aim of reducing duplication and making information easier to find and use. Good practice was noted, as service users were about to be actively involved in choosing their new key worker (this changed annually to enable the small staff team to work with service users with differing needs and for service users to build relationships with each staff member). Further good practice was noted, Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 11 as the manager continued to create a very open home, with service users being asked about and joining in with as many aspects of life in York Avenue as possible (e.g. from answering the door to taking responsibility for making sure there was enough milk). Monthly service users’ meetings continued to be held, with minutes showing service users raised a wide range of issues for discussion. Service users continued to be invited to the end of staff meetings (to bring any concerns/issues to the staff team). Good practice was noted, as service users were supported to be as independent as possible, with positive risk taking encouraged (e.g. regarding managing their own money, medication, shopping, meals and mealtimes). Documentation was in place regarding service users taking responsibility for their own medication and for their own and others safety when the home was unoccupied by staff (up to three hours). Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 16 and 17 Through attending a range of educational, occupational and social activities, service users were actively supported to live ordinary and meaningful lives. Service users were able to exercise choice and control over what they ate. EVIDENCE: Good practice was noted, as service users continued to be supported to maintain and develop a range of personal and practical life skills (e.g. money management; menu planning, food shopping and cooking skills). Service users generally led busy lives, having jobs and/or taking part in a wide range of courses. Service users were observed using their front door and bedroom keys, and also opening and handling their own mail. With staff support, service users continued to be responsible for buying and preparing their own meals. Individual, weekly menu plans were generally Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 13 used. However, no daily menu records were kept, as following a house meeting, service users had decided these were intrusive and unnecessary. Each service user had their own cupboard in the kitchen, with staff and service users also contributing to a communal cupboard for tea, coffee, bread, fruit etc. Good practice was noted, as staff were expected to eat with service users. Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 14 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 and 20 The personal support and medication needs of service users were well met, promoting good health and independent living skills. EVIDENCE: Relationships between staff and service users seemed warm, friendly, caring and respectful. Service users spoke very positively about the home and the staff team. Staff were very knowledgeable about service users likes, dislikes and preferred routines. Staff shift times had recently changed to better fit in with service users going to bed and getting up times. Two service users took medication. Good practice was noted, as both were supported to look after their own medicines, with one service user taking full control of their prescriptions/re-ordering. Records were kept of current medication, plus consent to, and risk assessments regarding, their use. Medicines were being stored safely, with a clear record of medicines received into the home and any returned to the pharmacist (ways of recording when medicines were handed to service users was discussed). Only one homely medication was used, with records kept in the diary and care files of its use. Medication refresher training had been provided to staff (12 July 2005). Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Practices and procedures were in place to listen to service users’ views and safeguard them from abuse or harm. EVIDENCE: Good practice was noted, as the manager encouraged service users to talk about any concerns they may have. Depending on the issue raised, discussions took place either individually; between staff and residents at the end of staff meetings; or at monthly house meetings. A small cash balance was looked after on behalf of one service user. This was checked and found to be correct, with clear transaction records also kept. With regard to other items of value or worth, several passports and savings book were also held. The home was advised to keep a separate record of these items (including passport numbers). Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 York Avenue provided service users with a comfortable, safe and homely place to live. Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 17 EVIDENCE: York Avenue was comfortable, bright and homely, with a good standard of décor and furnishings. The property is owned by Outreach. Service users had the use of a lounge, dining room, kitchen, a ground floor toilet and a first floor bathroom and separate toilet. Smoking was not allowed. Three service users showed the inspector their bedrooms. Good practice was noted, as all three were highly personalised. Since the last inspection, the brick wall to the front of the home had been repaired, the front door and window frames had been re-varnished and the dead lock facility had been removed from service users’ bedroom doors. Fencing to the side of the home (although the responsibility of the neighbour) has also been repaired, with Outreach contributing half the costs. At this inspection, the arms to the settee and chairs in the lounge were becoming quite marked (due to general wear and tear). The manager was aware of this and was organising for the suite and carpets to be deep cleaned. The carpet in the ground floor bedroom was also beginning to ripple (causing a possible future trip hazard). Responsibility for cleaning/housework was actively shared between service users and staff. This continued to work well, as the home was very clean and tidy. As a reflection of the independent living skills promoted and encouraged within the home, a range of ordinary cleaning products was kept in the kitchen (including bleach), with open access for both staff and service users. The home was advised to acknowledge this arrangement within the home’s general risk assessment. Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 34, 35 and 36 Service users benefited from a well-supported and supervised staff team, with their safety promoted through rigorous staff recruitment and selection procedures. EVIDENCE: Good practice was noted, as staffing levels remained good. One member of staff worked the ‘sleep-in’ shift (10am to 10.30pm, 7.30am to 10.30am), with day shifts provided three to four times a week. The staff team consisted of the manager, three support workers and one regular, bank support worker. Two support workers were due to go off on maternity leave early next year. Their hours are due to be covered from within the existing staff team and with additional bank staff, who are known to service users. Good practice was noted, as the shift patterns continued to provide staff with a paid handover and a copy of the rota was kept by the front door, for the use of service users. Further good practice was noted, as monthly team meetings took place, with both the manager and support workers contributing to the agenda. With regard to recruitment, copies of references, application form, interview record, proof of identity and CRB disclosure were seen for the last new starter. Following the last inspection, it had been agreed that original recruitment Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 19 documents would be brought to the home for its announced inspection. However, as this is no longer appropriate, CSCI visited Outreach’s head office (27 July 2005) to examine a random selection of recruitment documents for all the registered homes. Procedures and documents were in place. Good practice was noted, as Outreach was seeking to actively involve service users in the staff recruitment process, with a service user from York Avenue putting their name forward for consideration. Staff had completed a range of mandatory training, including moving and handling, health & safety, first aid and food hygiene. The new starter had completed induction training that had been designed within the LDA framework. Opportunities for staff to undertake further service specific training within the learning disability field was discussed. Good practice was noted, as staff received regular, usually monthly, supervision. The support worker spoke highly of the manager. Since the last inspection, a staff appraisal system had been developed and was now in the process of being introduced (the manager had completed appraisal training and was presently undertaking her own appraisal, after which she would then begin the appraisals of the support workers). Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 A range of quality assurance systems contributed to York Avenue being run in the best interests of service users. Regular fire safety checks were carried out, promoting the health and safety of both service users and staff. EVIDENCE: The manager had now completed the Registered Managers Award (NVQ level 4). Since the last inspection, Outreach had introduced its formal quality assurance system, gathering a range of positive views of York Avenue from service users, families and community stakeholders (e.g. social workers). Internal monthly, unannounced monitoring visits were also now taking place (conducted by managers from other Outreach homes). Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 21 Records showed that external checks of fire extinguishers (8/05) and smoke detectors and emergency lighting (9/05) were up to date (with smoke detectors also tested internally on a weekly basis). Good practice was noted, as an unannounced fire drill had been carried out shortly after the new service user had moved in (with names of those who participated being recorded). Following a Fire Authority inspection visit (6/05), Outreach had acted on the four recommendations made, including providing details of the fire safety training staff received within their annual health and safety training (8/05). Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 4 3 Standard No 22 23 Score 4 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 4 4 4 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 4 12 4 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X 4 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 X 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Refer to Standard YA23 YA24YA30 Good Practice Recommendations A separate record should be kept of service users’ valuables deposited for safekeeping. The rippling in the ground floor bedroom carpet should be addressed. As planned, the lounge suite should be deep cleaned. The access arrangements to cleaning products should be documented within the home’s general risk assessment. Opportunities for further service specific training should be developed. 3 YA35 Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Outreach Community & Residential Services 17 York Avenue DS0000008447.V256518.R01.S.doc Version 5.0 Page 25 - 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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