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Inspection on 17/08/05 for Outreach Community & Residential Services

Also see our care home review for Outreach Community & Residential Services for more information

This inspection was carried out on 17th August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is well run and has a good manager and a willing staff group who get on with the residents and with each other. The home gives good care to the residents and the staff knew a lot about the residents and the care they needed. Enough staff were on duty to see to the residents properly. The information recorded in the care plans is clear and it gives good guidance about how the residents are to be cared for. Visitors are welcome and in a written reply a relative said that they were kept informed about their relatives progress and that they were "very satisfied" with the overall care provided. The building is well looked after and clean, and it is safe.

What has improved since the last inspection?

Good progress had been made by the manager and the staff to make sure that the things, which needed improving from the last inspection, have been done. These include the bringing up to date of care plans and risk assessments, the keeping of accurate records of residents money and dealing with some health and safety matters. The staff group is settled and working well together with the residents also being noticeably more settled and content with the atmosphere in the home being much calmer.

What the care home could do better:

Although the residents are well cared for and content the staff should continue to look at different ways of providing the residents with stimulating and fulfilling things to do.

CARE HOME ADULTS 18-65 Outreach Community & Residential Services 86 Meade Hill Road Prestwich Manchester M25 0DJ Lead Inspector Stuart Horrocks Announced 17 August 2005 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. Outreach Community & Residential Services F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Outreach Community & Residential Services Address 86 Meade Hill Road Prestwich Manchester M25 0DJ 0161 740 3256 0161 740 5678 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) Outreach Lesley Ann Smith CRH Care Home 5 Category(ies) of LD Learning Disability : 5 Places registration, with number of places Outreach Community & Residential Services F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered for a maximum of 5 service users, to include: Up to 5 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. Date of last inspection 16 December 2004 Brief Description of the Service: 86 Meade Hill Road is one of a number of care homes managed by Outreach Care Services. Outreach is a charitable organisation offering 24-hour care, mainly to Jewish people with a learning disability or mental health problem. 86 Meade Hill Road is a six bedroomed detached house owned by Greater Manchester Jewish Housing Association. The home provides care and accommodation for five service users with profound learning disabilities. The remaining bedroom is used as an office/sleep-in room.The house is located close to local shops, pubs and Post Office. Buses to and from Prestwich and Manchester pass nearby and a metrolink station is within walking distance. A ramped path is provided to the front door and the house is accessed by one step both at the front and back entrances. A drive provides parking space and on street parking is available outside the house. A safe enclosed lawned and patio area is provided to the rear of the property. Outreach Community & Residential Services F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was started at 9.30am.It took place on one day and it lasted for about 5 hours. Much of this time was spent talking to the manager and four staff members and looking at paperwork. A short amount of time was also spent looking around the home. None of the residents have the ability to communicate verbally therefore the inspector was not able to talk to the residents to get their views about what it is like to live at the home. However the inspector noted that the home was quieter and more settled than at the time of the previous inspection and that the residents seemed to be happy and content. Before the inspection, satisfaction surveys had been posted to the residents and to their relatives. Unfortunately the residents were unable to complete these, but, one questionnaire was returned from a relative who said that they were “very satisfied” with the care and services provided. Four residents went out on a day trip to Southport during the late morning of the inspection whilst the remaining resident was taken out on a shopping trip to Manchester. What the service does well: What has improved since the last inspection? Outreach Community & Residential Services F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 Page 6 Good progress had been made by the manager and the staff to make sure that the things, which needed improving from the last inspection, have been done. These include the bringing up to date of care plans and risk assessments, the keeping of accurate records of residents money and dealing with some health and safety matters. The staff group is settled and working well together with the residents also being noticeably more settled and content with the atmosphere in the home being much calmer. 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 F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Outreach Community & Residential Services F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 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 standard(s) EVIDENCE: The above key standard was not inspected at this inspection. It will be inspected at the next inspection. Outreach Community & Residential Services F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 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 standard(s) 6 and 9. Individual care plans and risk assessments are in place, which were up to date, regularly reviewed and provided the staff with the information needed to give a good standard of care to the residents. EVIDENCE: The care files of three residents were looked at. These files contained detailed information about how the resident’s social, physical and health care needs are dealt with. This information includes what the residents support needs are, which goals are to be achieved and safety risk assessments. The information in these documents was up to date, regularly reviewed and the staff said that they looked at the care files as a guide to giving the right care to the residents. The details in the above care files are well laid out in an orderly fashion and are separated in to specific areas. The home has detailed risk assessment and risk management systems that protect the residents and other people from potential harm. The risks assessed Outreach Community & Residential Services F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 Page 10 are for personal risk and for activities that the residents are involved in both inside and outside of the home. They describe the management and the support needed for each sort of risk and activity. These risk assessments had been reviewed and they were up to date. Outreach Community & Residential Services F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 15 and 17. The residents are encouraged and supported to take part in activities that provide interest and purpose in their lives and enables them to be a part of the local community. Family and community contact helps the residents to have personal relationships and the resident’s health is maintained by the provision of proper meals. EVIDENCE: None of the residents living at the home are able to take part in formal education or work activities. However one resident attends a local college where he takes part in pottery, art, horticulture and computer classes. Two other residents attend a day centre where they have a meal and take part in a number of social activities. The residents go out on shopping trips and they usually go out for a drive on Sundays (a vehicle is available) and they have lunch. Outreach Community & Residential Services F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 Page 12 The residents had recently been on a day trip to Blackpool and they went out to Southport in the late morning of the day of this inspection. All of the residents have a “weekly planner” that describes how their time is spent. The home was noticeably quieter than on the previous inspection with the residents seeming to be more settled and content. Although the residents are not able to travel independently they do use local buses, trams, shops, parks, pubs and cafes and they are a part of the local community. Visitors are welcome at the home at any time and the residents are supported in seeing their relatives. All of the residents have contact with their families although for some this can be irregular whilst others see their relatives more often. In a returned questionnaire a relative said that they were “very satisfied” with the care and services provided by the home. The cultural and religious needs of the residents are respected and the home follows Jewish laws and customs. A Kosher diet is provided through a six-weekly menu. This menu has been put together from the known likes and dislikes of the residents. The menu describes a nourishing and attractive diet with the main meal of the day being eaten in the evening. The staff and the residents communicate in variety of ways with the staff knowing when the residents want a drink or a snack. The residents weight is checked regularly thus helping the staff to check the resident’s wellbeing. Outreach Community & Residential Services F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 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 standard(s) 19 and 20. Proper arrangements are in place that ensures the residents health care needs are monitored and met. The home’s medication systems are satisfactory in ensuring that residents receive medication as prescribed. EVIDENCE: Each resident has a section in their care file that includes information about their medicines, visits to the doctor and to hospital consultants and to other health care workers such as the dentist or optician. From the checking of these records and talking to the staff it is clear that the resident’s health care needs are looked after and that prompt action is taken if a resident becomes ill. Most medicines are provided by the chemist in individual made up packs with some being provided in packets. Medicines are safely and securely stored, and the staff have been given training about how to give out and deal with medicines. Records are kept of medicines received, given out and disposed of by the home therefore ensuring that medicines are handled properly. Outreach Community & Residential Services F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 Page 14 None of the residents are looking after their own medicines. Outreach Community & Residential Services F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 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 standard(s) 22 and 23. The home has a clear complaints system ensuring that concerns are properly dealt with. The residents would need support and assistance should they wish to complain. A protection of vulnerable adults procedure is in place that ensures a proper and prompt response to any suspicion or allegation of abuse . EVIDENCE: A clear and straightforward complaints procedure is available within the home. The staff said that they would know what to do if a resident showed that they were unhappy and that they would assist them in making their concerns known. The survey document received from a relative showed that they knew what to do should they wish to complain, but that they had never made a complaint and that they were happy with the service provided by the home. A book for recording complaints is kept at the home. No complaints have been made either to the manager or the CSCI during the past year. There are detailed written procedures for whistle blowing and responding to allegations of abuse. Staff members interviewed said that they were aware of these, having covered this topic in induction training, and the manager intends to give them further training. Outreach Community & Residential Services F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 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 standard(s) EVIDENCE: None of the above key standards were inspected at this inspection. They will be inspected at the next inspection. Outreach Community & Residential Services F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 and 35. Staffing levels were satisfactory thus ensuring both consistency of care and that the assessed need of the residents were met. Staff morale was good with the staff saying that they enjoyed their work at the home. The recruitment method is good, therefore ensuring that the residents are looked after by staff that are suitable to carry out care work. Staff training is also good thus making sure that the residents are provided with a good standard of care. EVIDENCE: Many of the staff team have worked at the home for some time, and there is little staff turnover and sickness. This ensures that residents are cared for by people they know and are familiar with. The staff said that “they worked well together”, that “there is a good team spirit” and that “they were like brothers and sisters”. The staff also said that the manager “was approachable” and that she “was easy to talk to”. Rotas showed that enough staff was on duty at all times to meet the needs of the residents. The manager and the staff said that the current staff numbers Outreach Community & Residential Services F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 Page 18 were sufficient to meet the needs and dependency levels of the residents living at the home at the time of the inspection. Although the staff were at times busy they had time to talk to the residents and they had a comfortable and friendly understanding with them. Outreach houses do not usually keep detailed staff recruitment information within each home. This information is kept in a central office. The CSCI therefore undertook a random sample of staff personnel files in July 2005 to check on the vetting arrangements for care staff working in Outreach properties. From the findings of this sample it was decided that the organizations recruitment systems are generally safe and sound. The checking of records and discussion with the manager and the staff showed that the staff have been given a range of training including the required health and safety subjects such as fire safety, first aid and food hygiene. The Outreach organisation gives new workers an induction to the job, which last for six weeks. Although this induction is wide-ranging the inspector recommends that it be checked against the “Skills for Care” (formerly TOPPS) induction scheme to ensure that the right information is being provided. The inspector gave the manager advice and written information regarding the above induction training. Outreach Community & Residential Services F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 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 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) 42. Safety checks of equipment and staff training promotes the health and welfare of the people living and working at the home. EVIDENCE: The checking of records and maintenance certificates showed that these were all up to date. The home is therefore safely maintained with fire precautions tests done weekly and details of accidents properly recorded. Records and discussion with the staff also showed that the training required to allow them to work safely had been provided. Two requirements regarding health and safety that were made at the time of the last inspection have been dealt with. Outreach Community & Residential Services F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score x x 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Outreach Community & Residential Services Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x Version 1.40 Page 21 F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc 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 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. Refer to Standard 35 Good Practice Recommendations The manager should check the homes new staff induction induction programme against the Skills for Care scheme to ensure that the correct specification is being met. Outreach Community & Residential Services F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 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 F56 F06 S8445 Outreach Community Residential Services - 86 Meade Hill Rd V232329 170805 Stage 4.doc Version 1.40 Page 23 - 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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