Inspection on 30/03/06 for Outreach Community & Residential Services 2 Devonshire Place

This inspection was carried out on 30th March 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Outreach Community & Residential... 01/12/06

Outreach Community & Residential... 22/06/05

Outreach Community & Residential... 14/12/04

Outreach Community & Residential... 23/08/04

Outreach Community & Residential... 21/01/04

Outreach Community & Residential... 03/09/03

Outreach Community & Residential... 07/01/03

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 2 Devonshire Place 2 Devonshire Place Prestwich Manchester M25 3FF Lead Inspector Sue Evans Unannounced Inspection 30th March 2006 10:00 Outreach Community & Residential Services 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 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 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 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 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Outreach Community & Residential Services 2 Devonshire Place 2 Devonshire Place Prestwich Manchester M25 3FF 0161 798 9023 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 Mrs Barbara Holden Care Home 4 Category(ies) of Learning disability (1), Mental disorder, registration, with number excluding learning disability or dementia (3) of places Outreach Community & Residential Services 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 4 service users, to include: Up to 3 service-users in the category of MD (Mental Disorder under 65 years of age); Up to 1 service-user in the category of LD (Learning Disabilities under 65 years of age). That the service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. 2. Date of last inspection Brief Description of the Service: Devonshire Place is one of a group of care homes managed by Outreach care services. Outreach is a charitable organisation offering 24-hour care, predominantly to Jewish people with learning disabilities or mental health needs. This home is registered to provide care and accommodation for up to 4 people. The house is owned by Irwell Valley Housing Association. It is situated in the centre of Prestwich village, close to bus and tram routes, shops, banks, synagogues, and other local amenities. The house is similar to other houses in the area and it is not distinguishable as a care home. It has a lounge, dining room, kitchen, and laundry room. All bedrooms are single. Outside, there is a small car parking space at the front, and an enclosed yard at the back. The philosophy of care, as described in the Statement of Purpose, promotes values such as independence, dignity, rights, fulfilment, and choice. Cultural needs are supported. Outreach Community & Residential Services 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took 5 hours. Most of this time was spent watching what went on in the home, talking to 3 of the residents, and interviewing 2 staff members and the manager. The inspector also looked round the house, and examined some key records. This inspection was the second to take place in the current inspection year. In order to gain a fuller picture of the home, this report needs to be read in conjunction with the report of the previous inspection of June 2005. What the service does well: Devonshire Place has a homely, comfortable atmosphere, and residents like living there. Residents are involved in meetings to review what they need support with, and what they would like to achieve. They are encouraged to be as independent as possible. They have choices about things such as meals, their daily routines (for example what time they get up or go to bed), and what activities to take part in. Residents’ cultural needs are respected and supported, for example by ensuring that only kosher food is brought into the house. Shabbas and Jewish festivals are observed and celebrated. Residents are involved in community activities such as employment, education, and leisure pursuits, helping them to lead lives that are meaningful and fulfilling. Staff support is provided where necessary. Residents said they were happy with the support provided. They gave examples of how their privacy was respected, for example staff members did not enter their bedrooms without invitation. They said that staff members treated them well and were polite and respectful. One person said, “Staff are very nice”. Another described staff as “very good”. 50 of the support workers have achieved NVQ level 2 in care and another has just begun the course. Staff members said that they received the support and direction that they needed to do their jobs. Regular, individual meetings with the manager or deputy help them to develop professionally and provide a good service to residents. Outreach Community & Residential Services 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Outreach Community & Residential Services 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 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 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 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): None None of the above standards were assessed this time. EVIDENCE: Standards 1 and 2 were assessed in June 2005. None of these standards was fully assessed this time. However, it was noted that a requirement made during the June inspection, in respect of updating the Statement of Purpose and Service Users’ Guide, had been addressed. Outreach Community & Residential Services 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 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 and 10 Residents know about their individual plans, and their needs and updating their goals. The home independent as possible, helping them to keep welfare to a minimum. However, one person’s updating to reflect the person’s current needs. Residents trust staff to maintain confidentiality. EVIDENCE: Standards 6, 7, 8, 9 and 10 were assessed in June 2005. The personal files for 2 of the residents were looked at. They included assessments, health plans, individual personal plans, review notes and risk assessments. They also contained separate information that gave specific direction for staff on residents’ daily routines, and the action they were to take to support the residents’ assessed needs. Residents’ preferences and choices, for example their preferred times for getting up and going to bed, were included in these records. Records and discussions also showed that risks were assessed, and balanced against the resident’s right to choice and independence. Staff gave examples Outreach Community & Residential Services 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 Page 10 they are involved in reviewing encourages residents to be as any risks to their health and risk management plan needs of potential risks and how residents were advised and supported to keep risks to a minimum. Staff members were consistent in their descriptions of how they assisted residents. This was mostly in line with the written information held on files. However, in the case of one resident, a recent change in one aspect of their support needs had not yet been recorded. The home needs to update this person’s risk assessment. The manager was also asked to make sure that all information held on files was dated. Records showed that needs and goals were reviewed every 6 months. Residents confirmed that they were involved in reviewing their needs and goals. Staff members were able to describe the home’s confidentiality procedures, and understood the importance of secure storage of personal information, and the need to only discus residents’ personal details with appropriate people, for example their manager. Residents said that they had not heard staff members discussing the personal information of others, and they trusted staff to maintain confidentiality. One said that staff members always spoke to him about confidential things in private. Outreach Community & Residential Services 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 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): 12, 13, 14 and 16 Residents have choice about their lifestyles, and take part in individual and group activities that they enjoy doing. They participate in the community, with staff support if needed, enabling them to lead fulfilling lifestyles. Practices in the home respect residents’ rights to privacy, dignity, choice, and independence. Cultural needs are supported. EVIDENCE: Standards 11, 12, 13, 14, 15, 16 and 17 were assessed in June 2005. Residents described some of the community activities that they were involved in. These included work, college, community groups, meals out, shopping, and going to synagogues. Means of transport included buses, trams, taxis or staff cars. Some residents were able to take part in community activities without staff support. However, staff members spent some time on community activities with all residents. This was observed during the inspection when residents and staff went out for lunch. Residents were looking forward to a holiday in Bridlington in the summer. Outreach Community & Residential Services 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 Page 12 The manager said that residents were included in the electoral register and entitled to vote. Residents said that they chose what time they got up or went to bed, and how they spent their time. They also met each week to decide upon menus, and they chose colour schemes and items for their bedrooms. Staff helped and encouraged residents to do things for themselves if possible. Some residents talked about the things they did for themselves such as keeping their rooms clean and tidy, doing their own laundry, making snacks and drinks, and helping out with vacuuming or table setting. This was observed during the inspection. Residents’ privacy was respected, for example they had keys to their bedrooms, and they said that nobody entered their bedrooms without permission. They said that mail was given directly to them. The staff members who were spoken with gave examples of how they promoted privacy and dignity, for example when helping someone with their personal care. It was observed during the inspection that staff spoke with residents in a friendly, natural way. Residents said that the manager and staff treated them well and that they were polite and respectful. One said, “Staff are very nice”. Another described staff as “very good”. Another said that they got on well with staff. Cultural and religious needs were respected. Shabbas and Jewish festivals were observed. It was expected that only kosher food would be brought into the house. Staff members said that they had been given training in Judaism. Outreach Community & Residential Services 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 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): 20 Medication storage and procedures promote good health and safety. EVIDENCE: Standards 18, 19, 20 and 21 were assessed in June 2005. The home had medication policies and procedures. Medicines that were kept in the home were stored in a locked cupboard. None of the residents looked after their own medication. As required at the time of the last inspection, the manager had done risk assessments to include the arrangements for the safe storage and administration of medication taken out of the home, for example on holidays or overnight stays with relatives. There were records of medication received, administered, and disposed of. No controlled drugs were being used but the home had nevertheless purchased a controlled drugs register. The manager had asked residents or relatives to sign a “Consent to Medication” form. Outreach Community & Residential Services 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 Page 14 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 Residents know who to complain to and are satisfied that any concerns are listened to and dealt with. Protection policies and procedures, and staff understanding of adult protection, ensure that the home has the means to be able to respond properly to any suspicion or allegation of abuse. However, the manager needs to seek opportunities for formal training. EVIDENCE: Standards 22 and 23 were also assessed in June 2005. Residents’ personal files contained signed confirmation that they had received a copy of the complaints procedure. The residents who were spoken with said that they would speak to the manager if they had any concerns. They felt that she would do her best to resolve their concerns. The home had a book in which concerns or complaints were recorded. The manager was asked to make sure that the book contained details of how and when the complainant was informed of the outcome. Staff members knew about the written procedures covering adult protection and whistle blowing. They understood their responsibilities in reporting any suspicions of abuse. One staff member said that the topic had been covered during induction training and that the training included reading the policy, understanding what constituted abuse, and who to report suspicions to. The manager said that adult protection training was covered during NVQ level 2 training and that it had been discussed in-house. Outreach Community & Residential Services 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 Page 15 The manager had not yet undertaken any training herself in adult protection. This needs to be arranged. Staff members would also benefit from formal training and this is strongly recommended. In the meantime, the manager is advised to regularly check out that team members understand their responsibilities in identifying and reporting potential abuse. Outreach Community & Residential Services 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 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, 25, 26, 27, 28 and 30 2 Devonshire Place provides a homely, comfortable, clean and well maintained environment for residents, suited to their lifestyles. EVIDENCE: Standards 24, 25, 26, 27, 28, 29 and 30 were assessed in June 2005. The home is situated in the centre of Prestwich village, close to bus and tram routes, shops, banks and synagogues. The house is a large terraced home, similar to other properties in the area. It is not identifiable as a care home. Residents said that they liked the house. Residents described how they kept their rooms clean and tidy, and helped out with general household tasks. Staff supported them as necessary. The communal rooms and 3 bedrooms were looked at this time. Since the previous inspection, the loose wallpaper in the bathroom had been rectified and plans were in hand to install a shower. The bedrooms that were looked at were single (as are all bedrooms in this home) and they were personalised with the residents’ own belongings. Outreach Community & Residential Services 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 Page 17 Residents had keys to their rooms. they liked their rooms. Those who were spoken with said that The lounge, dining room and kitchen were furnished and equipped in a homely way. There was a separate laundry room. Outside there was a small car parking space at the front, and an enclosed yard at the back. The home had no en-suite rooms. It had a bathroom with toilet on the first floor, and a toilet on the ground floor. These were fitted with locks. Standards of cleanliness were good. In line with good hygiene practices, liquid soap and paper towels were provided for hand washing downstairs, but in the upstairs bathroom, although there was liquid soap, there was only a cotton hand towel for hand drying. The manager explained the reason for this (for confidentiality purposes the reason is not included in this report). The manager was advised to contact the Communicable Disease Officer and request advice on this matter. Outreach Community & Residential Services 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 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): 32 and 36 Residents are supported by a staff team of which 50 of support workers are qualified to NVQ level 2. Staff members are appropriately supported and supervised to help them to develop professionally and provide a good service. EVIDENCE: Standards 31, 32, 33, 34, 35 and 36 were assessed in June 2005. Residents were happy with the support they received from staff members. They said that staff listened to them and had time for them when needed. Staff members talked about their experience and training. They had a range of knowledge and experience. 50 of the current support workers were qualified to NVQ level 2, with another staff member having recently started the course. Staff members said that they felt well supported by the manager. They said that she was approachable. One said, “She’s brilliant”. Staff members said that formal 1to1 meetings took place monthly or bi-monthly, with minutes recorded. Sessions included discussions about their personal development needs. They also said that weekly staff meetings took place. They said that there was always someone on call in case they needed help or advice. Outreach Community & Residential Services 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 The health and safety of service users and staff are promoted by means of regular safety checks. However, there are several fire safety matters that need attention. EVIDENCE: Standards 37, 38, 39, 40 and 42 were assessed in June 2005. Health and safety records and certificates were looked at last time and found to be in order so, this time, a sample of the records was looked at. These included the safety certificates for the electrical installation, gas soundness, portable electric appliance testing and Legionella testing. All were satisfactory. At the time of this inspection, the Fire Safety Officer was conducting his own inspection. He made several requirements that need to be addressed. Outreach Community & Residential Services 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000008449.V279969.R01.S.doc 2 X X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 3 17 X Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X X X X X X 2 X Version 5.1 Page 21 Outreach Community & Residential Services 2 Devonshire Place Are there any outstanding requirements from the last inspection? No 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 YA9 Regulation 14, 15 Timescale for action One person’s risk management 30/04/06 plan needs updating to reflect the person’s current needs. The registered person needs to 30/04/06 make sure the complaints and concerns book includes details of how and when the complainant was notified of the outcome. The manager needs to undertake 30/06/06 training in adult protection. She also needs to regularly check out that all support workers understand their responsibilities in identifying and reporting potential abuse. Paper towels must be available 30/04/06 for hand drying in the first floor bathroom/toilet. If the provision of paper towels is causing a problem, then the home needs to seek advice from the Communicable Disease Officer. The home needs to address the 31/05/06 fire safety requirements made by the Fire Safety Officer on 30/3/06, and inform the CSCI, by the date in the end column, of the action taken to comply. DS0000008449.V279969.R01.S.doc Version 5.1 Page 22 Requirement 2. YA22 22 3. YA23 13 (6) 4. YA30 16(2)(j) 5. YA42 23(4) Outreach Community & Residential Services 2 Devonshire Place 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 YA23 Good Practice Recommendations The registered person is advised to provide staff members with opportunities to undertake formal adult protection training. Outreach Community & Residential Services 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 Page 23 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 2 Devonshire Place DS0000008449.V279969.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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