Inspection on 23/06/05 for Outreach Community & Residential Services Highbury Court

This inspection was carried out on 23rd June 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Outreach Community & Residential... 05/03/08

Outreach Community & Residential... 05/09/06

Outreach Community & Residential... 19/12/05

Outreach Community & Residential... 27/01/05

Outreach Community & Residential... 24/08/04

Outreach Community & Residential... 12/02/04

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 HIGHBURY COURT 443-5 Bury Old Road Prestwich Manchester M25 1QP Lead Inspector Sue Evans Announced 23rd June 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. HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Highbury Court Address 443-5 Bury Old Road Prestwich Manchester M25 1QP 0161 773 0776 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 Community & Residential Services CRH PC - Care Home Only 6 Category(ies) of LD Learning disability - 3 registration, with number MD Mental Disorder - 3 of places HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered for a maximum of 6 service users, to include; up to 3 service users in the category of LD (Learning Disabilities under 65 years of age) up to 3 services users in the category of MD (Mental Disorder under the age of 65 years). The home should employ a suitable qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 27th January 2005 Brief Description of the Service: Highbury Court is one of a group of care homes managed by Outreach Care Services. Outreach is a charity that provides care and support predominantly to Jewish people with learning disabilities or mental health needs. Highbury Court is made up of six single occupancy flats, each linked by intercom to the staff flat. There are no shared areas apart from a small, private garden. The home is situated in a residential area of Prestwich, about three quarters of a mile from the village centre. It is close to bus and tram routes, local shops and synagogues. Staff members are available in the home 24 hours per day, including at night when a staff member sleeps-in. The level of staff support to be provided to each resident is agreed before the person moves in, and reviewed regularly. The aims of the service, as described in the Statement of Purpose, are to empower individuals, supporting them to make choices and decisions in their lives and to deveop their independent living skills to enable them to live independently in their own homes. HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and took place over 7 hours. About half of this time was spent watching what went on, talking to 4 residents and interviewing 2 staff members. The inspector also examined some key records, looked at the arrangements for giving medication, and interviewed the manager. Written comments were received from 5 residents, 3 relatives, and 2 Social Workers. Since the last inspection, the Registered Manager has left. The new Manager is not yet registered with the CSCI. What the service does well: What has improved since the last inspection? Since the last inspection, the outside of the home has been made safer following repairs to the outside paving. Some improvements have also been made to the kitchen in one of the flats. HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 Page 6 Bank staff are now being provided with training in topics that promote good health and safety for residents, for example food hygiene. 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. HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 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 HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 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) 2 Residents’ inclusion in the assessment of their needs enables all parties to decide whether the home will be suitable in meeting a person’s needs. This means that residents have a say about what they would like to do and what they feel they need help with. EVIDENCE: The manager said that a care management assessment was always obtained before a resident came to live in the flats. Records showed that the home also carried out its own assessments, and fully included each resident in agreeing their needs. Records for one resident showed that he had been included in the review meetings that were held to update his care management assessment. Residents confirmed that they were included in assessments and reviews. They said that Highbury Court had been a good choice of home. One of the residents who provided written comments said, I am very happy living here, and cope very well, and find staff very supportive”. HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 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, 7 and 9 Residents know that they can access their own care plans, and that, usually, these are regularly updated to reflect any changes in their needs and goals. They are able to make decisions about their lifestyles, with help and guidance from staff if needed, enabling them to exercise their right to autonomy and individuality. The home encourages residents to be as independent as possible, helping them to keep any risks to their health and well-being to a minimum. EVIDENCE: Records showed that care plans had been drawn up with the involvement of the resident. They were written in the first person, and they included each resident’s preferences and goals. One resident had provided information about himself that he had typed on his computer. Residents had signed their agreement to their care plan. The care plans were centred upon the “eight accomplishments” of community presence, independence, choice, individuality, status, respect and dignity, continuity, relationships, and culture. HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 Page 10 Records showed that residents’ needs and goals were reviewed every month, More formal review by the resident and a designated support worker. meetings, to which relatives and social workers were invited, took place every six months. The two Social Workers who provided written comments said that staff demonstrated a clear understanding of the needs of the residents, and that the care plans were being followed. The manager and staff members were asked about the needs of three of the residents. They were consistent in their descriptions of how they assisted them, and this matched with the information given by the residents. However, one of the three care plans had not been updated following the last review meeting, and it contained some out of date information. All three residents knew about their written records and knew that they could see them, or add to them, whenever they wanted. Residents were seen, throughout the inspection, coming and going from the flats. They said that they could choose how they spent their time. Five of the six residents managed their own finances. Records and discussions showed that staff helped people to make appropriate choices, for example when considering leisure or employment opportunities. One of the aims of the home is to help residents to live as independently as possible. Records showed that potential risks had been assessed, and balanced against the resident’s right to choice and independence. All of the residents, relatives, and social workers who gave their views about the home said that they were satisfied with the support provided. Information about residents’ needs, and any risks to their well-being, were kept in one folder. The folders needed re-organising to make it easier to pick out the most up to date information. HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 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, 14 and 16 Residents choose how they spend their time, taking part in activities that they enjoy doing. They participate fully in the community, enabling them to lead valued lifestyles. Practices in the home respect residents’ rights to privacy, dignity choice, and independence. EVIDENCE: Residents followed their own daily routines. During the inspection, they were seen coming and going from their flats, engaging in their chosen activities. It was clear, from discussions with residents and staff, that residents were encouraged and supported in pursuing valued, fulfilling activities. Most residents were able to take part in community activities without staff support. Any staff support that was needed was agreed as part of the resident’s care plan. Residents gave examples of the community facilities that they used such as public transport, cafes, shops, library, snooker club, and synagogue. They were also involved in various college courses, or part time HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 Page 12 work. One resident described how he regularly went to a gym and a local community centre. Another said that he went out with a staff member on two evenings a week to a place of his choice, for example shopping at the Trafford Centre. One resident said that he was looking forward to a holiday in Southport. At home, residents enjoyed pastimes such as watching television, listening to music or reading. Residents said that their privacy was respected, for example nobody entered their flats without permission. They undertook tasks such as shopping, cooking, cleaning, and laundry. Some carried out these tasks fully independently, others had varying degrees of staff support, as agreed in the care plan. Cultural and religious needs were included in care plans. For example, there was an expectation that only Kosher food would be brought into the flats. Residents said that they were happy to live at Highbury Court flats. person said, “This is a good place to live”. One HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 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) 18, 19 and 20 Service users are assisted to be as independent as possible, and they are fully included in decisions about how staff will support them. The staff team’s knowledge of the residents means that any changes in health needs are picked up and dealt with promptly, in liaison with the appropriate specialist health services. Medication storage and procedures promote good health and safety but there is a need for accredited training for all those who administer medicines. EVIDENCE: One of the aims of the service was to assist residents to be as independent as possible. In respect of personal and physical care, the residents were selfcaring, and any assistance from staff members took the form of encouragement and reminders. Residents were fully able to express their wishes about the way they were supported. It was clear, from discussions with them, that they had control over their daily routines, for example what time they got up or went to bed, what time they had their meals, and what activities they took part in. HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 Page 14 Residents and staff spoke with each other in a natural manner. Residents said that they were happy with the way that staff members treated them, and the way they spoke to them. Residents used community healthcare services such as opticians, dentists, psychiatrists, and GPs. Details of all contacts with health professionals were recorded. Records showed that health needs were monitored, and that any concerns were dealt with appropriately. Specialist services were obtained if necessary. The manager and staff spoke knowledgeably about the physical and emotional needs of the residents, demonstrating that they had the skills and experience to understand and respond to any problems. One resident said that he was trying to follow a healthy diet, and was going to a gym, to try to control his weight. Staff members were helping and encouraging him to achieve this. The home had written guidelines covering medication. It was recommended that these guidelines include reference to how non-prescribed medicines should be managed, for example if a resident tells a staff member that they have bought medicines to treat minor ailments such as coughs or colds. It was also recommended that the guidelines include details of the procedure for administration of medicines outside the home, for example on days out or weekends away with families. There were records of medication received, administered, and disposed of. Some residents looked after their own medication, as agreed and risk assessed during care planning. These arrangements were kept under review. There was evidence to show that, if problems arose, social workers or consultants were included in re-assessments. Residents had signed a “Consent to Medication” form. Training records showed that some staff members had undertaken medication training in June 2004 but there was no evidence to show that newer members of staff had done the training. However, it was noted that all the staff team had been booked onto medication courses, either on 5th or 12th July 2005. HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 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 The home has a written complaints procedure, and residents feel that any concerns will be listened to and dealt with. EVIDENCE: Residents said that they would speak to the manager or a staff member if they were unhappy about anything. They felt that they would be listened to. They were also able to raise concerns during the regular residents’ meetings. Notes were kept to show what topics had been discussed at the meetings. Residents’ personal folders contained signed confirmation that they had received a copy of the complaints procedure. The Service Users’ Guide also contained a copy. However, all copies of the procedure need to clearly state that complainants have the right to complain directly to the CSCI if they wished. Two of the relatives who sent in written comments said that they were not aware of the home’s complaints procedure. The manager was advised to provide families with up to date information. HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 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) None None of the above standards were assessed this time. EVIDENCE: The environment was not inspected this time. However, checks were made to see whether the home had addressed two requirements that were made during the last inspection. It was noted that, as required, action had been taken to repair the outside paving. It was also noted that there had been some improvements to the kitchen in flat 6. Loose cupboard doors and drawers had been repaired and new handles fitted. An extra wall cupboard was due to be fitted the following day. This will be looked at again during the next inspection. HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 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) 34 and 35 Thorough pre-employment checks are carried out in order to promote the safety and protection of the residents. The home is clearly committed to ongoing staff training to equip the team with the knowledge and skills that they need to meet the needs of the residents. However, there are some gaps that need to be addressed. EVIDENCE: Staff recruitment files showed that the necessary pre-employment checks had been done, for example obtaining employment histories, 2 written references, medical declarations, photographs, CRB (Criminal Records Bureau) disclosures and POVA (Protection of Vulnerable Adults) register checks. The records for the most recent recruit showed that gaps in their employment record had been looked into. Records also showed that new recruits received the LDAF (Learning Disability Award Framework) induction training. Staff training certificates showed that training was provided in topics such as food hygiene, first aid, moving and handling, and health and safety and that these were updated at the necessary intervals. There was evidence to show HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 Page 18 that recent recruits had been booked onto courses. However, all staff members need to have updated training in fire awareness. As already stated in this report, arrangements had been made for staff to receive medication training in July 2005. Other training included NVQ 2, epilepsy awareness, and introduction to mental health. The manager said that Bank staff, who provided staff cover throughout the Outreach scheme, were now included in the staff training programme. Staff training will be looked at again during the next inspection. HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 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 In the main, regular safety checks help to promote the health and safety of the residents. However, to avoid putting residents at risk, the fire alarm service needs to be done. EVIDENCE: Several safety records were checked. These included electrical installation, portable electrical appliance tests, weekly checking of fire alarms and means of escape, and the checking of smoke detectors. The home did not have a gas supply. Records showed that arrangements had been made for the fire alarms to be serviced within the next two weeks. This is an outstanding requirement from the last inspection. The Fire Safety Officer had also arranged to visit on July 5th. HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 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 3 x x x Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 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 3 x 3 x Standard No 31 32 33 34 35 36 Score x x x 3 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 HIGHBURY COURT Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 Page 21 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 6 Regulation 15 Requirement Residents files need reorganising so that staff can easily find the information they need. One care plan needs updating to reflect the residents current needs. Those responsible for administering medication need to undertake certificated training in safe medication procedures. The home needs to make sure that all copies of the complaints procedure clearly state that the complainant has the right to complain directly to the CSCI at any stage. Staff members need to undertake training in fire awareness. The home needs to supply the CSCI, by the date in the end column. with written evidence that the fire alarms have been serviced. (Timescale of 14 March 2005 not met) Timescale for action 31 July 2005 2. 20 13(2) 18(1)c) 16 31 July 2005 31 August 2005 3. 22 4. 5. 35 42 18(1) 23(4) 30 September 2005 31 August 2005 HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 Page 22 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 20 Good Practice Recommendations The home is advised to expand the medication procedures to include management of non-prescribed medicines, and medicines taken outside the home (for example on day trips or weekends away). The home is advised to provide residents families with up to date copies of the complaints procedures. 2. 22 HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 Page 23 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 HIGHBURY COURT F56 F06 S8444 Outreach - Highbury Court V215544 230605 Stage 4.doc Version 1.30 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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