Inspection on 10/01/06 for Palmyra

This inspection was carried out on 10th January 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Palmyra 20/04/07

Palmyra 09/08/05

Palmyra 10/03/05

Palmyra 25/08/04

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

CARE HOME ADULTS 18-65 Palmyra 38 Great Georges Road Waterloo Liverpool Merseyside L22 1RD Lead Inspector Ms Lorraine Farrar Unannounced Inspection 10th January 2006 02:30 Palmyra DS0000005388.V274111.R02.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 Palmyra DS0000005388.V274111.R02.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. Palmyra DS0000005388.V274111.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Palmyra Address 38 Great Georges Road Waterloo Liverpool Merseyside L22 1RD 0151 949 0529 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) Making Space North West Mrs Valerie Brown Care Home 14 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (14) of places Palmyra DS0000005388.V274111.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 14 MD Date of last inspection 9th August 2005 Brief Description of the Service: Palmyra is registered to provide support and accommodation for 14 adults who require support in managing their mental health. It is situated in a residential area of Waterloo and is well placed for providing access to local community and leisure facilities, shops and transport. The building is a large detached Victorian house and due to its location amongst similar properties it does not stand out as a care home. All private accommodation in the home is in single bedrooms with washbasins, bathroom facilities are shared. A number of shared areas are available, these include smoking and non-smoking areas, a quieter lounge, dining room and private garden. Staff are available twenty four hours a day, in addition to care staff, the home also employs cooks and cleaning staff, although residents are encouraged and supported to take part in these tasks where possible. The building is owned by Riverside Housing, a local housing association who are responsible for maintaining the premises. The home is operated by Making Space, an organisation and registered charity who provide support for adults who need support with their mental health. Palmyra DS0000005388.V274111.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Palmyra was last inspected in August 2005, information about core standards not looked at during this inspection can be found in the report from the August inspection. During this inspection discussions took place with three residents and three members of staff, records and files were read and parts of the building toured. What the service does well: What has improved since the last inspection? Since the last inspection the home have begun to provide action plans following residents meetings to make sure that issues raised are dealt with. They have also improved on the assessment process for new residents and make sure that their assessment form if fully completed. Residents are involved in their care planning process and given the opportunity to sign their agreement. Palmyra DS0000005388.V274111.R02.S.doc Version 5.1 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. Palmyra DS0000005388.V274111.R02.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 Palmyra DS0000005388.V274111.R02.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): X These standards were not looked at during this inspection. EVIDENCE: Palmyra DS0000005388.V274111.R02.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): 9 The home provides support and advice to residents in identifying and minimising risks, written risk assessments are not all regularly reviewed and Do not contain sufficient information for staff to follow. EVIDENCE: Care plans contain some risk assessments for residents, which identify the action, and support staff should provide to lessen risks for that person. A resident spoken with was able to talk about their care plan and explained that they discuss the contents, including risk assessments with their keyworker whom they described as “very good I think a lot of her”. Another resident explained that their keyworker “tries to talk about it”. Some of the risk assessments looked at had not been reviewed recently and did not contain sufficient information to support the person effectively. Both residents and staff spoken with were able to give examples of the way in which staff support residents to identify risks and talk through the options available. Palmyra DS0000005388.V274111.R02.S.doc Version 5.1 Page 10 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): 15 & 17 The home provides appropriate support to residents in maintaining relationships. Residents are offered a variety of meals with alternatives available and drinks and snacks available throughout the day. EVIDENCE: Residents confirmed that they can have visitors whenever they want and that they can meet with them in private. The home provides a smaller private lounge as well as the larger communal area and residents and their visitors have been seen to use this to meet in private. The homes service user guide states that visitors are welcome with at all reasonable times with residents’ agreement. The people living at Palmyra have plenty of opportunities to meet people without disabilities thorough their involvement in and use of, local community facilities. The home has polices in place for supporting people with personal, social and sexual relationships. Palmyra DS0000005388.V274111.R02.S.doc Version 5.1 Page 11 One of the resident spoken with described the food as “all right” and explained that if they did not like what was on the menu they could ask for something else and this would be made. They also explained that juice is available all day and if they want a cup of tea they ask the cook who will always make it. The cook explained that there is a set menu with alternatives always available and residents are asked what they would like, a list in the home showed that several people had chosen sandwiches for their tea although hot alternatives were available. The evening meal was advertised on a board in the dining room and listed the meal as fish, potatoes, cauliflower and egg custard and a hot meal had also been provided at lunchtime. The home has a separate dining room, which was nicely decorated and laid, a tray was available throughout the day with 3 different types of fresh and mixed juice and fresh fruit. The home had plenty of stocks of food including, salad, vegetables tins and meat. The cook explained that they use catering suppliers and the local supermarket and there was always enough budget and supplies to make meals. Another resident said that “you can have something else if you want, staff are very good if you want a drink”. Palmyra DS0000005388.V274111.R02.S.doc Version 5.1 Page 12 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& 20 The home provides individual support to residents with their personal care when needed. Medication in the home is well managed by staff who have received training in dealing with medication. EVIDENCE: Not many of the people living in the home need support from staff with their personal care although staff said they provide this if needed. A resident spoken with said that staff help her to have a bath and use the bath chair and confirmed that she can have a bath whenever she wants and “staff stay with me” and that staff had helped her with her hair and it was “lovely”. Residents said that they decide when they want to get up or go to bed and choose their own clothes. The home provides some aids and adaptations including a bath chair, walk in shower, grab rails and ramps. Medication is the home is stored correctly in locked cabinets and a system is in place for staff to check this on a daily basis. The home uses a blister pack system whereby medication is dispensed into packs by the chemist and later given out by staff. Staff record and sign for all medication received and returned and the home provides records of medication given were in order. Palmyra DS0000005388.V274111.R02.S.doc Version 5.1 Page 13 Medication stocks were looked at for three residents and these all matched records in the home. Palmyra DS0000005388.V274111.R02.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): 23 The organisation provides training and polices for staff in adult protection issues and staff have a good understanding of these. EVIDENCE: The home has copies of the organisations adult protection policy and those from the local authority. Staff spoken with had an understanding of the action they should take if there is an allegation of abuse and the home have acted appropriately on this in the past. Staff spoken with had all had training in the protection of vulnerable adults and said that further training was planned. Residents spoken with were aware that they could complain if they were unhappy with something and of who they could complain to. Records and storage of money for two residents was checked and was in order. Palmyra DS0000005388.V274111.R02.S.doc Version 5.1 Page 15 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): X These standards not fully examined during this inspection EVIDENCE: Palmyra DS0000005388.V274111.R02.S.doc Version 5.1 Page 16 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 & 35 Staff in the home have a good understanding of residents and the ability to provide effective support. This is backed up by a good training plan for the home with all staff receiving regular, appropriate training and updating. EVIDENCE: The organisation has a training department, which provides a list of training staff can access. A member of staff said that the training provided is “very good, very through” and all staff spoken with said that if training is needed it is always provided. Training request forms had been completed for induction to care updates and health and safety. Staff files had records of training in, fire, medication, protection of vulnerable adults, 1st aid, challenging behaviour, healthy eating and moving and handling. The home provides a structured induction for new staff based on national standards and supports staff to obtain a care qualification (NVQ). One member of staff spoken with had obtained this award and another member of staff was in the process of completing hers. Residents described staff and the support they provide as “alright” and “very good”. Staff have a good understanding of the support residents needs and were seen to take time to talk with residents and discuss issues raised. Palmyra DS0000005388.V274111.R02.S.doc Version 5.1 Page 17 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): 39 The home obtains residents views through regular meetings and surveys are in the process of arranging for an external quality audit to be carried out. EVIDENCE: Making Space have arranged for an outside company to carry out a quality audit of the service they provide, this is due to take place on 8-10th February 2006. The organisation have carried out surveys of residents and relatives to obtain their views of the service and what could be improved upon. Some of the results of these were not readily available, however new surveys will be carried out as part of the external audit. Regular residents meetings are held and these now include action plans to make sure that anything suggested is acted upon. During inspections residents are given tine and privacy to talk with the inspector if they wish. The organisation update their polices and procedures regularly and these are read and signed by the home manager. The home work well in meeting most inspection requirements, where requirements are not met evidence is available that these are being addressed, Palmyra DS0000005388.V274111.R02.S.doc Version 5.1 Page 18 for example a requirement relating to care plan information has not been fully met but the home are in the process of changing the format used and training for this has been provided for staff. Palmyra DS0000005388.V274111.R02.S.doc Version 5.1 Page 19 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 X 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X 2 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 X X X 2 X X X X Palmyra DS0000005388.V274111.R02.S.doc Version 5.1 Page 20 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 YA6 Regulation 15(1) Requirement The home must ensure information in care plans is sufficient for unfamiliar staff to support the resident. This is a previous inspection requirement 3 YA34 17(2) The home must ensure copies of two written references for staff are held on file Previous inspection requirement, not checked at this inspection due to managers absence. 4 YA9 13(4)(c) The home must ensure residents 01/04/06 risk assessments are reviewed and contain sufficient information for unfamiliar staff to support the person. 01/04/06 Timescale for action 01/04/06 Palmyra DS0000005388.V274111.R02.S.doc Version 5.1 Page 21 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 YA34 Good Practice Recommendations The home manager should have sight of references for potential staff. This is a previous recommendation, not checked at this inspection due to manager’s absence. Palmyra DS0000005388.V274111.R02.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Palmyra DS0000005388.V274111.R02.S.doc Version 5.1 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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