Inspection on 07/11/06 for Parliament Street (23)

This inspection was carried out on 7th November 2006.

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.

Other inspections for this house

Parliament Street (23) 19/10/05

Parliament Street (23) 20/05/05

Parliament Street (23) 09/12/04

Parliament Street (23) 26/07/04

Parliament Street (23) 10/10/02

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

CARE HOME ADULTS 18-65 Parliament Street (23) 23 Parliament Street Morecambe Lancashire LA3 1RQ Lead Inspector Ms Jenny Hughes Unannounced Inspection 7th November 2006 11:00 Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 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 Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 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. Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parliament Street (23) Address 23 Parliament Street Morecambe Lancashire LA3 1RQ 01524 414353 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) Mrs Mollie Green Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th October 2005 Brief Description of the Service: This home is a large, 3-storey terraced domestic house, which is in a road of similar properties running adjacent to the promenade in Morecambe. There is a small yard at the back, and seats to the front of the house, where people can sit in the better weather. The owner of the home provides non-personal care, emotional support, and guidance in this family environment, for younger adults with a mental health problem. It is a family home, with the owner’s daughter and grandson helping when needed. The three bedrooms are on the first floor, with a shower room next to them. The front lounge, dining room, and basement lounge give plenty of communal space. There is easy parking for cars on the road outside the home, and local shops and the seafront are a short walk away. Information about the service the home provides is available in a ‘Welcome Pack’, which provides an easy to read brochure, which tries to cover everything a resident needs to know about daily life in the home, and other information leaflets on advocacy services, health advice, and activities in the area. CSCI reports are readily available from the manager to anyone who asks to see them. As at 7th November 2006 the fee is £340 a week. Residents receive varying benefit payments, which they use for whatever they wish. Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced site visit to the home, in that the owners were not aware that it was to take place. The site visit was part of the key inspection of the home. A key inspection takes place over a period of time, and involves gathering and analysing written information, as well as visiting the home. The length of the visit was for 2.5 hours. Before the visit took place, the manager was asked to complete a preinspection questionnaire, and a response to surveys was requested from residents, any relatives, and visiting professionals. During the site visit, staff records and resident care records were viewed, alongside the policies and procedures of the home. The manager, residents and care staff were spoken to. Their responses are reflected in the body of this report. A tour of the home was made, viewing lounges, dining room, bedrooms and bathrooms. Everyone was friendly and cooperative during the visit. What the service does well: The owner has many years experience providing care, and is able to pass on her knowledge to staff and other family members. The owner is able to give confidence to new and existing residents, by encouraging them to join in conversation and activities in and outside the home, positively developing personalities. Residents are encouraged not to have any secrets, but makes sure confidences are kept. Residents are given a choice in everything they do, so that they are in control of their own lifestyle. As one resident stated, “I like it here. I am well fed and live in a clean house. The staff do their best to make us happy”. Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 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 Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A service is provided tailored to the individuals needs, following an assessment of need provided by the social worker, and individual discussion with the resident. EVIDENCE: Individual assessments are provided by the social worker, and were available on the files of the people in the home. Residents visit the home with their social worker before deciding whether they would like to stay there. One new resident said they had visited with their support worker, and then “just stayed. It seemed nice here”. The owner said she had been told of the residents’ needs before the visit, and had told the other residents in the house of a possible new person staying. The owner said she thought it was very important to have a talk with the new resident first, to make sure they would get on with the other residents, and also that they would get what they wanted out of staying there. Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 9 Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents take part in deciding what their personal goals are, and benefit from constant support and encouragement to enable them to make their own decisions and live an independent life. EVIDENCE: The residents’ files showed the assessments making the basis of care plans, where the aim was to make the residents as independent as possible, with goals for them to attain. “I try to get them to take responsibility for their lives, but in a supportive way”, commented the owner “I constantly praise and encourage residents to make their own decisions”. Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 11 “I’ve seen my file, and the owner says I can look at it anytime I want. I had to fill in one of the forms about what sort of things I like or don’t like. You know, what sort of things I prefer”, stated one resident. “We do what we want. I like to have a chat with the staff member, or sometimes go for a walk on the front. Molly (the owner) suggested I join the library, and this will help me as I love studying”. Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16,and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to make decisions on what they wish to do in their daily lives, and benefit from the guidance and support of the owner, enabling them to become independent and feel fulfilled. EVIDENCE: The owner was very aware of the diverse needs of the residents, and tried to make sure each individual had their own needs met within the small group. On the day of the visit one resident was having a lie-in, before he met with his girlfriend. The owner and staff member both said that residents’ friends were always welcome, and the girlfriend often had a drink or something to eat in the home. Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 13 Another resident sat in the lounge watching the world go by through the large bay window, listening to the newly resident parrot mimicking daily sounds in the home. “I like to talk to people. Molly and the staff member are good to talk to. She makes good food as well. I like to go for a walk; sometimes we go together (with another resident). I’ve been to the church up the road as well”. One resident was being encouraged to give up smoking, which he said he wanted to do so that he would have more money. He was very clear about what his problems were and how he already felt an improvement. “The staff are warm, friendly people who do their best to make us happy. I pursue my interests and have comfort, food and good natured company” The residents were relaxed and happy, and praised the owner and staff member. They said they felt safe and comfortable. Both of the residents spoken to smiled at how they enjoyed their daily cooked breakfast, and had enjoyed egg, bacon, beans and toast that morning. The main meal of the day is home-cooked. “We have a dinner at night”, confirmed one resident, “I like that.” The owner confirmed that the residents sometimes go food shopping with her and pick what they would like her to prepare, with her guidance. “I also like to give each person some responsibility in the house, from helping with the laundry, to making sure doors are locked at night. Again trying to support and develop confidence and skills in each person. The residents are part of a family and are treated as such – these things are all part of everyday life”, stated the owner. Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from the support of social and healthcare professionals. The system for administering medication is satisfactory, with arrangements in place to ensure residents medication needs are met. EVIDENCE: The individual records show any choices residents have in what care they would like, and how they would like it given. “He likes having a lie-in”, commented one resident about another who was still in bed at lunch time, “But I like to get up – it’s a good breakfast!” Records also showed regular contact with social workers and G.P’s, and a survey returned from the Community Mental Health Team confirmed that the home worked in partnership with them, and understood the care needs of the residents. They stated that they were satisfied with the overall care provided at the home. Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 15 “I regularly speak to the Mental Health Team and the Community Psychiatric Nurses who call, to make sure they are happy with what I’m doing”, said the owner. A structured system for administering medication is used, with signed records of when medication has been given to residents, and waivers signed by the residents when they are given the responsibility of taking the medication themselves after it has been handed to them by the owner. Each record has a photograph of the resident it refers to, to lessen the risk of giving the wrong medication out. A locked safe holds all medication securely. “I think this is the most important thing”, commented the owner about monitoring the medication, “This has to be right. Just a small error can make a huge difference. I’ve made sure my new staff member understands that as well. The medication levels are carefully monitored by health care professionals, and residents may have monthly tests to make sure the levels are right for them.” The staff member confirmed that he was being trained and guided in the medication procedure. Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confident their concerns will be listened to and acted upon. The owner and her family have an understanding of Adult Protection issues, which protect residents from abuse. EVIDENCE: There is a complaints procedure in place, and a complaints book to record any complaints in. The owner said that she always discussed the need to be open with the residents, and to tell her if they were not happy with something. Both of the residents spoken to said that they would tell the owner any problems they had. A survey returned from a resident said “I can discuss any problem I have with Molly (owner). I would tell her verbally of any complaint, and if it is valid she will do what she can to rectify the problem. The staff are very good listeners” The owner said that she monitored visitors to the home, and tried to guide the residents on risk taking and personal safety. “They always know this is a safe place to come home to”, stated the owner. The staff member said they followed the owner’s lead, and would let her know if they had cause for concern. The owner confirmed that she was aware of the Adult Protection procedure. Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 17 The residents confidently chatted with the inspector about their day, and their plans for the following day. Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment in this home provides its residents with a clean, comfortable, and pleasant place to live. There is evidence of future planning to make ongoing improvements. EVIDENCE: The home is in a residential area, and is of similar type to all the family homes around it. As a resident told the inspector, “the shops are only around the corner, and there’re some good cafes as well”, another adding, “I like to go to church, and I can walk to the nearest one from here. The people were very welcoming and friendly there”. The house is not suitable to anyone with a physical disability, as there are no aids to help and support, so all of the residents need to be mobile, and selfParliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 19 caring, as no personal care is provided. All parts of the house are open to residents, except the owner’s private room. There is a dining room near to the lounge, to encourage residents to eat meals at the table, and a comfortable second lounge area in the basement space next to the kitchen, affording residents more privacy with any visitors. The owner has recently decorated the hall, stairs and landing, and had a new carpet fitted, making the area fresher and lighter. She said she aims to refresh the bedrooms every year. The lounge has been painted, and a new large television is in place in one corner, with a chatty parrot in the other, entertaining everyone as it mimics the telephone, or the smoke alarm! All of the residents are responsible for keeping their own room as tidy as possible, with guidance and help from the owner. Bedrooms contained personal belongings which mean a lot to the owner, with family photographs, toiletries, and wall posters and a much loved mountain bike being examples of this. The rooms were all clean, comfortable and safe, and adequately maintained. The owner or staff test smoke alarms every week. Most of the laundry for the home is done as a service wash at the local launderette, although there is a washing machine in the home to use if needed. The owner said that she tried to keep the home as bright and airy as possible for the residents, so that they had a nice place to live. “The home is cleaned regularly”, commented a resident, “The staff member does a very good job, and he is friendly”. Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home operates a good recruitment policy, which ensures that only people who are suitable for this type of work are offered an appointment. Training is provided and this means that residents are provided with appropriate care and attention EVIDENCE: The home has recently recruited its first member of staff, having previously been solely run by the family in the home. Changes in circumstances demanded the need for one staff member to help support the service provided. “It has helped a lot having a regular staff member. My family still call in and help though. After all, that’s what this is – a family home”, said the owner. The recruitment was carried out formally, and references and a Criminal Records Bureau disclosure were received for the staff member. Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 21 The owner carried out induction training for the staff member. “I feel very happy with the work, and am enjoying helping and guiding the residents to live an independent life”, said the staff member. “The owner is constantly guiding and teaching me the best ways to deal with the different circumstances of each individual. She is a very good role model” The staff member had received formal food hygiene and health and safety training, and the owner was giving in-house training in the medication procedures. “I’m also looking for any other external courses available”, said the owner. Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems and practices in the home promote and safeguard the health, safety and welfare of the people living there. EVIDENCE: The owner of the home has many years experience of looking after people with mental health problems. The residents said that they always told the owner if they liked or disliked something, and that the owner told them to do that. They said she always tried to make it better for them. The owner recorded their comments in a diary, and said that she dealt with them straight away, or as soon as possible. Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 23 Records showed contact with the GP’s, Community Psychiatric Nurses and social workers, with any comments they had made on the service. The owner said that the residents are instructed on fire safety, and one confirmed this by telling the inspector what they would do and where they would go if there were a fire. The owner said that the appliances in the home are maintained as in any domestic home. An accident book recorded all residents’ accidents, and any follow-up required. Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 24 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 3 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 25 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Parliament Street (23) DS0000009912.V311639.R01.S.doc Version 5.2 Page 27 - 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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