CARE HOME ADULTS 18-65
Phoenix Court 16 & 18 Phoenix Court Todmorden Lancashire OL14 5SJ Lead Inspector
Lynda Jones Unannounced 6 September 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. Phoenix Court 20050906 Phoenix Court IR OP J51 v248076 s1069.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Phoenix Court Address 16 & 18 Phoenix Court Todmorden Lancashire OL14 5SJ 01706 819608 01706 819608 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) St Annes Community Services Miss Amanda Morgan Care home with nursing 7 Category(ies) of 7 x Learning Disability registration, with number of places Phoenix Court 20050906 Phoenix Court IR OP J51 v248076 s1069.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Conditions of this registration are listed on the registration certificate displayed at the service. Date of last inspection 3 March 2005 Brief Description of the Service: Phoenix Court care home is a stone built property, offering 24 hour nursing and personal care to 7 people with learning disabilities. The accommodation is divided into two areas, upstairs and downstairs. There are four bedrooms on the ground floor, a kitchen, lounge, bathroom, bathroom/ WC, WC and a laundry. Upstairs the accommodation comprises three single bedrooms, a kitchen, lounge, bathroom, bathroom/WC and an office. Externally the service users have secure access to the fenced garden at the rear of the property. Phoenix Court 20050906 Phoenix Court IR OP J51 v248076 s1069.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was carried out over a 4-hour period. The manager who was on duty provided some helpful background information about the service provided, as this was the inspector’s first visit to Phoenix Court. Introductions were made to all of the residents who were at home and to the staff on duty. A tour of the building also took place. What the service does well: What has improved since the last inspection?
Some creative work has been carried out in part of the garden to make an additional safe and secure paved area for people to use. Phoenix Court 20050906 Phoenix Court IR OP J51 v248076 s1069.doc Version 1.40 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. Phoenix Court 20050906 Phoenix Court IR OP J51 v248076 s1069.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Phoenix Court 20050906 Phoenix Court IR OP J51 v248076 s1069.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,5. Information about the home is available. Everyone has a statement outlining the terms and conditions of residence. EVIDENCE: Phoenix Court has been home to the three men and four women who live there, since 1993. They moved there following the closure of a nearby hospital. This will remain their home for as long as their needs and aspirations can be met by the service provided. St Anne’s has all of the required policies and procedures in place regarding admission to the services provided. These are available at the home but have not been put to the test at Phoenix Court because there has been no change in the people living there. Every person has a contract which outlines their terms and conditions of residence. Phoenix Court 20050906 Phoenix Court IR OP J51 v248076 s1069.doc Version 1.40 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7. The staff have a good understanding of the needs of each individual, this helps them to assist people to identify their personal goals and work towards achieving them. EVIDENCE: Personal plans were not examined on this inspection. Discussion took place with the manager about the person centred planning system that is used. From discussions with the staff on duty it is clear that they have a good understanding of the needs of everyone living at phoenix Court. Some staff have known people for many years. As people living at the home have complex disabilities and are unable to express themselves verbally, this detailed knowledge and understanding of each person is of paramount importance. The needs of each person living at the home are continuously assessed. Everyone has a plan of care to show how these needs are to be met on a dayto-day basis. Additionally, the staff work with people to help to identify the sorts of goals that individuals aspire to achieve, these are discussed at personal planning meetings, highlighted on the plans and achievements are monitored and recorded.
Phoenix Court 20050906 Phoenix Court IR OP J51 v248076 s1069.doc Version 1.40 Page 10 Personal plans are reviewed every six months or sooner, to reflect any changes in the needs of individuals. Phoenix Court 20050906 Phoenix Court IR OP J51 v248076 s1069.doc Version 1.40 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,14,16 Residents use the amenities that are available locally and take part in a range of leisure activities. EVIDENCE: The home has a number of staff hours (74 hours per week) that are allocated specifically to support people on leisure activities. Details of all activities are recorded and a monitoring system is in place to ensure that these hours are dedicated to activities and not to the general staffing of the house. Through their knowledge about the interests of individual residents, the staff enable people to take part in activities, which they enjoy. These are highlighted in personal plans and scheduled each week so that the appropriate numbers of staff are available to support people. On the day of the visit to Phoenix Court, one person was out on a horse riding session, accompanied by two members of staff. Other activities include swimming, attending a local social activity session at which people are also assisted to prepare their own lunch. One person is starting a community living skills course at college and another person will be taking part in a rhythm and music college course.
Phoenix Court 20050906 Phoenix Court IR OP J51 v248076 s1069.doc Version 1.40 Page 12 According to the records, some activities appeared to involve shopping, going out to local cafes and occasionally accompanying staff who were dealing with matters relating to household finances. Activities should be meaningful and appropriate, with the focus on the interests and hobbies of each resident. Staff report that relationships with local neighbours are good. Everyone living at Phoenix Court uses the amenities that are available in the locality. Phoenix Court 20050906 Phoenix Court IR OP J51 v248076 s1069.doc Version 1.40 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not assessed on this inspection. EVIDENCE: Phoenix Court 20050906 Phoenix Court IR OP J51 v248076 s1069.doc Version 1.40 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 standard(s) 23 Staff are made aware of their responsibilities about protecting people. EVIDENCE: The organisation has an adult protection procedure and whistle blowing policy. All staff are made aware of these policies and procedures and staff attend periodic training on Abuse Awareness. All new staff are made aware of their responsibilities during the course of their induction. Phoenix Court 20050906 Phoenix Court IR OP J51 v248076 s1069.doc Version 1.40 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 standard(s) 24,25,27,29,30, The home is comfortable and well maintained. Specialist equipment is provided to meet the needs of residents. EVIDENCE: The stone built detached house is at the end of a cul de sac. It is in keeping with all the other properties on the small development. At the back of the house there is an enclosed garden, which is well maintained. Part of this area has recently been redesigned to create a safe patio area for people to use. At the front of the house there is a safe paved area, which can be reached from the lounge. Outdoor furniture is available for people to use when the weather is good. All parts of the house are comfortably furnished, pleasantly decorated and equipped with TV’s videos and sound systems. A system is in place for reporting repairs to the maintenance division of St Anne’s. The manager said that the upstairs kitchen was due to be replaced. Phoenix Court 20050906 Phoenix Court IR OP J51 v248076 s1069.doc Version 1.40 Page 16 All bedrooms are single and decorated to suit each occupant. Everyone has lots of their own personal possessions in their rooms. The house has been adapted and fitted with the equipment that each person has been assessed as needing. Overhead tracking is provided for people who have mobility difficulties and door closures are linked into the fire alarm system. The privacy and dignity of male residents is compromised by the inability to find a suitable door for the bathroom that could meet the needs of all the men people living on the upper floor. This matter should be revisited. Phoenix Court 20050906 Phoenix Court IR OP J51 v248076 s1069.doc Version 1.40 Page 17 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,34,36 Appropriate checks are carried out on all staff to make sure that they are suitable to provide care and support to residents. EVIDENCE: Procedures are in place to ensure that appropriate references are obtained in respect of all staff. All new staff are checked with the Criminal Records Bureau before they take up post and any gaps in employment history are explored with prospective employees. The manager said there are usually two support assistants plus one qualified nurse on duty from 7.30am to 9.30pm. At night there are two staff, one awake, one on “sleeping in” duty. There are staff vacancies at the present time and recruitment is underway. Staff rotas are prepared 4 weeks in advance, any gaps on the rota are either covered by members of the team working additional hours or by St Anne’s bank staff. When agency staff are required, the manager said she always tries to employ people who are known to the residents. The manager reported that staff supervision was taking place, it was expected that the target of six sessions per year would be met. Staff meetings have been taking place every other month.
Phoenix Court 20050906 Phoenix Court IR OP J51 v248076 s1069.doc Version 1.40 Page 18 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) None of these standards were inspected. EVIDENCE: Phoenix Court 20050906 Phoenix Court IR OP J51 v248076 s1069.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x x x 3 Standard No 22 23
ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 x 2 x 3 3 Standard No 11 12 13 14 15 16 17 3 x x 3 x 3 x Standard No 31 32 33 34 35 36 Score x 3 x 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Phoenix Court Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x 20050906 Phoenix Court IR OP J51 v248076 s1069.doc Version 1.40 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 27 Good Practice Recommendations A suitable door should be found for the upstairs bathroom. Phoenix Court 20050906 Phoenix Court IR OP J51 v248076 s1069.doc Version 1.40 Page 21 Commission for Social Care Inspection Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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