Inspection on 27/09/05 for Phoenix House

This inspection was carried out on 27th September 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 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

Phoenix House 24/06/09

Phoenix House 21/04/08

Phoenix House 09/07/07

Phoenix House 24/11/06

Phoenix House 03/02/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Phoenix House 54 Andrews Lane Formby Liverpool Merseyside L37 2EW Lead Inspector Mrs Trish Thomas Unannounced Inspection 27th September 2005 10:30 X10015.doc Version 1.40 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 Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 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 Older People. 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. Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Phoenix House Address 54 Andrews Lane Formby Liverpool Merseyside L37 2EW 01704 831866 01704 831866 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) Total Care Homes Ltd Mr Ralph Edisbury Care Home 18 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (16), of places Sensory impairment (1) Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include 18 OP The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection Brief Description of the Service: Phoenix House is a care home for 18 older people situated in a quiet residential street in Formby, close to a bus route and train station. The home is a converted Victorian villa with a car park at the front of the building and secluded gardens at the back. There is a large communal lounge, a separate dining room, and bedrooms are situated on ground and upper floors. The home has a passenger lift but does not have a hoist. Phoenix House is staffed throughout the day and night, providing personal care, home cooked meals and a laundry service. All residents are registered with a G.P. of their choice and are supported in accessing district nursing and paramedical services, in accordance with need. Phoenix House has recently changed ownership, and Mr. Chris Farrar, Total Care Homes Limited, has appointed a manager, Christina Narracott, who has applied for registration with CSCI. Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The methods used during the inspection were, discussion with eight residents, discussion with one member of staff, reading records and direct observation of conditions in communal areas, the laundry and storage areas. Mr. Farrar, the registered provider, was present during the inspection. Mr. Farrar has created a number of administration systems since taking over the home. He has recently carried out an audit of the premises and has employed a handy-person to undertake routine maintenance work. Mr. Farrar has obtained quotations for the upgrading of the kitchen, which he considers to be a priority. He has re-arranged the cleaning rosters to improve levels of cleanliness throughout the building and established a quality monitoring procedure in line with National Minimum Standards. Mr. Edisbury, the previous registered manager, has now left the home and a replacement manager, Christina Narracott, recently took up her post. Residents’ comments were generally favourable and they appear to have accepted the recent change of ownership. Mr. Farrar spends time with the residents and there appeared to be a good rapport established and, as usual, a pleasant and friendly atmosphere in the home. Records were in generally good order however, some shortfalls were noted in the care plans, medication administration records and staff rosters. Some of the residents said they would like more social activities and outings. More consultation with residents is recommended with regards to activities and meals. Communal areas were in generally good order, but shortfalls were observed in the laundry and freezer storage area. What the service does well: What has improved since the last inspection? Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 Page 6 Improvements have been made to the maintenance and quality monitoring systems and staffing levels have been increased during the daytime. What they could do better: The manager must arrange for the needs of one resident (with regards to swallow), to be addressed in the care plan and if needed, professional advice obtained, in accordance with assessment. The manager must arrange for the special dietary needs and food and fluid intake of the resident referred to above, to be recorded on his care plan. The manager must arrange for staff to receive instruction in stoma care, from a qualified health professional. The manager must ensure that handwritten MAR sheets are signed by the writer and checked and signed by a colleague. The manager must ensure that all medication is signed for as administered and refusal is indicated by the appropriate code. The manager must ensure that laundered cook’s overalls are not stored in the laundry. The manager must arrange for the laundry to be cleaned and re-organised. The manager must arrange for the laundry to be decorated and the floor covering upgraded. The manager must arrange for the freezers to be cleaned and the shed to be cleaned and re-organised. The home must employ a suitably qualified manager who is registered with CSCI The manager must arrange for the emergency lighting to be repaired. The manager should arrange ongoing consultation with residents regarding social activities in the home. The manager should arrange activities in accordance with residents’ preferences and maintain an activities diary. The manager should arrange for the menu to be distributed to residents daily, and any choices of alternative meals be recorded and returned to the chef. The manager should arrange for the full names of staff to be recorded on the rosters. Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 Page 7 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 House DS0000064015.V255881.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 5. Standards 3 and 5. The home was meeting standards 3 and 5. All prospective residents are visited and their needs assessed, prior to admission, by senior staff. Admissions are arranged subject to satisfactory assessment within the services and facilities on offer in the home, and pre-admission day visits are arranged. Phoenix House will not be measured against standard 6 as this home is not registered to provide intermediate care. EVIDENCE: Pre-admission assessments were discussed with the senior on duty, Mrs. Sandra Farrell, who confirmed that she visits prospective residents prior to admission, to carry out an assessment of their personal care needs. On reading residents’ records, it was evident that a standard format is in use as a needs assessment tool for those referred to the home. The outcome of the assessment forms the information on which the individual’s care plan is based. In addition, social work assessments and community care reviews were in evidence for residents placed by the local authority. Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 and 9. The home was not meeting standards 7, 8 and 9. Shortfalls were noted with regards to nutritional records, stoma care and medication administration records. Care plans were in place for all residents and reviews were generally up to date. All residents were registered with a G.P. and had access to paramedical and district nursing services. EVIDENCE: Standard 7. Three care plans were read in detail and in general, action plans were in accordance with assessed needs of each individual. There was no evidence of a frail resident’s special dietary needs and food intake and fluids, being recorded on his care plan. Standard 8. G.P. and district nurses’ visits are recorded on a separate sheet, which is filed with the care plan, providing clear and easily accessible evidence of all medical interventions. From reading records and by discussion with staff and residents it was confirmed that residents retain their usual G.P. whilst living in Phoenix House, alternatively, if this is not possible, they are registered with a local G.P. There were records on individual care files of G.P. and district nurse visits and attendance at hospital appointments and clinics. Staff have not received instruction in stoma care, and this will be required, regardless of whether or not, any resident who has a stoma, is self caring. Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 Page 11 Standard 9. Nominated staff administer prescribed medication and this is stored in a locked cupboard. Shortfalls were noted with regards to records of the administration of Warfarin. The home has a procedure to double check any change of dosage of Warfarin, by the anti-coagulant clinic. It is required that any records of change in dose be double signed (by the writer, and a colleague, who checks and countersigns). It is always advisable to obtain a pharmacy label, to be attached to the Medication Administration Record regarding any changes in prescribed medication. On inspecting the MAR sheets, one dose of Warfarin had not been signed for. In accordance with the home’s medication procedure, all medication must be signed for as administered. Any non-acceptance of a drug must be indicated by inserting the appropriate code. Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,14,15 The home was not meeting standard 12. Social activities on offer were not to the satisfaction of all residents who made comment. The home was not meeting standard 14 with regards to meals. Some residents who commented said they did not know what was on the menu that day. The home was meeting standard 15, as adequate quantities of wholesome food are served, either in residents’ bedrooms or in the dining room, which is newly decorated and well presented. EVIDENCE: Standard 12. In order to become better acquainted with the residents of Phoenix House, the new owner, Mr. Farrar, takes part in a weekly quiz with them. Residents who commented said they enjoy the quiz. One resident said, “The home is very pleasant and staff are good but not much goes on here”. One resident said she goes out several times a week with her family. Another lady said, “If you have to live somewhere, it might as well be here. It is very nice.” There were no structured activities during the morning of the inspection. The majority of residents were in the lounge with the television switched on. One resident lays the tables in the dining room. There appeared to be a wide range of opinion, personal taste and capabilities regarding residents’ thoughts of activities. Some remain in their bedrooms during the day and join the others for meals and activities. Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 Page 13 Mr. Farrar said that he intends to arrange outings for residents in the near future. It is recommended that there is ongoing consultation with residents to ascertain their preferences for social activities and that an activities diary is maintained. Standard 14, residents appeared to be spending time as they chose, either in the bedrooms or in the lounge, and there was a pleasant atmosphere in the home. A number of residents who commented said that they did not know what was on the menu for that day. One lady said she usually asks the chef, but had forgotten to ask that day. Standard 15. The general opinion amongst residents was that the food is very good. A lady said, with regards to her meals, “I don’t know what I’m getting, but it is always very nice.” Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not assessed at this time EVIDENCE: Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 The home was not meeting standards 19 and 26. Residents’ personal accommodation and communal space is pleasantly decorated, comfortable and generally well maintained. Shortfalls were noted with regards to exterior maintenance and the condition of the kitchen, food storage areas and the laundry. Shortfalls were noted with regards to the risks of cross contamination present in the laundry. EVIDENCE: Standard 19. On visiting various areas of the home to which residents’ have access, they were found to be in generally good order and comfortably furnished. Mr. Farrar said that repairs are needed to the gutters as some damp has appeared in the front lounge. No requirement is given as Mr. Farrar has established a maintenance programme and has employed a handy person. The kitchen fittings are in poor condition and in need of replacement. No requirement is given, as Mr. Farrar has obtained quotes for replacement kitchen units and is in the process of arranging a refurbishment. Standard 26. The laundry was cluttered and the walls and floor covering in poor condition. Laundered cook’s overalls are stored in the laundry. Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 Page 16 This poses a risk of cross contamination if protective clothing was to come into contact with soiled items, and then worn in the kitchen. A requirement is made that the laundry be upgraded and that the cook’s laundered overalls be stored elsewhere. The freezers are situated in a shed. The freezers’ exteriors and door seals were in a dirty condition at the time of inspection and there were cobwebs hanging from the ceiling, which could fall onto the food. Requirements are made with regards to the laundry and food storage areas. Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 The home was meeting standard 27 with regards to staffing levels. Mr. Farrar has increased care staff numbers by one during the day since the previous manager, Mr. Edisbury, has left the home. Shortfalls were noted with regards to maintenance of the staff roster. EVIDENCE: The staff rosters were inspected and found to be satisfactory with regards to staffing levels. Staff rosters recorded staff Christian names only and it is advised that in future, staff’s full names are included. Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 38 The home was not meeting standard 31 as the appointed manager Christina Narracott, is not yet registered with CSCI. Ms. Narracott has made an application, which was being processed at the time of inspection. Health and Safety certificates records were not available at the time of inspection. EVIDENCE: Standard 31. At the time of transfer to new ownership, the existing manager, Mr. Edisbury remained in post to assist during the transition period. Mr. Edisbury has now left the home and Mr. Farrar has recently employed a manager and applied to CSCI for her registration. Standard 38. Health and Safety records were not available and will be inspected on a future visit. The home was not meeting Standard 38 as Mr. Farrar said that there is a fault on the emergency lighting system. Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X X 2 Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement The manager must arrange for the needs of one resident (with regards to swallow), to be addressed in the care plan and if needed, professional advice obtained, in accordance with assessment. The manager must arrange for the special dietary needs and food and fluid intake of the resident referred to above, to be recorded on his care plan. The manager must arrange for staff to receive instruction in stoma care from a qualified health professional. The manager must ensure that handwritten MAR sheets are signed by the writer and checked and signed by a colleague. The manager must ensure that all medication is signed for as administered and refusal is indicated by the appropriate code. The manager must ensure that laundered cook’s overalls are not stored in the laundry. The manager must arrange for DS0000064015.V255881.R01.S.doc Timescale for action 27/11/05 2 OP7 15 27/11/05 3 OP8 13 27/11/05 4 OP9 13 27/11/05 5 OP9 13 27/11/05 6 7 OP26 OP26 13 13 29/10/05 29/10/05 Page 21 Phoenix House Version 5.0 8 9 OP26 OP26 13 13 10 12 OP31 OP38 8 23 the laundry to be cleaned and re-organised. The manager must arrange for the laundry to be decorated and the floor covering upgraded. The manager must arrange for the freezers to be cleaned and the shed to be cleaned and reorganised. The home must employ a suitably qualified manager who is registered with CSCI The manager must arrange for the emergency lighting to be repaired. 27/01/06 29/10/05 29/12/05 29/11/05 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 2 3 4 Refer to Standard OP12 OP12 OP14 OP27 Good Practice Recommendations The manager should arrange ongoing consultation with residents regarding social activities in the home. The manager should arrange activities in accordance with residents’ preferences and maintain an activities diary. The manager should arrange for the menu to be distributed to residents daily, and any choices of alternative meals be recorded and returned to the chef. The manager should arrange for the full names of staff to be recorded on the rosters. Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 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 Phoenix House DS0000064015.V255881.R01.S.doc Version 5.0 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!