Inspection on 15/11/05 for Premier Homes

This inspection was carried out on 15th November 2005.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Premier Homes 11/09/07

Premier Homes 13/02/06

Premier Homes 20/01/05

Premier Homes 03/06/04

Premier Homes 17/02/04

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

CARE HOME ADULTS 18-65 Premier Homes 8 Premier Street Old Trafford Manchester M16 9ND Lead Inspector Judith Morton Unannounced Inspection 11:15 15 November 2005 th Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 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 Premier Homes DS0000040225.V265044.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 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. Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Premier Homes Address 8 Premier Street Old Trafford Manchester M16 9ND 0161 226 2270 0161 226 5903 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 Michelle Regan Mr John Patrick Andrew Regan Mrs Michelle Regan Care Home 15 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (3) Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. On admission, services users will be adult ie aged between 18 and 65 years. 3 named service users will fall within the category of MD(E), mental disorder, excluding learning disability or dementia, and who are over the age of 65. These service users will be accommodated in Number 10 Premier Street. A maximum of 12 service users will fall within the category of MD, mental disorder, excluding learning disability or dementia. The care home operates at numbers 4, 6, 8, 10 and 12 Premier Street and 29 Premier Street which is situated opposite. No more than 15 service users will be accommodated at any one time. Minimum staffing levels as specified in the Residential Forum Guidance in Care Homes for Younger Adults shall be maintained. 20th January 2005 3. 4. 5. 6. Date of last inspection Brief Description of the Service: Premier Homes is comprised of five separate houses located in Premier Street, Old Trafford, with the office being located separately in number 8. Premier St. The home is registered to provide care and accommodation to fifteen service users with mental health needs, three who may be over the age of 65yrs. Three service users live in each house. On the day of inspection there were fifteen service users living at the home. Each house is linked to a central fire and security alarm system. The home is situated close to pubs, shops and the local Metro link tram network and bus routes. Good relationships exist between the service users and their neighbours. Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 4 hours. The manager was available throughout the inspection. Two residents’ files were examined - one belonging to a resident who had lived at Premier Homes for a number of years and another from a resident who was new to the service. In addition to visiting the office at number 8, a visit was also made to house numbers, 10, 12 and 29. Five residents were spoken with during the inspection. What the service does well: 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. Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 Page 6 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 Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 Page 7 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): 1, 2, 3, 4 & 5 There is sufficient information available so that residents would know whether the home could meet their needs. However, the information may not be suitable for residents who have difficulty reading, learning difficulties or failing sight. EVIDENCE: The statement of purpose and service user guide contained detailed information of the services, support, staffing and terms and conditions of living at Premier Homes. It was Premier Homes intention to produce both of these documents in a handy, smaller size. However, the print was already small and some of the terminology used might not be understood be the residents, such as, ‘an holistic view’. Two or three versions of the service user guide should be produced so that the most appropriate version can be given to each resident dependant on their ability. For example, the information should be specific and simplified, the print size larger on some and another may have photographs or symbols to aid reading. (See recommendation 1) Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 Page 8 There was a very detailed assessment of each residents needs held on their file. Premier homes conducted their own assessment even though the Local Authority may have provided one. The resident had been actively involved in the assessment. Prospective residents are provided with sufficient information to help them to decide on whether the home can meet their needs and aspirations. They are also able to visit the houses stay for a meal and overnight before deciding if it is right for them. One resident spoken with confirmed that he had done this before moving in to number 12. There is also a three-month trial period where either party may decide that the arrangement is unsuitable. Residents have a contract held on their file. This identifies the house, and the room in the house, that would be their bedroom. In some cases this would be the ground floor front room. On one contract viewed the fee had not been written. None of the contracts had anywhere for both parties to sign their agreement. These must be added and both parties must sign the contract. (See requirement 1) Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 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): 6, 7, 8, 9 & 10 The staff would know how to meet each of the residents’ needs by the information provided to them in the care plans. The residents could feel they have no control over their lives if their views and choices are not listened to. EVIDENCE: Very detailed care plans had been devised from the assessment information gathered. The residents’ files were very well organised and dividers made it easy to find information. The care plans were being reviewed and updated six monthly. However, even if there had not been any changes made to the plan a new copy of the plan was being placed in the file, making it bulky and repetitive. It was suggested that a front sheet be attached to the care plan containing the date recorded of when they were reviewed, no change or identify where change had been required and a space for both the resident and staff member reviewing the plan to sign. (See recommendation 2) Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 Page 10 The care plans had been completed with the inclusion of the resident, who had also signed both the original and any updates. The daily records had been written by the manager or senior staff following feedback from the care staff. The resident had no involvement in this and they were largely the view of the care staff as to whether the resident’s day had gone well. For example, one resident’s daily record read, “…….seemed to be in a good mood today”. The daily records should be first hand information, written and signed by the member of staff who had provided the care or support to the resident. (See Requirement 2) The residents were able to make decisions, sometimes with guidance, about how they spent their day, what they had to eat, who to keep in contact with and what they wanted to wear. However, when visiting number 10 one resident said that he had wanted tomatoes on toast for lunch but the staff member had told him that he could have that tomorrow and he was to have beans on toast. On checking, there were tomatoes in the fridge. The staff must take into account the individual wishes of the residents when preparing food on their behalf. (See requirement 3) Residents meetings were being held every two months and the minutes are recorded. All of the residents are given a copy of the minutes. The manager should consider producing the minutes in a variety of formats so that the majority of residents would be able to read them regardless of their ability. (See recommendation 3) The manager should explore ways of the residents being more involved in their own meetings, either in gathering an agenda or chairing the meeting. (See recommendation 4) There are risk assessments held on the resident’s files. These are also reviewed regularly. The management of the risk is recorded and the support needed is reflected in the care plan. The residents are aware that their file is held in a lockable cabinet in the office at number 8, as they can call to the office at any time if they feel they need help, have a problem or need their medication. Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 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 the following standard(s): 11, 12, 13 & 17 Some appropriate risks are being taken to make sure residents have activities and social occasions that stimulate and further their independence. EVIDENCE: The residents attend a variety of daytime classes or occupations, depending on their needs, wishes and ability. One resident spoken with described his placement at Premier Homes as a stopgap, as he intended learning to drive and going to college to train as a plasterer. Another resident said he attends a woodwork class on a Thursday and a further resident said that because of his age he did not wish to attend a college, day centre or have a job. The residents at Premier Homes are free to socialise independently in any location in the community unless a risk has been identified through assessment. They may need support to access some activities and the staff employed at Premier Homes would provide this. Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 Page 12 During the initial assessment of a resident a comprehensive list of foods that the resident likes and dislikes is recorded. Residents attend to their own breakfast and lunch and tea are prepared by the staff. The residents decide the choice of meal. Residents can have alternatives if they don’t like what is proposed and if their choice of food is available in the house. One resident spoken with said that he could make himself toast or a snack for his supper. Another resident said that the staff know what foods he doesn’t like. The manager may consider providing additional support to each house around the evening meal. In order to increase independence, those residents, who are risk assessed as able, can take it in turns to cook the evening meal. (See recommendation 5) Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 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 the following standard(s): 19, 20 & 21 The residents’ health needs are maintained with regular visits to appropriate health services. The residents’ last wishes would be clearly met if the comprehensive details that are recorded on their files are followed. EVIDENCE: There is a detailed history of medical and mental health issues, held on the resident’s file. Appointments to or by the psychiatrist were recorded on each file, together with dates of visits to the dentist, doctor and chiropodist. Regular blood tests are carried out before certain medication prescriptions are renewed. Those residents who have been assessed as able to do so administer their own medication. They receive a week supply of medication in a dosette box, which they keep in their bedroom. The risk assessments are held in the medication file. Some residents call to the office for their medication and others have the medication taken to them. The residents’ wishes in the event of their death had been recorded in very good detail. This included their religion, whether practicing, the minister they Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 Page 14 wanted to perform the ceremony, any preference for music to be played, whether they wanted to be buried or cremated, if buried, was a particular plot identified and any particular people they wished to be invited. Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Staff and residents clearly hold conversations throughout the day where the resident may have expressed a view, made a decision or asked advice. As this is not reflected in the daily recordings made by staff there is no evidence that they are being listened to or their views acted upon. EVIDENCE: The residents have regular meetings and are also able to call to the office during the day if they wish to talk to the manager or person in charge. The minutes of the meetings show that the resident’s views have been sought in relation to the food they are offered, the activities they do and their choice of holiday. On a daily basis the staff have conversations with the residents which may include decisions that the resident has made, advice given or a view expressed about the care or running of the service. None of this information is recorded in the daily records therefore it is not clear that the residents’ views are being listened to or acted on. The staff member should record the view of each resident on how they feel their day has been and how well they felt the care had been delivered. The resident should read and sign the daily record. (See Recommendation 6, also standard 7) Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28 & 29 The residents would be comfortable and can maintain a degree of independence by living at Premier Homes. Personalising their own room would help new residents to settle in more easily. EVIDENCE: The residents live in domestic style properties within the same street, and therefore walking distance, of the house in which the office is based. The houses are linked to a central fire and security alarm system. One resident in number 10 said that he had difficulty in opening the back door from the kitchen to the rear yard. This was very stiff and the key would not turn in the lock. This must be repaired urgently as this would be the only means of escape for those in the kitchen, in the event of a fire in the lounge. (See requirement 4) The resident s each have their own bedroom and are free to furnish them with small items from their own home such as ornaments, photographs and pictures. Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 Page 17 The residents spoken with said that they were happy with their room and said that it was comfortable. They could spend as much or as little time in their room as they wished. The residents also have access to a communal lounge, kitchen diner and bathroom. In the minutes of the residents’ meeting, the residents had been asked to limit calling to the office to make telephone calls to between 6pm and 7pm, as the telephone was busy during the day and was required for the running of the business. This restricts the residents’ freedom to call their family or friends when they wish. The manager may consider having payphones installed in the individual houses, particularly for those residents who are unable to go out to a public telephone or those who do not own a mobile telephone. (See recommendation 7) Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 Page 18 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, 33 & 36 The residents would be well supported by the varying experience and qualifications of the staff team. EVIDENCE: The home had 4 full time staff, including the registered manager. The manager had achieved NVQ level 4, Registered Managers Award. One of the full time staff was also studying towards an NVQ in Care at Level 4. Four of the 9 part-time staff had achieved NVQ level 2 and other staff had expressed an interest. The staff working at Premier Homes had varying degrees of experience both in a work setting and in their own life experiences. All staff had undertaken induction training and additional training The home carried out regular supervision sessions and all relevant areas were covered in these sessions including training needs. Staff also met regularly as a team and new or revised policies and procedures were presented during these meetings. Areas covered in these sessions included Adult Protection and confidentiality. The home has also achieved the Investors in People award. Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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): 37, 38, 40 & 42 The residents’ health and safety is promoted by the regular checks being made by staff and health and safety professionals. EVIDENCE: It was clear through discussion during the inspection that the manager was knowledgeable regarding her role and her responsibilities towards both resident’s and staff. Staff and residents called to the office and approached her throughout the inspection with various queries and requests. It was apparent that she was considered to be open and approachable in her management role. The home has a comprehensive file containing all policies and procedures relevant to the running of the home and safeguarding of the residents. These are provided by a company and are updated every three months. New or revised policies are discussed with staff at staff meetings. The manager said she also checks the staff’s understanding of the policies during supervision sessions. Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 Page 20 Weekly health and safety inspections were being made of each of the houses and the findings recorded. A column should be added to record the date the identified problem had been repaired/ resolved. This would help in tracking that jobs were completed. (See recommendation 8) Fire safety inspection and service reports were available. These included servicing of alarms, emergency lights, smoke detectors, batteries and alarm panels. Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 Page 21 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 3 3 3 2 Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 2 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 X 3 3 X LIFESTYLES Standard No Score 11 4 12 3 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 X X 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Premier Homes Score X 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X 3 X DS0000040225.V265044.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? yes 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 YA5 Regulation 5 Requirement The fee, including any contribution from the resident, must be recorded on the contract. The manager and resident must sign the contract. The daily records must be completed and signed by the staff member who provided the care/support. Staff must acknowledge the residents choice if it is available. The lock on the back door in number 10 must be repaired so that it unlocks easily. Timescale for action 01/02/06 2 YA7 12 01/02/06 3 4 YA7 YA24 12 16 01/02/06 01/12/05 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 Refer to Standard YA1 Good Practice Recommendations The statement of purpose and service user guide should be produced in alternative formats. Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 Page 23 2 3 4 5 6 7 8 YA7 YA8 YA8 YA17 YA22 YA29 YA42 A front sheet should be added to the care plan. The date of review, any changes identified and the signature of person reviewing should then be recorded. The minutes of the resident’s meetings should be produced in alternative formats. Residents should be supported to be more actively involved in their meetings. The residents should be supported to prepare the evening meal on a rota basis. The daily recordings should reflect the views and wishes of the residents. The manager should consider installing payphones into the individual houses. The date that any health and safety repairs were completed should be recorded in the inspection book. Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Premier Homes DS0000040225.V265044.R01.S.doc Version 5.0 Page 25 - 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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