Inspection on 01/07/05 for Priory Close (3)

This inspection was carried out on 1st July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Priory Close (3) 11/08/08

Priory Close (3) 06/06/07

Priory Close (3) 29/06/06

Priory Close (3) 19/12/05

Priory Close (3) 20/01/05

Priory Close (3) 07/07/04

Priory Close (3) 04/02/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Priory Close 3 Priory Close Aigburth Liverpool L17 7 EG Lead Inspector Beate Roth Unannounced 13 June 2005 and 1 July 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. Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Priory Close Address 3 Priory Close Aigburth Liverpool L17 7EG 0151 727 1886 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) Community Integrated Care CRH PC 3 Category(ies) of LD - 3 registration, with number of places Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20 January 2005 Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 Page 5 Brief Description of the Service: 3 Priory Close is registered to provide care for three adults with a learning disability. 3 Priory Close is a detached bungalow, there are three single bedrooms, a large lounge, kitchen and an office. Laundry facilities are situated in the garage. There is a garden to the rear of the home with a patio and grass areas. There is wheelchair access to the property. Bathing aids are provided. The home is situated in a quiet cul-de-sac in the Riverside district of Liverpool. Local shops and amenities can be found a mile or so from the home. Otterspool Promenade and local parkland are within walking distance. The home has its own minibus, which has a lift. Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a morning and a one and a half hour follow up visit to the home. During the inspection time was spent in the office examining records and policies and procedures and talking to the staff. A tour of the home was undertaken. Staff were observed delivering care to service users. During the follow up visit the acting manager was spoken with. 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. Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 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 Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 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 and 3 Service users would benefit from a service user guide that is more suited to their needs. The needs of service users are not being appropriately met. EVIDENCE: Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 Page 9 Information is available to enable the representatives of service users to make a decision about the suitability of the home. Since the last inspection the service user guide has been amended and now contains the required information. A guide that is more accessible to the service users living at the home would be beneficial. It is suggested that further information on the arrangements for service users to engage in social activities, hobbies and leisure interests could be included. There is a wide variance of need between the service users. The service provided is not at present offering activities that would meet the intellectual and social development needs of a service user. It is understood that multiprofessional discussions have taken place and that appropriate activities have been identified. The last inspection report made a requirement that staff are to receive training appropriate to the work they are to perform. At this inspection steps have been taken to address this. 2 further staff are now undertaking an NVQ Level 2. Some staff have had refresher training around health and safety, moving and handling and first aid. Some staff continue to need a refresher course, 2 staff have not completed first aid training and 1 member of staff has not completed food hygiene training. Steps are to be taken to ensure that all staff have up to date training in moving and handling, food hygiene and first aid. Records and a discussion with the acting manager indicated that rectal diazepam is administered in accordance with a care plan however only 2 staff have had up to date training in the administering of rectal diazepam. A further 3 staff had this training a number of years ago. Staff who are to perform this procedure must be provided with up to date training by an individual who is appropriately qualified. There is information around the communication needs of service users in their care plans. It is recommended that this be expanded upon. Service users would perhaps benefit from personal communication dictionaries. It continues to be recommended that an independent advocate is made available for the service user who does not have family members to act on their behalf. Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9 Care planning reflects the assessed and changing needs of service users. EVIDENCE: A sample of service user plans were examined. These cover the information recommended in the National Minimum Standards and there was evidence that these plans are subject to a review. The records indicated that consultation takes place with relevant professionals regarding meeting the needs of service users. A daily record is made regarding the well being of service users. A member of staff interviewed was knowledgeable about the needs of the service users. A sample of risk assessments were examined. These had been reviewed and provided clear information to staff. Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 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, 12 , 13 and 15 Activities that promote social and personal developmental needs are not provided for all service users. Service users needs are met through arrangements for family contact and by ensuring they are part of the local community. EVIDENCE: There is a written record of the activities service users take part in each week. At present all 3 service users undertake the same activities. These activities meet the needs of 2 of the service users. The service provided is not at present offering activities that would meet the social and personal developmental needs of the remaining service user. It is understood that multi-professional discussions have taken place and that appropriate activities have been identified. The staff interviewed reported that they consider that this service user needs to be provided with more stimulating activities. At present there are generally 2 staff on duty. This does not allow for individual activities to take place with the service users. Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 Page 12 Both the records show and staff indicated that service users take part in community life. Local shops and amenities can be found a mile or so from the home. Otterspool Promenade and local parkland are within walking distance. The home has its own minibus. The records show that service users have regular contact with family members. The staff interviewed provided information as to how this is facilitated. Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 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) 19 The health needs of service users are met. EVIDENCE: Records indicate that staff support the health care needs of service users and that medical interventions are sought as and when necessary. The accident records indicated that there have been no recorded accidents since the last inspection. Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 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 Service users are protected by the homes policies and practices. EVIDENCE: The care home has a copy of the Liverpool Adult Protection Procedures. All staff, except for agency workers have been provided with appropriate training. Agency workers do have access to the procedures for the protection of vulnerable adults. It is recommended that the induction record for agency staff indicates that they have received guidance around the homes adult protection procedure. A member of staff was aware of the action that would be taken following an allegation of abuse and their own responsibilities to report concerns regarding abuse. The home manages the personal allowances for all service users. The records relating to this were examined for one service user and found to be accurately maintained. There is a procedure available around managing service users money. There is a system in place for checking that the monies held correspond to the records maintained. Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 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 and 30 The home is well presented and provides a comfortable and pleasant environment for service users. EVIDENCE: A tour of the home indicated that the home is well maintained and comfortably furnished. The home was registered prior to the introduction of National Minimum Standards. The size of the bedrooms does not comply with the current space standards outlined in the National Minimum Standards. There is a large living room available for communal living. The kitchen is quite small so meals tend to be eaten in the living room or service users bedrooms if they require. A suitably adapted shower room is provided. There is a pleasant, well-maintained garden available for service users. This comprises a grass and patio area. There is ramped access to the garden through the patio doors. Access to the front door is via two small steps. There is ramped access through the garage but the staff reported that this is not used. It is recommended that a ramp be provided at the front door for ease of access. Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 Page 16 The home was in general clean and fresh smelling. There was a malodorous smell in one room. A member of staff reported that work is taking place on the best means of addressing this. Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 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) 33 and 34 There are not always enough staff to ensure service users can take part in individual and meaningful activities. The recruitment records do not demonstrate that service users are protected by the homes recruitment practices. EVIDENCE: The rotas for a 4 week period were examined. These indicated that there are two staff on duty from 8.00am until 8.00pm, on occasion there is a third member of staff available. At night there is a waking member of staff. As already indicated two staff does not allow for individual activities to take place due to the needs of the service users currently living at the home. A member of staff said that it is difficult for 2 members of staff to take all 3 service users out together, and if there are only 2 staff it can sometimes mean not getting off the minibus. The acting manager reported that there has recently been a change to the staffing levels at the home to enable 3 members of staff to be on duty on the majority of shifts. It is recommended that 3 members of staff be deployed on all shifts to enable individual and meaningful activities to take place with service users. Two new members of staff have been employed since the last inspection. The records of recruitment were examined. The records showed that references were not available for one member of staff. There was no evidence of further Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 Page 18 information being ascertained in relation to a reference that was not clear about suitability. A medical reference/declaration was not available for one member of staff. Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 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 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) 37 and 42 The management arrangements at the home do not promote the wellbeing of the service users. EVIDENCE: A requirement was made at the last inspection that the registered person must appoint an individual to manage the home and that in the interim an application by the acting manager to become the registered manager must be made to the CSCI. This has not been addressed. The acting manager has worked at the home for many years and has been the managing the home for 17 months. An assessment of the acting managers skills, knowledge and experience to run the home cannot be made until a formal application for registration is made to CSCI. There are policies and procedures to promote safe working practices. A sample of safety check records were examined and found to be in order. The records showed that tests of the fire alarms had not been occurring on a weekly basis since the last inspection and that 2 new staff had not received fire Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 Page 20 safety training. A risk assessment for the use of a bed rail was being reviewed on a 6 monthly basis. A review of this risk assessment needs to take place monthly. This assessment did not indicate who is to provide the instruction to new staff around the use of the bed rails or whether the service user continues to need the bed rails. Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 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 2 x 1 x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 2 2 3 x 3 x x Standard No 31 32 33 34 35 36 Score x x 2 1 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Priory Close Score x 3 x x Standard No 37 38 39 40 41 42 43 Score 1 x x x x 2 x Version 1.30 Page 22 F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc yes 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 3 Regulation 18 Requirement Steps must be taken to ensure that all staff have up to date training in moving and handling, food hygiene and first aid (previous timescale not met). Staff must be provided with up to date training in the administering of rectal diazepam by an individual who is appropriately qualified to provide it. Activities that promote the social and personal developmnent of service users must be provided in accordance with their wishes. The records of recruitment must contain all the information detailed in Schedule 4 of The Care Homes Regulations 2001. The registered person must appoint an individual to manage the home. In the interim an application by the acting manager to become the registered manager must be made to the CSCI. The registered person must ensure that the fire alarms are tested on a weekly basis. The registered person must make arrangements for all F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Timescale for action 01/10/05 2. 3 18 01/10/05 3. 11, 12 16 01/07/05 4. 17 34 01/07/05 5. 37 8 01/08/05 6. 7. 42 42 23 23 01/07/05 01/07/05 Page 23 Priory Close Version 1.30 8. 42 13 persons working at the care home to receive suitable training in fire safety. A review of the risk assessment for the use of a bed rail must take place monthly. This assessment must indicate any changes to a service users needs which may affect the use of the bed rail and that staff have been appropriately trained to use the bedrail. 01/07/05 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 1 Good Practice Recommendations A service user guide that is more suited to the abilities of the service users should be made available. Further information on the arrangements for service users to engage in social activities, hobbies and leisure interests should be included in the service user guide. Further written information around communication should be made available for staff to ensure that they and future staff can as far as possible communicate effectively with each service user. The registered person should consider the introduction of an independent advocate for the service user who does not have family members to act on their behalf. The induction record of agency staff should indicate that they have received guidance around the homes adult protection procedure. It is recommended that a ramp be provided at the front door for ease of access. Three members of staff should be deployed on all shifts to enable individual and meaningful activities to take place with service users. 2. 3 3. 4. 5. 6. 7. 3 23 24 33 Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Liverpool Area Office 3rd Floor 10 Duke Street Liverpool, L1 5AS 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 Priory Close F52_F02_s25316_PrioryClose_v230505_130605_Stage 4.doc Version 1.30 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. 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!