Inspection on 30/06/06 for Riverside Close, 8

This inspection was carried out on 30th June 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Riverside Close, 8 08/12/05

Riverside Close, 8 05/05/05

Riverside Close, 8 08/02/05

Riverside Close, 8 01/07/04

Riverside Close, 8 18/03/04

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 Riverside Close, 8 8 Riverside Close Bootle Liverpool Merseyside L20 4QG Lead Inspector Debbie Corcoran Unannounced Inspection 30th June 2006 10:00 Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Riverside Close, 8 Address 8 Riverside Close Bootle Liverpool Merseyside L20 4QG 0151 944 2716 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) www.peterhouseschool.org Autism Initiatives Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 3 LD. Date of last inspection 8th December 2005 Brief Description of the Service: 8 Riverside Close is a small home registered for three people with a learning disability. The service is provided by Autism Initiatives and the registered Landlord for the property is Riverside Housing Association. Autism Initiatives was formerly called the Liverpool and Lancashire Autistic Society and it was established in 1971. The organisation provides a variety of services to adults and children who have autism. These include residential care, day care, supported tenancies, outreach, domiciliary care, respite and educational services. Autism Initiatives is a voluntary organisation with charitable status. 8 Riverside Close is a four bedroom house which is located in a residential area in Seaforth, Merseyside. The home has good transport links. There are two staff available to support the service users throughout the day and a sleep in member of staff. The home is a domestic property which promotes the principles of ordinary community living. Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on an unannounced basis over 2 visits and a period of approximately 6 hours. During the visits 2 of the 3 service users were spoken with to obtain their views on the home and all of the staff team were spoken with. Service user plans, health and safety records and other relevant records were examined in some detail. A tour of the home was carried out and all communal areas were checked. What the service does well: What has improved since the last inspection? There have been a number of improvements to the home since the previous inspection. The home had been without a designated and appropriately experienced manager for some time and this was clearly reflected in the findings of the last inspection. A few days before the previous inspection a temporary acting manager was appointed and a manager from another service was brought in to oversee the management the home. Therefore the home has had an increased level of management since the previous inspection and a number of concerns raised at the last inspection have now been addressed. The home does however continue to run without a permanent manager and one who has gone through registration with the Commission. Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 Page 6 Improvements since the last inspection include; Care planning and risk assessments are in place for each of the service users. Service users are now being appropriately supported with their health care and records to evidence this are up to date. The home is presented as clean and hygienic and there has been some improvement to the presentation of the home. Staff are being supervised on a regular basis and staff team meetings are taking place regularly. In between the two site visits to carry out the inspection a service manager has introduced a new staff rota which increases the number of staff on the team and allows for greater opportunity for one to one support for the service users. 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. Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 The home has a statement of purpose and service user guide to provide service users and their representatives with information on the home. Systems are in place for ensuring the needs of prospective service users are assessed. EVIDENCE: A statement of purpose which describes the services offered by the home is available. A guide for service users which describes the services offered by the home is also in place. This should also be produced in formats suitable to the needs of the service users. Autism Initiatives has assessment and referral policies and procedures to be used when a new service user is referred to the home. These detail that an assessment of the prospective service user’s needs is carried out prior to the person moving in to the home. The assessment format is good and includes areas for information which are specific to the needs of people who have autism. There have been no new service users to the home over the past 12 months. Previous inspections have evidenced that new service users have only been admitted to the home following receipt of a Community Care assessment as carried out by a social worker and a further assessment has been carried out by staff at Autism Initiatives. Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 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 Each of the service users has a care plans and these are generally of a good standard. Service users are encouraged and supported to make their own decisions and to participate in the decision making in the home. When a service user is involved in an activity which involves taking risks then the risk is assessed and plans are put in place to manage the risk. EVIDENCE: Each of the service users has a care plan / support plan. The service user’s care plans are clear, informative and easy to follow. The plans are reviewed regularly and kept up to date. The plans include information on the service user’s daily routines, likes and dislikes, skills and needs, health, weekly activities and includes a goal plan which identifies targets for development. When appropriate, guidelines for supporting the service users with particular challenges or needs are included in the individual’s plan. Service users have a full review of their support every 12 months and care plans are reviewed less formally on a regular basis. The full review involves a meeting with the service user, members of their family or other representatives eg social worker. Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 Page 10 The service users are encouraged to make choices as to the running of the home and are clearly making their own decisions as to their daily support. During discussions with service users they confirmed that they are using and developing their independent living skills. Following discussions with one of the service users it is recommended that service users have the opportunity to attend house meetings whereby they can discuss the running of the home with staff on a more formal basis. Where a service user is involved in activities which pose a risk to their safety then a risk assessment is carried out. The risk assessments cover different aspects of the persons support. For example support with communication, keeping safe, managing medication. The risk assessments include a good level of information on what the potential risk is and what steps need to be taken to prevent the risk from occurring. Risk assessments are reviewed regularly and updated accordingly. Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 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, 14, 15, 16, 17 Service users are supported to develop their independent living skills, to develop and maintain relationships and to be involved in local community activities. The service user’s diet is not varied but is reported to be of their choosing. The food budget needs to be reviewed as a matter of priority as this may further restrict service users in their choice of food. EVIDENCE: Service users are well supported in developing their independent living skills, in being involved in activities and in accessing the local community. This was evidenced during discussions with service users and staff, through examining the service user’s care plans and through other records. Service users are supported in developing and maintaining relationships. This has been confirmed during discussions with service users. Service users are encouraged to develop and maintain relationships through work placements, social groups and in using community facilities. Service users and care staff maintain regular contact with members of the service user’s family. Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 Page 12 In assessing the diet and meals available to service users menu records were examined, service user and staff feedback was sought and the storage and availability of food at the home was checked. The service users reported to be happy with their meals, they choose their meals and are clearly supported to prepare and cook their meals. There was improvement on the quality and quantity of food available at the home. Menu records indicate that there has been some improvement in the variety of the service user’s diet however, the service users are still not having a varied or nutritious diet. This was reported to be the service users choice. At the previous inspection it was noted that there had been a reduction in the budget available for shopping. The registered person has been required to ensure that the shopping / food budget is reviewed. This was a requirement given following the previous inspection. Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 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): 18, 19, 20 Service users are well supported with their health care needs and with their emotional well being. Medication procedures are appropriate but there is some room for improvement in the administration records. EVIDENCE: Service users are well supported to attend health related checks. Service users care plans include a good level of information as to support the person with their physical, emotional and personal care needs. One of the people who lives at the home has declined support with a number of health related checks and this has been recorded and signed by the individual. Service users are encouraged to maintain and administer their own medication based upon a risk assessment and risk management. As a safeguard to service users all medication, which is received in to the home or administered, is recorded. Information on medication and side effects of these is available in each of the service user’s records. The medication administration records were found to have improved since the previous inspection however there are still areas for improvement. For example for one service user the information on the medication is that it is to be administered in the morning but the recorded on the medication Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 Page 14 administration record is that this is to be administered in the evening. This needs to be clarified and changed appropriatly. Staff must not use liquid paper on the medicatin administration records and must make any ammendemnts appropriatly and staff must ensure that they sign and date any authorised changes to the service user’s medication. Two of the four members of staff who are responsible for the administration of medication have been provided with medication training. All staff who are responsible for the administration of medication should be provided with appropriate training in this. Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 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, 23 Policies, procedures and practices are in place for dealing with complaints and for aiming to protect service users against abuse or neglect and systems are in place for dealing with allegations of abuse. EVIDENCE: The home has a complaints procedure which is time scaled appropriately. One of the service users has been clearly unhappy with a situation at the home and the person has voiced this concern. A co-ordinator for the service reported that they have dealt with the concern on an informal basis (ie not through the complaints process) and the issues concerned have been addressed. The home has a protection of service users policy and an abuse policy. The majority of staff have been provided with training on the protection of vulnerable adults. The home has a policy and procedure on the management of service user’s money. Service users are requested to pay members of staff for travel purposes if they use the staff’s own transport. This agreement must be formalised in the policy and procedure and audited to ensure that service users and staff are not left in a vulnerable position. A record of key events is maintained for example incident reports, accident reports, service user’s monies and medication administration records. Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 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, 30 The home is a small domestic property. It is presented as safe and clean. There is room for improvement in the presentation and decor of the home. EVIDENCE: The home is in keeping with others in the area and is an ordinary domestic property. The home has a lounge and dining room and therefore service users have use of a private room if they so wish. There has been some improvement in the presentation of the home since the previous inspection but there is still room for improvement and not all areas identified at the previous inspection have been addressed. Autism Initiatives has an ‘estates department’. Staff report that they report all repairs and redecoration to this department but that there are long delays in the work being carried out. The registered person must review this situation and ensure that necessary works are carried out within a reasonable timescale. A tour of the home revealed that a number of areas require attention; The kitchen cupboards are in need of replacement. These are not well repaired / matched. The dinning room and down stairs wc are in need of redecoration. Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 Page 17 The décor and presentation of the house is showing signs of gradual deterioration. Members of the staff team have carried out some decorating in the home. Whilst this is admirable it is not the most appropriate use of staff time, particularly as the task does not involve the service users. The home has health and safety practices and procedures which are aimed at ensuring the home is safe and clean and as free from hazards to the health and safety of service users and staff. Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 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, 34, 35 Service users are supported by appropriately trained staff. Staffing issues have been resolved to ensure service users receive consistency of support from the staff team. Staff recruitment and selection practices aim to protect the service users. Staff are supported by the manager and provided with regular supervision. EVIDENCE: Staff are provided with training as appropriate to meet the needs of the service users. Staff training includes training on topics such as first aid, fire safety, adult protection, moving and handling, infection control and supporting people who have autism. Three out of the four members of staff on the team have attained a National Vocational Qualification (N.V.Q) in care. During the first visit as part of this inspection a number of staff and service users voiced concern as to the number of staff on the team and the difficulty in covering all of the necessary staff hours. This had been resolved by the time the second visit was carried out. A service manager for the service has developed a new rota and incorporated a minimum of one additional member of staff in to this. The new rota has been drawn up so as to benefit the needs of the service users and ensure staffing levels are such so as to allow for a good level of one to one support to service users. During the first visit there was also concern expressed that members of the staff team are transferred to Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 Page 19 work at different homes at short notice to cover staff shortages. This is the cause of concern to one of the service users in particular. At the second visit to the home a service manager confirmed that this practice has ceased and staff are not to be moved from 8 Riverside Close to other services. There has been one new recruit to the staff team since the last inspection. This member of staff and a service manager for the service reported that all pre employment checks had been carried out before commencement of employment. Staff records were not accessible to confirm this however previous inspections have evidenced that the home does have appropriate staff recruitment procedures. Staff and a service manager for the service reported that staff are now being provided with regular and recorded supervision. Staff files were not available for examination as they were being held in a locked cabinet and the manager was not available during both visits. Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 Page 20 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, 39, 42 The quality of service provided at the home has improved since the previous inspection. The home does not have a manager who is registered with the Commission and the registered person is failing to meet requirements given for this to have been achieved. Monthly unannounced visits are being carried out at the home as part of the quality assurance process. Health and safety practices and checks are carried out. EVIDENCE: The home does not have a manager who is registered with the Commission and as a result the registered person is failing to meet the Care Home Regulations 2001. The registered person has been given numerous requirements to ensure a manager is in post and registered with the Commission but has failed to meet this requirement. Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 Page 21 The home is visited on an unannounced basis once per month by a representative of the organisation as a quality check. The Commission must be provided with a report on the findings of the visit in line with Regulation 26 of the Care Home Regulations 2001. Fire safety and health and safety practices are adopted. Records of fire and health and safety checks were checked and found to be up to date with the exception of the fire alarm which should be tested more frequently. A requirement was given for this following the previous inspection. The registered person has failed to ensure that this requirement has been met. Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 1 x 2 x x x 2 Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 Page 23 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 YA37 Regulation 8 Requirement The registered person must ensure that a manager is appointed to the home and an application for the registration of manager is made to the Commission. The registered person shall ensure that the Commission is sent a report following unannounced visits to the home. Fire alarm tests must be carried out at appropriate intervals. The registered person shall ensure that a policy and procedure is in place regarding money paid by service users to staff for any purposes. The registered person shall review the arrangements for the maintenance of the home. The dinning room and downstairs w.c must be redecorated. Medication administration records must be maintained accurately and appropriately at all times. Staff responsible for the administration of medication must be provided with medication training. DS0000005240.V295143.R01.S.doc Timescale for action 30/09/06 2. YA39 26 (5) 30/08/06 3. 4. YA42 YA23 23 (4)(c) (v) 13 (6) 15/08/06 30/09/06 5. YA24 23 (2)(d) 30/09/06 6. YA20 13 (2) 15/08/06 7. YA20 18 (c) (1) 30/09/06 Riverside Close, 8 Version 5.2 Page 24 8. YA17 16 (2) (i) The registered person must review the budget arrangements for food / provisions and provide the commission with information on the outcome of this review. 30/08/06 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. Refer to Standard YA24 YA24 Good Practice Recommendations Service user’s should be given the opportunity of attending meetings to contribute to the running of the home on a more formal basis. Kitchen cupboards should be replaced. Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 Page 25 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 Riverside Close, 8 DS0000005240.V295143.R01.S.doc Version 5.2 Page 26 - 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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