Inspection on 08/12/05 for Riverside Close, 8

This inspection was carried out on 8th December 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 no outstanding requirements from the previous inspection report, but made 16 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Riverside Close, 8 30/06/06

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 8th December 2005 10:00 Riverside Close, 8 DS0000005240.V273696.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 Riverside Close, 8 DS0000005240.V273696.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. Riverside Close, 8 DS0000005240.V273696.R01.S.doc Version 5.0 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) Autism Initiatives Mr Paul Binks Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Riverside Close, 8 DS0000005240.V273696.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 3 LD. Date of last inspection 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.V273696.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on an unannounced basis and over a period of approximately 4 ½ hours. During the visit all of the service users were spoken with to obtain their views on the home and all of the staff were spoken with either on an informal group basis or on a one to one basis. Service user plans, health and safety records and other relevant records were examined in some detail. A tour of the home was carried out. This include the whole of the property with the exception of one of the service user’s bedrooms. What the service does well: What has improved since the last inspection? What they could do better: A suitably experienced, qualified and competent manager needs to be appointed to the home. An application to register this person with the Commission must then be made. The previous manager who was working at the home had made an application for registration however since the previous inspection he has left the home. Since the previous inspection there have been two adult protection investigations at the home. Riverside Close, 8 DS0000005240.V273696.R01.S.doc Version 5.0 Page 6 There has been a decline in the quality of the service provided at the home. Numerous areas of concern have been identified at this inspection and need to be addressed as a matter of priority by the registered person. These include, as previously mentioned, the appointment of a manager, ensuring each service user has an appropriate risk assessment, ensuring medication administration records are appropriately maintained, ensuring staff are supervised regularly, ensuring that staff records are available at the home, a comprehensive review of the food budget and catering arrangements needs to be carried out, health records need to be maintained appropriately, there is a need for some redecoration and refurbishment as identified throughout the report, the registered person must ensure unannounced monthly visits are carried out at the home and a report on the findings is forwarded to the Commission. 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.V273696.R01.S.doc Version 5.0 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.V273696.R01.S.doc Version 5.0 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): 2, 4 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, however, there have been no introductory visits for a new service user. EVIDENCE: A statement of purpose which describes the services offered by the home is available. The statement of purpose needs to be updated to reflect changes at the home. 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. One service user has moved in to the home since the previous inspection. Members of the staff team visited this person in order to build up a knowledge of their needs and determine the appropriateness of the home in meeting their needs. An assessment of the service users needs had been carried out by a social worker and this information was provided to the staff team. At the time of the previous inspection it was evident from discussions with members of the staff team that staff did not seem to be fully aware of the planning involved in the new service user’s placement. Discussions with the service user, members of staff and the examination of records indicated that the service user did not have the opportunity of visiting the home prior to moving in and this is not good practice. Riverside Close, 8 DS0000005240.V273696.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, 9 Care plans are of a good standard with the exception of one which is incomplete. 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. Risk assessments are of a good standard however they are only in place for two of the three service users. EVIDENCE: Each of the service users has a care plan / support plan. For two of the service users these are of a good standard. The plan for one of the service users is not yet complete and the service user has no knowledge of the 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 review of their support plans every six months. The reviews involve a meeting with the service user, members of their family or other representatives e.g. social worker. Riverside Close, 8 DS0000005240.V273696.R01.S.doc Version 5.0 Page 10 Risk assessments are in place for two of the three service users. 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. There is no risk assessment in relation to the support of one of the service users. Risk assessment should be carried out with regards to the support provided to each of the service users. Riverside Close, 8 DS0000005240.V273696.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): 15, 17 Service users are supported to maintain relationships. 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: The 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.V273696.R01.S.doc Version 5.0 Page 12 In assessing the diet and meals available to service users the inspector examined menu records, spoke to service users and checked the storage and availability of food at the home. The service users reported to be happy with their meals, they choose their meals and are clearly supported to prepare and cook their meals. Menu records, along with the variety of food available, indicate that the service users are not having a varied or nutritious diet. This was reported to be the service users choice. However, the service users should be encouraged to have a greater variety in their diet and this could be encouraged by them having access to a greater choice of food. The acting team leader at the home has been informed that the shopping budget for the home has been reduced. Based on the findings of this inspection and the previous inspection this is not appropriate and must be thoroughly reviewed as a matter of priority. Some food was found to be stored inappropriately. Food must be stored safely and staff should receive training or refresher training in food hygiene. Riverside Close, 8 DS0000005240.V273696.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 Service user’s health related records are not up to date. The home is therefore not demonstrating that service users are being supported to maintain their health. Medication records are not being maintained appropriately and this can present a risk to service users. EVIDENCE: Staff are failing to appropriately record when they are supporting the service users with visiting their G.P and attending hospital or specialist health related appointments. This must be rectified. 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. The medication administration records were found to be poorly maintained. There were gaps in the records and symbols being used which gave no explanation as to what the symbol meant. Only one member of the staff team has received training in the administration of medication. Riverside Close, 8 DS0000005240.V273696.R01.S.doc Version 5.0 Page 14 All staff who are responsible for the administration of medication should be provided with appropriate training in this. Medication was not being stored securely, this was discussed with the acting team leader. Riverside Close, 8 DS0000005240.V273696.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): 23 Policies, procedures and practices are in place which aim to protect service users against abuse or neglect and systems are in place for dealing with allegations of abuse. The home has been the subject of adult protection investigations. Staff are not trained in the protection of vulnerable adults. EVIDENCE: The home has a protection of service users policy and an abuse policy. There is also a management of service users money and financial affairs policy and a physical intervention by staff policy. All staff should be provided with training on the protection of vulnerable adults. A record of key events is maintained for example incident reports, accident reports, service user’s monies and medication administration records. The home has been subject to two adult protection investigations since the previous inspection. The relevant Social Services Department and police have been informed of these matters. Riverside Close, 8 DS0000005240.V273696.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, 30 There is room for improvement in the presentation and cleanliness 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. 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 needs to be redecorated and the tumble dryer needs to be moved to another area of the house. The dinning room furniture needs to be replaced and the small table needs to be discarded. A mattress which is being stored in the dinning room must also be moved. 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 general cleanliness of the home could also be improved with particular attention to the kitchen cupboards, the bathroom and the inside of the windows. One of the service user’s bedrooms is in need of redecoration. Riverside Close, 8 DS0000005240.V273696.R01.S.doc Version 5.0 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 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): 33, 34, 36 There has been an improvement in the number of staff at the home and all care staff vacancies have now been filled. Staff have not been provided with regular supervision since the previous inspection. EVIDENCE: There have been new staff taken on at the home since the previous inspection and the staffing compliment is now being met. There were no staff files available at the home and therefore staff recruitment and selection procedures could not be examined. The staff files were reported to be at head office as one of the filing cabinets at the home had been broken in to and had not been replaced. Staff records must be maintained at the home for inspection purposes. As the staff files were not available there was no evidence of the training staff have been provided with and no evidence that staff have been provided with regular and recorded supervision. Riverside Close, 8 DS0000005240.V273696.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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, 39, 42 The quality of service provided at the home has deteriorated due to the home not being managed by a suitably experienced and qualified manager for some time. The registered provider is not ensuring that monthly unannounced visits are carried out at the home and not providing a report on the findings of these to the Commission. 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. An acting team leader has been appointed four days prior to this inspection and a manager from another service has been asked to oversee the management of this home on a part time temporary basis. The quality of the service provided at the home has suffered from the lack of a suitably experienced and qualified manager and the registered person must rectify this. Riverside Close, 8 DS0000005240.V273696.R01.S.doc Version 5.0 Page 19 The registered person should ensure that the home is visited on an unannounced basis at least once per month and provide a report on the findings of the visit to the Commission in line with Regulation 26 of the Care Home Regulations 2001. These visits should form part of the quality assurance process and should involve seeking the views of service users (and their representatives as appropriate) and staff in order to form an opinion on the standard of care provided. The registered person should liase with the service users as to announcing these visits to the service users before the visit takes place. 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. The fire risk assessment should be reviewed. Water temperatures are regulated. The temperature of the water was tested in the bathroom and was close to 43 degrees centigrade thus ensuring the service users are not at risk from scalding. Gas and electricity safety certificates were checked and found to be appropriate. Riverside Close, 8 DS0000005240.V273696.R01.S.doc Version 5.0 Page 20 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 x 3 x 2 x Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 x x 2 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 x x x x 2 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x x 3 2 x 2 CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Riverside Close, 8 Score x 2 2 x Standard No 37 38 39 40 41 42 43 Score 1 1 2 x x 2 x DS0000005240.V273696.R01.S.doc Version 5.0 Page 21 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 must ensure that risk assessments are carried out in relation to the support provided to each of the service users. Staff must be provided with regular and recorded supervision. 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. The registered person shall ensure that the home is visited at least once per month on an unannounced basis and shall supply a copy of the report following the visit to the Commission. Fire alarm tests must be carried DS0000005240.V273696.R01.S.doc Timescale for action 08/03/06 2 YA9 13 (4) (b) 08/03/06 3 4 YA36 YA20 18 (2) 13 (2) 08/02/06 08/01/06 5 YA20 18 (c) (1) 08/05/06 6 YA39 26 (5) 08/01/06 7 YA42 23 (4)(c) 08/01/06 Page 22 Riverside Close, 8 Version 5.0 (v) 8 9 10 11 12 13 14 YA24 YA30 YA24 YA24 YA25 YA19 YA34 23 (4) (c) (v) 23 (2) (d) 23 (2)(d) 23 (2) (h) 23 (2) (d) 12 (1) (a) 17 (2) schedule 4 out at appropriate intervals. The fire risk assessment must be reviewed. All parts of the care home must be kept clean. The dinning room and downstairs w.c must be redecorated. The dinning room must be refurbished and items of furniture discarded. One of the service user’s bedrooms is in need of redecoration. Service user’s health records must be maintained appropriately. Staff files should be kept at the home and be available at all times to be inspected by the National Care Standards Commission. Food must be stored safely and staff must be provided with training in food hygiene. The registered person must review the budget arrangements for food / provisions and provide the commission with information on the outcome of this review. 08/02/06 08/01/06 08/02/06 08/02/06 08/03/06 08/01/06 08/01/06 15 16 YA17 YA17 13 (3) 16 (2) (i) 08/04/06 15/01/06 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 YA4 Good Practice Recommendations The kitchen cupboards should be replaced. Prospective service users should be offered the opportunity of visiting the home and introductory visits prior to deciding to move in to the home. Riverside Close, 8 DS0000005240.V273696.R01.S.doc Version 5.0 Page 23 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.V273696.R01.S.doc Version 5.0 Page 24 - 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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