Inspection on 21/07/05 for Salisbury Park (31)

This inspection was carried out on 21st July 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Salisbury Park (31) 11/06/07

Salisbury Park (31) 31/08/06

Salisbury Park (31) 09/01/06

Salisbury Park (31) 17/01/05

Salisbury Park (31) 12/05/04

Salisbury Park (31) 03/02/04

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 Salisbury Park 31 Salisbury Park Woolton Liverpool L16 0JT Lead Inspector Les Hill Unannounced 21 July 2005 9:15 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. Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Salisbury Park Address 31 Salisbury Park Woolton Liverpool L16 0JT 0151 722 9729 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 Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 17 January 2005 Brief Description of the Service: 31 Salisbury Park is a care home registered with the CSCI to provide care and support to three adults with a learning disability. The home is part of the Community Integrated Care network of small homes. Salisbury Park is situated in the Woolton area of Liverpool and is close to local amenities, bus and rail routes. The care home is of a bungalow construction and all facilities for residents and staff are situated on one floor. The home is accessible for wheelchair users and is generally well maintained. The three residents who live at Salisbury Park were formerly resident in the companys home in Cardwell Road, Liverpool. They moved to Salisbury Park as it provided ground floor accommodation. Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of 31Salisbury Place took place on Thursday 21st July 2005 over a period of two hours. It involved the examination of some records, a tour of the building and discussion with the two members of staff on duty. None of the three residents at the home has the ability to communicate verbally. The inspection was part of the Commissions requirement to visit and report on each registered care home on two occasions each year. What the service does well: What has improved since the last inspection? What they could do better: The homes manager has been required to ensure staff issue medicines in line with the pharmacist’s instructions. Some minor repairs to furniture and fittings were necessary. The level of staff with an award at NVQ level 2 in care is below the standard of 50 expected by the Commission. Formal staff supervision should be resumed at the home. Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 6 The organisation has concluded a quality assurance survey across all its services but has not indicated any actions it intends to take in response to the comments made. Fire prevention training should be undertaken on a regular basis and a record of staff attendance kept in the home. 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. Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_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 Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_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, 2, 3, 4 and 5. Good assessments of need were in place and residents had contracts to confirm their placement in the home. EVIDENCE: The home has a statement of purpose that contains all matters identified in Schedule 4 of the National Minimum Standards, Care Homes for Younger Adults. A service users guide was also in place. The three residents at Salisbury Park had lived together in another of CIC’s homes in Cardwell Road Liverpool and had been there for some time. The move to Salisbury Park was agreed to provide ground floor accommodation for the men one of whom had a risk assessment in place around the use of stairs. Most of the staff from Cardwell Road moved to Salisbury Park with the residents. The transfer was completed over a period of time. Staff brought the residents to visit the home and to look around. They spent some time in the home and had meals there before moving in. The member of staff assisting the inspector said that the transfer went well and the residents quickly settled into their new home. The property was smaller than their former home but was more suitable for their needs. Good quality assessments had transferred with the residents and were being maintained through the care planning and review processes. Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 9 One of the residents care files was examined during the inspection. It contained an Assured Tenancy Agreement for Maritime Housing, who own the property and a set of terms and conditions of residency provided by CIC. Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_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, 7, 8, 9 and 10. The needs of individual residents are central to the running of the home. EVIDENCE: Good quality care plans are in place. They identify the areas of need that are to be addressed and the ways in which staff should respond. Care plans are clearly written in a simple and easy to understand style. Confirmation that each area of need has been reviewed is written on the back of the plan. The care plans are a model for good practice and staff at the home have prepared them well. Care plans identify that residents must be able to make decisions about their daily life. None of the three residents is able to communicate verbally and they do not have Makaton or other communication skills to convey their wishes. However, staff have developed an understanding of body language and gestures that are unique to each resident and have recorded these in the care plans to help new and existing staff understand what the resident might be trying to say. The care plans also record what staff should do when a resident does not wish to comply with what they are trying to achieve. It was evident that staff in Salisbury Park respect the residents wishes and are expected to work with them to ensure they are supported safely. Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 11 The residents at Salisbury Park would be unable to contribute directly to the development and review of policies and procedures but evidence in the records maintained at the home confirmed that the service was responsive to the needs and wishes of the men who live there. Risk assessments are in place on the resident’s files. They identify any particular hazards and give advice to staff on how they should be managed. The home also has risk assessments in place to cover the building and the area surrounding the home and staff undertake risk assessments when taking residents into new situations. Each of the resident’s files contains a statement to confirm that information about them will be held confidentially. Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 12 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, 14, 15, 16 and 17. Residents were encouraged to maintain and develop social, emotional, communication and independent living skills. EVIDENCE: A weekly activity sheet was in place on each of the resident’s files. The inspector was told that this forms the basis of activity but factors such as the weather and other events occurring in the home could mean that the programme would be changed. Each Tuesday the three men spend some time in the CIC Sensory room in Hoylake. Other activities recorded included, help with shopping for food, visits to local places of interest, quiet times in the house and shopping for personal items. The home has television, radio and music facilities and residents enjoy spending time in the garden when the weather is good, going for walks, going to the cinema and eating out in pubs and restaurants. One of the residents enjoys swimming. The home has its own minibus. Staff at the home were planning a foreign holiday for the residents. Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 13 The home is situated on a small private housing estate and there is little contact with neighbours but staff take residents to the local shops and use community facilities such as pubs and cafés. Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 14 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) 18, 19 and 20. Resident’s personal and health care needs were given appropriate priority. One medicine was incorrectly labelled. EVIDENCE: Care plans identified the ways in which personal care tasks should be undertaken for individual residents. They also identified what staff should do if a resident was unhappy about a particular task being carried out. During the course of this inspection one of the residents was unwell. Staff responded calmly and ensured he was cared for with dignity. Resident’s files contained sections for staff to record contacts with health care professionals. All of the residents had been registered with a local GP practice and had records of visits to the dentist and to the optician where appropriate. A chiropodist visits the home to maintain foot care. None of the residents had been admitted to Accident and Emergency and none had pressure sores. All of the residents have medical conditions that are being monitored and records of significant events linked to health needs, are made on the resident’s file. None of the residents would be able to manage their own medicines. A check of medicines kept in the home identified that those supplied in “ blister packs” were being managed appropriately. However, the instructions for dosage on Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 15 the package of one of the medicines not in “blister pack” differed from the dosage being administered by staff. The member of staff on duty made contact with both the GP’s surgery and the supplying pharmacy. The GP was unavailable but the pharmacist recognised there was a problem and agreed to resolve the matter in consultation with the GP. The inspector was told that staff were giving out the dosage they had been told to give by the residents GP. Staff must only give out medicines in line with the instructions on the pharmacists label and confirm any differences in their understanding of the doses before administering it to a resident. Any changes to the dosage of a medicine must be confirmed in writing by the GP. Information about the medicines prescribed for each resident was contained in their file. Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 16 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) 22 and 23. Policies, procedures and staff training confirm the organisations commitment to protecting residents from abuse. EVIDENCE: It is unlikely that any of the residents in Salisbury Park would be able to make a formal complaint. However, the organisation has policies and procedures in place to deal with any complaints that conform to good practice standards. No complaints have been made to the home or to CSCI about the home in the past twelve months. Only one of the residents has regular contact with family members and the organisation continues in its attempts to engage an appropriate advocate. Policies and procedures are in place to advise staff on the correct course of action should they suspect that one of the residents is the victim of abuse. Training is provided for staff during their induction and is ongoing. Some staff have recently attended a training event that dealt with the new POVA regulations. Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 17 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, 25, 26, 27, 28, 29 and 30. Salisbury Park provides a homely, comfortable and safe environment for residents. EVIDENCE: 31 Salisbury Park is a three-bedroom bungalow situated on a small estate of private properties in the Woolton area of Liverpool. The home is well decorated and is fitted out in a comfortable domestic style. Residents are accommodated in single rooms. Some minor repairs are necessary. The radiator guard in the kitchen is damaged and the drawers in the smallest bedroom are broken. The lounge dining room is well fitted out and is decorated in a modern domestic style. The member of staff told the inspector that new curtains had been provided and the staff are to redecorate the room to lighten the colours on the walls. The kitchen is domestic in style but is adequate for the needs of three residents and two staff. Two of the bedrooms are double rooms. The one seen by the inspector was well decorated and furnished and had patio doors leading to the garden. The Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 18 smallest room has the damaged bedroom furniture and the member of staff said it is to be decorated in more appropriate colours. The home has a small shower room that is mainly used by staff and a “walk in Shower room for residents. The inspector was told that at the request of one of the resident’s parents, the room is to be refitted with a bath. The organisation should consider the current and future needs of all the residents before it replaces disabled access facilities with more traditional equipment. The radiator cover in the bathroom was loose and required fixing to the wall. A separate utility room holds a washing machine and tumble dryer but a second tumble dryer has been fitted in the kitchen because neighbours complained of the noise from the existing appliance, during the night. Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 19 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) 31, 32, 33, 35 and 36. The home has a stable and committed staff team but the organisation must ensure they can meet the target for trained personnel. EVIDENCE: The organisation has robust employment policies in place that ensure all members of staff have job descriptions and contracts of employment. However, only one member of staff currently holds an award at NVQ level 2. The inspector was told that all six other members of staff are either undertaking the appropriate training or will be signed up for the training during the current year. Staffing is arranged so that at least two care staff are on duty during the day and one member of staff is on duty at night with back up management support. From time-to-time additional staff are on duty during the day and this allows for residents to go out or be supported individually. Most of the staff team moved with the residents from their former home in Cardwell Road. All new staff are inducted into work practices in the home and after three months are expected to attend the organisations formal induction training programme that deals with first aid, health and safety, moving and handling and food safety. Staff are also trained in Crisis Prevention Interventions (CPI) Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 20 and in the use of rectal diazepam. The member of staff told the inspector that fire prevention training is to be provided. The organisation will need to ensure it can meet the requirement of regular fire training updates required by the Merseyside Fire Authority. The home’s manager left the organisation shortly after the move to Salisbury Park and a new manager has been identified. However, for various reasons formal staff supervision has not been taking place at the home. The home’s manager should ensure that formal staff supervision takes place not less than six times each year. Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 21 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, 38, 39, 41 and 42. Service users are supported in a safe and comfortable environment by a strong staff team and the robust policies and procedures of the organisation. EVIDENCE: The homes manager has applied to CSCI for registration. He has worked with the current group of residents for some considerable time. The two members of staff on duty at the time of this inspection got on with their work and appeared to know exactly what was expected of them. The residents were calm and appeared comfortable with the staff. Each member of staff is allocated particular responsibilities (eg fire prevention) but they share their knowledge with colleagues so that all staff are aware of what is happening. A copy of the results from a recent resident/parent survey across all of the organisations services was available in the home but it was not clear what the organisation intends to do with the results. A manager from the organisation Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 22 visits the home monthly and prepares a report a copy of which is forwarded to CSCI. The homes fire alarm is tested weekly and practice evacuations are held on a regular basis. The temperature of fridges and freezers in the home was being recorded. Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 23 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 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 2 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 2 x 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Salisbury Park Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 3 3 x 3 3 x F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 24 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 YA20 Regulation 13(2) Requirement The manager must ensure that medicines are only given out in line with the pharmacists instructions and ensure regular audits are accurate. Timescale for action 21/07/05 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 YA26 Good Practice Recommendations The homes manager should ensure that minor repairs detailed in the report are attended to and pay particular attention to the broken bedroom furniture in the smallest of the three bedrooms. The homeowner should consider the current and future needs of the residents before it replaces the walk in shower with a conventional bath. The homeowner should ensure that at least 50 of care staff have an award at NVQ level 2 in care by the end of 2005. The homes manager should ensure that all care staff receive formal one-to-one supervision at least six times each year. The homeowner should make it clear what actions it intends to take following the recent quality assurance survey. F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 25 2. 3. 4. 5. YA27 YA33 YA36 YA39 Salisbury Park 6. YA41 The homes manager should ensure that fire prevention training is updated on a regular basis and that a record of staff attending the training is kept in the home. Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 26 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 Salisbury Park F52_F02_s25164_SalisburyPark_v230533_210705_Stage_4.doc Version 1.30 Page 27 - 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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