Inspection on 09/01/06 for Salisbury Park (31)

This inspection was carried out on 9th January 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 no outstanding requirements from the previous inspection report, but made 7 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) 21/07/05

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) 31 Salisbury Park Woolton Liverpool Merseyside L16 0JT Lead Inspector Lynn Sharples Unannounced Inspection 9th January 2006 11:00 Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 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 Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 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. Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Salisbury Park (31) Address 31 Salisbury Park Woolton Liverpool Merseyside L16 0JT 0151 722 9729 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) Community Intergrated Care Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st July 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 (31) DS0000025164.V276436.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home did not know about the visit and it took two and half hours. The inspector read files, spoke and spent time with service users, the manager and one member of staff. 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. Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 The homes’ Statement of Purpose needs improving and the Service User Guide needs to be made available for inspection. The Statement of Purpose does not provide sufficient information for prospective service users to be clear about the services the homes provides to meet their needs. EVIDENCE: The home has a Statement of Purpose that does not contain all the items listed in Schedule 4 of the National Minimum Standards, Care Homes for Younger Adults. The manager could not find the Service User Guide and said that this would be addressed today. 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. Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 Page 8 Good quality assessments had transferred with the residents and were being maintained through the care planning and review processes. Two of the residents care files was examined during the inspection. It contained an Assured Tenancy Agreement for Maritime Housing, who owns the property and a set of terms and conditions of residency provided by CIC. Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 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, Service users needs are reflected in their care planning and they are supported in making decisions and taking risks as part of their lifestyle and routines. EVIDENCE: The home operates a key worker system and each service user has an Essential Lifestyle Plan (ELP) that provides holistic information regarding their assessed needs, likes/dislikes, personal goals etc. In addition, service users have a care plan, which documents how individual needs are generally met. 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. Care plans identify that residents must be able to make decisions about their daily life. None of the three residents are able to communicate verbally and they do not have Makaton or other communication skills to convey their wishes. However, the staff team 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 through observation that the staff team in Salisbury Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 Page 10 Park respect the residents’ wishes and are expected to work with them to ensure they are supported safely. 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. Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 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): 12,13,14,15,16,17. The service users engage in community and leisure activities appropriate to their age. There is no evidence that the service user is offered quality meals and that the nutritional needs of the service user is being met. 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. Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 Page 12 The home is situated on a small private housing estate and there is little contact with neighbours but staff team take residents to the local shops and use community facilities such as pubs and cafés. On the day of the inspection, the staff were observed interacting appropriately with the service users and treating them with respect. There is a meal plan in the kitchen, but this is used as a guide. There are no records kept of the meals the service users eat and no evidence that the service users have a well-balanced nutritional diet. The manager said that this would now be included on the social inclusion sheet in each service users file. Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 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. There is a clear care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users needs. The medication at the home is well managed promoting good health. 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. The care plans and risk assessments need reviewing. Most of the care plans are written on old forms from the last home they lived at, they need updating. Resident’s files contained sections for staff to record contacts with health care professionals. All the service users have a Health Action Plan. 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. However, one service user did not visit the chiropodist any more and the staff team were cutting their nails, the staff had not been trained to do this. Also, on one service users risk assessment it is recommended that they visit the opticians and no record could be found to indicate that they had visited the opticians in the last twelve months. Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 Page 14 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. Home remedies were also kept in the locked cabinet that did not belong to the service users; the manager said they would address this today. The inspector recommended that patient information leaflets regarding all the medication in the home be kept with the MAR sheets. Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 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 Staff have a good knowledge and understanding of Adult Protection issues, which protects service users 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. Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30. The standard of the environment within the home is good providing service users with a homely place to live. 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. The lounge dining room is well fitted out and is decorated in a modern domestic style. The inspector recommended that a risk assessment is completed for the fireplace, some of the service users have epilepsy can could injure themselves if they fell against the fireplace. 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. One seen by the inspector was well decorated and furnished and had patio doors leading to the garden. The smallest room has damaged bedroom furniture and the manager said that this would be addressed soon, the other bedroom could benefit from pictures being placed on the walls to make this more homely. Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 Page 17 The home has a small shower room that is mainly used by staff and a “walk in shower room for residents. The manager informed the inspector that the shower chair was too small; the inspector recommended that they contact an occupational therapist to address this. The shower floor was slippery and two tiles were cracked. The manager said that a new floor would be put in soon. 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. The home was clean and free from malodour on the day of the inspection. Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 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): 31,32,33,35,36 The staff team are enthusiastic and work positively with service users to improve their whole quality of life. EVIDENCE: The organisation has robust employment policies in place that ensure all members of staff have job descriptions and contracts of employment. There are six care staff and four members of staff currently holds an award at NVQ level 2. The staff duty roster indicated that there was a low sick leave at the home and six of the staff had worked at the home for over 12 months. There are problems with keeping records and on the day of the inspection the manager could not find records of staff meetings. He has recently purchased a locked cabinet and will keep a record of staff meetings. 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. Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 Page 19 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. Not all the staff team have received five paid days training and the manager should ensure that specialist training is provided, for example epilepsy. There was no record of staff supervision last year, the manager has completed some supervision with staff this year and these are recorded. Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 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): 37,39,42,43 The management of the home is satisfactory overall but records are not well managed. This practice could potentially place the services at risk. The lack of a registered manager leaves the home without effective leadership and supervision. EVIDENCE: The manger is not registered with CSCI, they have recently started their NVQ 4 award. He has worked with the current group of residents for some considerable time. The home carries out regular quality assurance audits and the Service Manager visits the home monthly and also carries out a thorough audit of service users’ health and welfare, accidents, risk assessments both personal and environmental, staffing levels and other issues. The Fire Safety officer have not visited the premises, the inspector strongly recommended that they contact them to rectify this. The fire drills were out of Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 Page 21 date; only one drill had been completed last year. The fire blanket in the kitchen had not been checked since February 2004. The home has a robust financial audit, which was recently undertaken. The inspector examined one service users finances and was found to be correct. Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 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 2 2 3 3 3 4 3 5 3 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 3 26 2 27 3 28 3 29 2 30 3 STAFFING Standard No Score 31 3 32 3 33 2 34 X 35 2 36 2 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 X 12 3 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 2 X 3 X X 2 3 Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 Page 23 No 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 YA1 Regulation 4,5 Requirement Timescale for action The responsible individual should 13/02/06 ensure that home has a Statement of Purpose that includes all the items in Schedule 1. The Service User Guide should be completed and available to read. The home must ensure that records of food provided for the service user is available. The responsible individual should ensure that the service users have access to a chiropodist/podiatrist and opticians. The responsible individual should ensure that no other medicines are kept in the locked cabinet other than service users. The manager should ensure that staff have regular, recorded supervision meetings at least six times a year. The responsible individual must ensure that the home has a DS0000025164.V276436.R01.S.doc 2 YA17 17(2) 13/02/06 3 YA19 13 (1b) 13/02/06 4 YA20 13 (2) 11/01/06 5 YA36 18 (2) 06/03/06 6 YA37 8 27/03/06 Salisbury Park (31) Version 5.1 Page 24 registered manager in post. 7 YA42 23 (4) The responsible individual should ensure that the home is visited by a fire officer and fire drills are completed twice a year. The fire blanket needs maintaining regularly. 27/03/06 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 Refer to Standard YA24 Good Practice Recommendations It is recommended that the home’s manager ensure that the premises meet the requirements of the local fire service and environmental health department. It is recommended that the homes manager 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 and the broken tiles in the shower room. It is recommended that the home’s manager consult with a suitably qualified specialist regarding the shower chair. It is recommended that regular staff meetings take place and are recorded and actioned. It is recommended that the home’s manager ensure that all staff have an individual training and development assessment and profile and at least five paid training and development days (pro rata) per year. 2 YA26 3 4 5 YA29 YA33 YA35 Salisbury Park (31) DS0000025164.V276436.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 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 (31) DS0000025164.V276436.R01.S.doc Version 5.1 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. 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