Inspection on 01/02/06 for Saughall Road (88)

This inspection was carried out on 1st February 2006.

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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Saughall Road (88) 18/09/07

Saughall Road (88) 10/06/06

Saughall Road (88) 24/08/05

Saughall Road (88) 04/03/05

Saughall Road (88) 06/09/04

Saughall Road (88) 29/01/04

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 Saughall Road (88) 88 Saughall Road Saughall Massie Wirral CH46 5NG Lead Inspector Leila Mavropoulou Unannounced Inspection 1st February 2006 03:00 Saughall Road (88) DS0000019004.V282120.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 Saughall Road (88) DS0000019004.V282120.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. Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Saughall Road (88) Address 88 Saughall Road Saughall Massie Wirral CH46 5NG 0151 678 9751 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) Alternative Futures Limited Sheridan Green Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th August 2005 Brief Description of the Service: 88 Saughall Road is a bungalow in the Saughall Massie area on the Wirral. It provides care and personal support to three men under the age of 65 years that have learning disability. Some of the service users require one to one care throughout the day. All accommodation is provided in single bedroom. The home has a walk in shower, bathroom, sitting room and a separate bathroom. There is a large enclosed garden to the rear of the building and in the front garden car parking space is provided. The home has its own mini bus, thus allowing service users to access various community facilities. The home is staffed with three support workers throughout the day and one waking staff night plus one staff doing a sleeping duty. Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which lasted for two and a half hours. During this time one of service user and the three staff were spoken to find out their views about the home. Service users and staff records were inspected together with other records such as: fire records, accident book etc. The building was also inspected. What the service does well: What has improved since the last inspection? What they could do better: To review the compatibility of service users and work towards providing accommodation that support their individual needs. To demonstrate that service users are given the opportunity to engage in different activities other than what is being pursued currently. Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 Page 6 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. Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 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 Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 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): 1,2,3,4,5 The admission process of a new service user is over several months to ensure that the service is confident in meeting the assessed needs of the service user and that they are compatible with existing service users. EVIDENCE: A Statement of Purpose has been produced in a pictorial format to improve service user understanding of the services and facilities provided at 88 Saughall Road. The registered manager should review the Statement of Purpose to ensure that it continues to reflect accurately the qualification of staff at the care home. The service has not had an admission for many years. However, discussion with the registered manager and the home’s admission procedure indicate that before a decision is made regarding the suitability of a service user an initial assessment would be made by the registered manager and that the assessment would be ongoing for several months. This would include a number of short stays at the care home to assess their needs within the service environment and their interaction with existing service users and staff. The information obtain during the admission process would be used to inform the service user initial service user plan and risk assessments. Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 Page 9 Service users are provided with a licence agreement of the service showing what is included in their weekly fees. Service users files show that they are informed of increases in their weekly fees. Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 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 the following standard(s): 6,7,8,9,10 Service users exercise control and make decision over their daily lives within certain constraints to promote their health and safety. EVIDENCE: Service users have a detailed service user plan, which is reviewed by their key worker regularly. In addition, formal reviews are held every six months at Ashton House where service users needs are discuss by a multidisciplinary team or at the care home when the service user family or their representatives are invited. Currently, the staff are working with a behavioural nurse to develop a Person Centred Plan to meet service user needs. Observation, discussion with staff and entries in service users daily records demonstrate that service users make decision over most aspect of their daily lives such as: how to spend their day, participation in leisure activities etc. Service user family are consulted about the service user plan and to promote the interests of the service users. Information is available for accessing independent advocacy when the service user requires someone to promote their interests. Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 Page 11 Service users participate in the recruitment of staff to the service. This is achieved through prospective employees being invited to the home to assess how they interact with service user and to gauge service users feelings through their behaviour and other non-verbal communication. Staff accompany service user at all times outside the home. Service user risk assessments show that risk outside of the service are considered and strategies are developed to minimise these to enable service users to engage in community activities such as: shopping, going swimming etc. Confidentiality of service users information is maintained, as their records are kept in a secure place. Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 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 the following standard(s): 11,12,13,14,15,16,17 The staff supports service users to maintain a lifestyle that reflect their needs and preferences. Thus promoting their rights as an individual. EVIDENCE: The service users engage in activities in the home and access community facilities according to their individual needs, interests and capabilities. This is evidence in the individual service user activity programme. Currently, one service user is being assessed to attend college. Discussion with staff indicated that they are constantly looking for new activities, which service users may wish to participate in. Service users records show that they access various community activities regularly. Some of these are planned, whilst others are accessed on the day depending on service user wishes. The home has a mini-bus, which allow service user to access community services easily as there is no reliance on transport being provided by an external agency. Service users ability to access community services is not determined by staffing level at the care home, as Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 Page 13 there are always three staff on duty throughout the day. Service users access the following regularly: local shops, leisure centres, social clubs, rambling group, pubs etc. The staff bring into the care home information of local activities/events to enable service user to decide if they wish to attend. A holiday is included in the service users weekly fees. The service users are involved in deciding where they wish to go on holiday. Staff carries out risk assessment on the holiday venue before booking holiday to promote the safety of service users. Last year one service user went to Ribby Hall, one went on a walking holiday and the other went on a caravan holiday in the Lake District. The staff support service users to maintain and develop contact with their families. This is evidence by one service user going home weekly for the day and others receiving regular visit from friends and family. Strategies are in place if home visits have to be curtailed for whatever reason to minimise anxieties for both the service user and the person they are visiting. The home has an unrestricted visiting policy. Service users have access to all parts of the home and are able to choose whether to be on their own or to be with others in the communal areas. Currently, the service users are not responsible for household tasks because of their disability. Mealtimes are very flexible at the care home as evidenced in the weekly activity programme. The service users frequently have their meals in local restaurants or are taken out for a meal if they wish. A record is kept of all food provided to service users. Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 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 the following standard(s): 18,19,20,21 The staff provide personal and health care to service users in manner that promote their rights to privacy and dignity. EVIDENCE: Service users have a key-worker who support the service user in making choices/decisions. The service users are involved in deciding their key-worker through their interaction with staff, as the communication of some service users is limited. Currently, service users do not require aids to assist with transferring or other specialist aids to promote their independence. The staff monitor closely the health needs of the service users and advice is sought from the service user GP in the first instance. Service users receive regular health checks from their GP, dentist, chiropodist, optician, dentist etc. as evidence in their records. The service maintains a record of all service users medication received into the care home, administered and returned to the pharmacist. The home uses a monitored dosage system for the administration of service users medication. The registered manager should request that the dispensing pharmacist provide a description of service user medication on the back of the blister pack. Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 Page 15 Where possible staff discusses with the service user family their wishes in the event of the service user becoming terminally ill. Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 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 the following standard(s): 22,23 The service takes appropriate action on alleged incidents of abuse in accordance with the service policy and Wirral Adult Protection of Vulnerable Adult procedure promptly, to protect service users. EVIDENCE: The registered manager support and encourage service users and their family to raise concerns regarding the quality of the service provided. Wherever, possible the registered manager would address their concerns informally, before it develops to the point where it has to be addressed through the formal complaints procedure. The service has a complaints procedure, which sets out the timescales when any investigation would be completed and by whom. All staff have attended training on the management of physical and verbal aggression. There has been one alleged incident of abuse at the care home since the last inspection. This was investigated with other external agencies. Policies and procedures are in place to protect service users from financial abuse. This is achieved through maintaining written records of all incoming and outgoings payments from service users accounts. The Responsible Person checks the service users financial records on their monthly visits. Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 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 the following standard(s): 24,26,27,28,30 The service is well maintained and furnished accordingly to protect and minimise harm to service users EVIDENCE: 88 Saughall Road is a bungalow with a large enclosed garden to the rear of the property. All parts of the service are easily accessible to the service users. The property is in keeping with other properties in the street. It is well maintained both internally and externally. The home is furnished to reflect the assessed needs of the service users, yet striving to maintain a homely environment, as furnishings must be secured to the wall and equipment such as: televisions are stored where they can be locked away to protect service users. Wherever, possible domestic furnishings are used and service users bedrooms are decorated and furnished to reflect their taste and preferences. The rooms are bright and well ventilated. The bedrooms have adequate number of electrical outlets for service users electrical appliances. There are two communal rooms a sitting room and a dining room. Both of these areas could be used for a variety of purposes. All service users accommodation is in single bedrooms. Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 Page 18 The toilets and bathrooms meet the needs of the service users. There is a walk in shower, bath and two toilets in the care home. It was noted that the radiator in the office was not working properly. Discussion with the staff indicated that there have been some problems with the boiler recently and that the heating engineers were called out several times. The service has a separate laundry area and policies and procedures are in place to minimise the spread of infection. Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 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 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): 31,32,33,34,35,36 The staff at the care home has the necessary skills and experience to promote service users individual needs and integration into community life. EVIDENCE: Staff have the time to get to know and develop relationships with the service users. This is particularly important for the service users at Saughall Road because of their individual needs. The staff group at Saughall Road have a good gender mix of staff to ensure that the needs of the service users are met, as all of the service users are male. Discussion with staff indicated that they are aware of their knowledge and skills limitations and would seek advice and support from others with more specific expertise as evidenced in the service users files. Observation of staff showed that they are accessible and have a good rapport with the service users. All staff have attended training on understanding physical and verbal aggression as service users present challenging behaviour on occasions. Discussion with the registered manager indicated that the service has good professional relationships with service users GP, social workers, etc. Most of the staff are working towards the NVQ level 2 Care qualification or have completed the award and are awaiting their certificates. Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 Page 20 The staffing level at the care home equate to one to one care for all service users between 8:00 to 22:00 hours. There is one waking staff at night and one sleeping in. A manager is on call for to provide advice and support. The service has low staff turnover and sickness level is relatively low. Wherever, possible the existing staff would provide cover to promote continuity of care to service users, as it is difficult for a new staff to provide suitable care and support to service users without shadowing another member of staff for some time because of service users limited communication skills and behaviour. The staff at the care home continues to receive ongoing communication training to improve their understanding of service users needs. The service obtains two written references and a Criminal Record Bureau check for all staff before they commence their employment at the care home. All staff are inducted into their role and receive within six months of commencing their employment the training required to meet the TOPPS induction specification. The registered manager ensures that staff attend refresher training courses in: food hygiene, first aid, fire awareness, health and safety, fire awareness, calm and restraint etc. to maintain their skills and knowledge. Discussion with staff and staffing records showed that the manager has regular supervision with staff and a record is maintained of issues discussed. Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 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 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): 37,38,39,40,41,42 The registered manager strives to improve the quality of the service at Saughall Road to meet the goals of the service users, as identified in their Personal Development Plan. EVIDENCE: The registered manager at Saughall Road has worked with the service users for many years. She continues to improve her knowledge and skills of the needs of the service users by attending various courses. She has recently completed the A1 NVQ Assessors Course. This would benefit the service, as she would be able to assess the staff working towards their NVQ Care qualification. Regular staff meetings are held and a coffee morning is held monthly for family and friends to visit the home to discuss with the registered manager and staff any issues, as the registered manager may not be on duty when the family normally visit. Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 Page 22 The quality of the service is monitored by the monthly visit by the Responsible Person and a report of their visit is forwarded to the Commission. The service complies with requirements identified in the Commission for Social Care inspection reports within agreed timescales. Alternative Futures has recently developed a forum where service users meet the managers of Alternative Futures of discuss and give their opinion about the quality of the service. 88 Saughall Road is part of Alternative Futures. The policy department reviews the care home policies and procedures to ensure they continue to reflect current legislation and best practices. The records at the care home are well maintained and kept in a secured place. The service promotes the health and safety of service users and staff through regular check of equipment used at the care home (fire check, fridge temperatures, hot water, small electrical appliance test current, fire risk assessment). The registered manager ensures that staff have the necessary skills and knowledge to carry out their roles effectively to promote the health and safety of service users. A monthly environmental audit is carried out to ensure the safety of the building. This is to minimise risks to service users. A copy is maintained of all incident/accidents at the care home and the Commission is informed promptly of significant incidents to service users and staff. Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 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 Standard No Score 1 3 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 X 26 2 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 3 3 3 3 Saughall Road (88) DS0000019004.V282120.R01.S.doc Version 5.1 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 YA24 Regulation 23 Requirement The registered person must ensure that the heating system in the care home is in good working order. The registered person must replace the carpet in the bedroom nearest to the office at is worn and dirty. Timescale for action 20/03/06 2 YA26 16 30/04/06 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 YA1 YA20 Good Practice Recommendations The registered person should review the Statement of Purpose to ensure it reflect the current staff group qualifications. The registered person should ensure that the dispensing pharmacist provide a description of tablets contained in the blister pack. Saughall Road (88) DS0000019004.V282120.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 Saughall Road (88) DS0000019004.V282120.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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