Inspection on 10/06/06 for Saughall Road (88)

This inspection was carried out on 10th June 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Saughall Road (88) 18/09/07

Saughall Road (88) 01/02/06

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 Key Unannounced Inspection 10th June 2006 2:30 Saughall Road (88) DS0000019004.V296369.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Saughall Road (88) DS0000019004.V296369.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Saughall Road (88) DS0000019004.V296369.R01.S.doc Version 5.2 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.V296369.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 1st February 2006 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.V296369.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was unannounced inspection, which lasted two hours. During which time care provided to service users was observed and two staff were spoken to. One service user was spoken to and two staff members. A tour of the building was undertaken and service users plans, risk assessments and other records relating to the building was inspected. At the time of the inspection the registered manager was “hands on” and did not have access to staff records. What the service does well: What has improved since the last inspection? What they could do better: The home is continually working towards reviewing the quality of the service provided. The service could review the range of activities provided to service Saughall Road (88) DS0000019004.V296369.R01.S.doc Version 5.2 Page 6 users and to assess if recreational budget is a limiting factor in facilities accessed. 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.V296369.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Saughall Road (88) DS0000019004.V296369.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5, “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” The admission procedure of the service ensures that service users would be met at the care home. EVIDENCE: A Statement of Purpose is in pictorial format to enable prospective service user to understand the services and facilities offered 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. Given the future plans as discussed for 88 Saughall Road it is unlikely that further admissions would be made to the care home. However, the service admission procedure and discussion with the registered manager indicated that the process of admitting a service user to the home would be over a period of time to ensure their compatibility with the other service users and that the staff have the necessary skills and experience to meet the needs of the service user. Saughall Road (88) DS0000019004.V296369.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” Staff monitor the social and emotional needs of service users and ensure that specialist health professional are involved in their care to promote their health and wellbeing. 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 discussed 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 decisions 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 Saughall Road (88) DS0000019004.V296369.R01.S.doc Version 5.2 Page 10 the interests of the service users. Information is available for accessing independent advocacy when the service user requires someone to promote their interests. 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.V296369.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” 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 evidenced in the individual service user activity programme. Discussion with staff indicated that they are constantly looking for new activities, which service users may wish to participate in. The registered person should consider if activities provided to service users is limited because of limit of activities budget. Saughall Road (88) DS0000019004.V296369.R01.S.doc Version 5.2 Page 12 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 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. Individual holidays are planned with service users: one is going to Scotland, one to the Lake District as they both like walking and the other is going to Raby Hall as there is a wide range of activities for service user to participate in. The staff support service users to maintain and develop contact with their families. This is evidenced 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.V296369.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,29,21 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” Staff monitor the social and emotional needs of service users and ensure that specialist health professionals are involved in their care to promote their health and wellbeing. EVIDENCE: Service users key-worker support them 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. Saughall Road (88) DS0000019004.V296369.R01.S.doc Version 5.2 Page 14 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. Where possible staff discuss with the service user family their wishes in the event of the service user becoming terminally ill. Saughall Road (88) DS0000019004.V296369.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” 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.V296369.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” 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. Saughall Road (88) DS0000019004.V296369.R01.S.doc Version 5.2 Page 17 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. 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.V296369.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33, 34,35,36 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” The staff have the necessary skills and experience to provide appropriate care to service users. EVIDENCE: The staffing level ensures that staff have the time to get to know and develop relationships with the service users. Continuity of staff working at the care home is essential for the wellbeing of service users as they have very complex needs and one service user communication is impaired. There is a good gender mix of staff group at Saughall Road to ensure that service users have a diverse experience of support when meeting their social and physical needs. Service user files examined showed that staff are aware of their knowledge and skills limitations and advice and support would be sought from others that have specialist knowledge. 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. Saughall Road (88) DS0000019004.V296369.R01.S.doc Version 5.2 Page 19 Many of the staff are working towards the NVQ level 2 Care qualification. 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 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. One new members of staff has been recruited since the last inspection. However, it was not possible to evidence that that Criminal Record Bureau check was obtained and two written references for the employee as the registered manager was working “hands on” and did not have the key to staff files with her. This information was to be forwarded in the Pre-Inspection Questionnaire. Previous inspection showed that the staff recruitment procedure met the requirements of the Care Home Regulations 2001. Discussion with staff indicated that they are inducted into their role and receive within six months of commencing their employment the training required to meet the Sector Skills Council workforce training targets. Discussion with the registered manager indicated that training is planned for staff to attend refresher training courses in: food hygiene, first aid, fire awareness, health and safety, calm and restraint etc. to maintain their skills and knowledge. Discussion with the registered manager indicated that staff receive regular supervision and a record is maintained of issues discussed. Saughall Road (88) DS0000019004.V296369.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41, 42,43 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” 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 continues to improve her knowledge and skills by attending various courses. She has recently attended a training course on developing Person Centred Care Planning, as this would benefit the service users and enable her and team to develop the future plans of the care home to meet the service user future needs. There is ongoing staff supervision, house meetings, which is attended by both service users and staff. There is a coffee morning once a month where family and friends are able to visit the home and the registered manager is available Saughall Road (88) DS0000019004.V296369.R01.S.doc Version 5.2 Page 21 to discuss any issues family may have, as she may not be on duty when they visit. The Responsible Person visit the service at least once a month 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. The policies and procedures are reviewed centrally and copies of the amended policies are sent to the home, which is dated and initialled by the registered manager. Observation of service users records showed that they are well maintained and kept in a secured place. The pre-inspection questionnaire show that regular check of equipment used at the care home (fire check, fridge temperatures, hot water, small electrical appliance test current, fire risk assessment) is carried out to promote the health and safety of service users. Staff receive ongoing training and refresher training courses are attended by staff to ensure that their knowledge and skills are current. The induction process and recruitment procedure for new staff ensures that they have the necessary skills and knowledge to carry out their roles effectively to promote the health and safety of service users. An environmental audit is carried out monthly to promote a safe environment for service users. A record is kept 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.V296369.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 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 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 X 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 3 3 3 3 3 3 3 3 Saughall Road (88) DS0000019004.V296369.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action 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 YA14 Good Practice Recommendations The registered person should review the Statement of Purpose to ensure it reflect the current staff group qualifications. Saughall Road (88) DS0000019004.V296369.R01.S.doc Version 5.2 Page 24 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.V296369.R01.S.doc Version 5.2 Page 25 - 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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