Inspection on 18/09/07 for Saughall Road (88)

This inspection was carried out on 18th September 2007.

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) 10/06/06

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 Peter Cresswell Key Unannounced Inspection 18 and 19 September 2007 09:30 th th Saughall Road (88) DS0000019004.V343517.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.V343517.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.V343517.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.V343517.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th June 2006 Brief Description of the Service: 88 Saughall Road is a bungalow in the Saughall Massie area of Wirral. The home provides care and personal support to two people who have a learning disability and need one to one care. Each person has a single bedroom. There is a main lounge, conservatory, dining room, kitchen, walk in shower, bathroom, office and a utility room. There is a large enclosed back garden and car parking space at the front. The home has its own mini bus, so the service users can get to various community facilities. There are three support workers on duty through the day; at night there is one waking member of staff and one who sleeps in the home and can be called on if necessary. Fees are negotiated individually with the commissioning authorities. Saughall Road (88) DS0000019004.V343517.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection included an unannounced site visit during which the inspector spoke to both of the people who live at Saughall Road, the staff on duty and the Registered Manager. He toured the home and looked at documents including care plans and fire safety records. He returned the following day to see recruitment records and staff training records. Before the site visit the manager completed an Annual Quality Assurance Assessment (AQAA). The AQAA is required by the Commission for Social Care Inspection and contains a self assessment of how the service is operating. What the service does well: What has improved since the last inspection? What they could do better: 88 Saughall Road receives very heavy wear and tear, needing a lot of work to keep it in a suitable state of repair and décor. Repairs and maintenance can be slow and the home is not maintained to normal domestic standards in every area. Saughall Road (88) DS0000019004.V343517.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Saughall Road (88) DS0000019004.V343517.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.V343517.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are fully assessed, ensuring that their needs can be met at the home. EVIDENCE: The Statement of Purpose is a general one for Alternative Futures, who are the owners. It should be adapted to reflect the individual philosophy and purpose of 88 Saughall Road. The service user guide also needs to be updated. There have been no new admissions to 88 Saughall Road for many years and one of the current service users will be leaving for a new home in the not too distant future. After that the home will cater for only one person and at that stage the home’s registration will need to be varied. Each of the existing service users has a written contract that includes the weekly fees agreed with the commissioning authority in each case. Saughall Road (88) DS0000019004.V343517.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. 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. The service users’ needs are met on the basis of detailed care planning. EVIDENCE: Both people who live in the home have detailed support plans and care plans which are called ‘Successful Support for (X)’. These include brief summaries of the support needed, pen pictures of the individuals and ‘Top Tips’ for their support. In one case there is a guide to the special ‘language’ that the individual uses. There is a daily diary for each service user and these consist of separate bound books for each person. Staff make entries in them at least three times a day and they describe daily life and activities in some detail. The manager and her staff are preparing Essential Life Planning documents for each service user. It is hoped that these can be more readily updated, especially if computer based records are introduced as planned. The plans are reviewed regularly, with families and other professionals involved, as are the service users if they want to be. Neither service user goes out unaccompanied and a range of detailed risk assessments is in place. The wishes and interests of the service users are at the heart of how the home is organised and they are involved to the best of their ability in all of the Saughall Road (88) DS0000019004.V343517.R01.S.doc Version 5.2 Page 10 decisions made. Advocacy services are available via Wirral Mind, and Alternative Futures organises regular meetings of their service users in the area, though the people from Saughall Road are not usually inclined to attend. All files and notes on the service users are kept securely in the home’s office. Saughall Road (88) DS0000019004.V343517.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. 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. Service users are able to take part in appropriate, community based activities. They enjoy a healthy diet of their own choice. EVIDENCE: Staff have gone to great lengths to become familiar with the very different tastes and wishes of the two people who live in the home. The manager said that the home has good relationships with its neighbours. Activities and routines are structured to help meet those needs, though they are kept as flexible as possible. The home has a minibus which is used to take the service users out, with appropriate staff support. Activities one or both of the service users enjoy include walking, swimming, eating out, going to the local pub, shopping and visiting family. The service users take part as much as possible in everyday activities; one of them for instance is a keen walker and belongs to the Ramblers Association. Both of them pay for holidays; one has already been abroad this year and there are plans for the other to go on a special holiday in France. A menu is planned but it is varied as often as is needed to in line with the service users’ wishes. Staff take care to ensure that this Saughall Road (88) DS0000019004.V343517.R01.S.doc Version 5.2 Page 12 involves a healthy, balanced diet and a full record is kept of the food actually served. Saughall Road (88) DS0000019004.V343517.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal support is provided safely and medication is safely administered. EVIDENCE: Each person has their own bedroom and there are two bathrooms so personal care can be provided in private and with dignity. They receive all necessary community and specialist healthcare services, including visits to GPs, dentists and a ‘well man’ clinic. A record is kept of all contact with all health care professionals. Medication is dispensed every week by a local pharmacist in dedicated blister packs. All medication is recorded on a Medication Administration Record (MAR) sheet. The home has a controlled drugs register should any be prescribed. Liquid medication is measured using a measuring cup as neither service user is inclined to co-operate with the use of a syringe. Where medication is to be administered ‘as required’ (PRN) there are instructions on file as to the circumstances in which it is to be given. All medication is securely stored. One medicine is treated as a controlled drug on senior management advice, though it is not listed as such in the reference books (British National Formulary). This matter should be checked with the home’s pharmacist. Saughall Road (88) DS0000019004.V343517.R01.S.doc Version 5.2 Page 14 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. 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. Service users are protected from abuse by the registered person’s adult protection policies, procedures and training. EVIDENCE: Alternative Futures has a well established complaints system and Safeguarding Adults policies. All staff are trained in safeguarding adults. Over the last twelve months there have for different reasons been three referrals to the local safeguarding procedures, and in each case the incidents and procedures were dealt with appropriately and professionally. Saughall Road (88) DS0000019004.V343517.R01.S.doc Version 5.2 Page 15 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. 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. Saughall Road is homely and domestic in character, providing a suitable and safe environment for the people who live there. EVIDENCE: Saughall Road is a spacious three bedroom bungalow. It has a separate dining room, conservatory and dining room as well as a large, well maintained back garden which is well used. Fencing has been erected to keep all parts of the garden safe for the service users. Furniture is fitted in a way that is suitable for the demands that some of the service users make of it; for instance the televisions are all well protected and boxed in. As a result, the building has a slightly spartan appearance but it is comfortable and well suited to the needs of the people who live there. On the days of the site visit several maintenance items needed to be carried out. These included a number of holes in the plaster in different rooms, a door removed from a cupboard in the dining room, holes in the wall of the main lounge following the removal of pictures, kitchen floor badly marked, cracked floor tiles in the conservatory and broken blinds in the conservatory. In addition the shower room is poorly maintained and needs refurbishment and the carpet in one bedroom needs to be replaced. The manager said that the owners plan to do this work when one of the service Saughall Road (88) DS0000019004.V343517.R01.S.doc Version 5.2 Page 16 users leaves. This is a suitable plan for major redecoration and refurbishment but it is also important that daily repairs are carried out promptly to ensure that the home retains a homely appearance, in accordance with the excellent atmosphere created by staff, management and service users. The home was clean and hygienic on the days of the site visits. Saughall Road (88) DS0000019004.V343517.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are supported by well trained, enthusiastic staff. EVIDENCE: There are always three staff on duty during the day at Saughall Road, reflecting the needs of the people who live there. At night there is one member of staff on waking duty and one sleeping in (in an exceptionally plain staff room). Staff are well trained. All but two now have at least NVQ2 and those remaining two are expected to complete the qualification by December 2007. Training for the newest member of staff has included First Aid, Health and Safety, Food Hygiene, Fire Awareness, Manual Handling, Adult Protection, Understanding Learning Disability and Understanding Challenging Behaviour. Statutory training such as manual handling is renewed annually. Two members of staff are qualified nurses who are currently unable to find work as nurses. There have been a number of team based training days including a personcentred team building day and a course on physical interventions. Staff spoke highly of the owner’s training policies and programmes. Staff who spoke to the inspector were enthusiastic and highly motivated, showing great affection, understanding and care for the people living in the home. Saughall Road (88) DS0000019004.V343517.R01.S.doc Version 5.2 Page 18 Two staff have been recruited since the last inspection and their recruitment records were in order, with all of the necessary checks carried out. All applicants have a second interview in the workplace where service users have the chance to talk to them if they want to, and form a view as to their suitability. The manager supervises staff every two months and is in turn supervised by a locality manager. Saughall Road (88) DS0000019004.V343517.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ safety and welfare is protected by the management of the service. EVIDENCE: The Registered Manager has managed 88 Saughall Road for five years and is well qualified. She has a ‘hands on’ approach to managing the home and all of the staff who spoke to the inspector were enthusiastic and highly motivated. Service users’ families are closely involved with their welfare and are consulted on all aspects of how the home is run. A senior manager with Alternative Futures visits the home at least every month, audits files and completes a report. Fire safety and food safety checks were properly recorded and up to date. Electrical and gas safety certificates were up to date. The owners have a comprehensive range of policies and procedures which are regularly reviewed. The manager and staff do not have access to a computer, which is surprising for such a large agency. This makes some management and administrative tasks rather cumbersome (though the manager does use her own computer to some extent). Alternative Futures has plans to introduce Saughall Road (88) DS0000019004.V343517.R01.S.doc Version 5.2 Page 20 computers in its homes in the near future. The manager has two days set aside for the completion of administrative tasks. If routine paperwork becomes excessive it may be appropriate for the registered person to consider some sort of additional administrative support for the service. Saughall Road (88) DS0000019004.V343517.R01.S.doc Version 5.2 Page 21 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 X 4 X 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 4 33 4 34 4 35 4 36 4 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 X 3 X Saughall Road (88) DS0000019004.V343517.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. 2. 3. Refer to Standard YA1 YA20 YA24 Good Practice Recommendations The statement of purpose and the service user guide should be updated. The status of the medication treated as a controlled drug should be checked with the dispensing pharmacist. Repairs, maintenance and refurbishment should be completed promptly by the registered person. In particular the shower room should be prioritised for refurbishment. 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