Inspection on 24/08/05 for Saughall Road (88)

This inspection was carried out on 24th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Saughall Road (88) 18/09/07

Saughall Road (88) 10/06/06

Saughall Road (88) 01/02/06

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 88 Saughall Road Saughall Massie Wirral CH46 5NG Lead Inspector Leila Mavroupoulou Unannounced 24 August 2005 09:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 88 Saughall Road Address Saughall Massie Wirral CH46 5NG Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0151 678 9751 Alternative Futures Limited Sheridan Green PC Care Home 3 Category(ies) of LD Learning Disability - 3 registration, with number of places 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 4 March 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 a disability. Some of the residents 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 seperate 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 residents 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. 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which lasted for three and a half hours. During this time one of the resident and the three staff were spoken to find out their views about the home. In addition resident and staff records were inspected together with other records the home are expected 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: 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 Page 6 The management should review the range of activities provided to the residents to identify if the activities pursued by the residents is determined primarily by the activity budget. The resident activity should also be linked to the resident’s care plan to give a holistic approach towards the resident’s care. The lock on the front door should be reviewed to promote the health and safety of the resident and staff in the event of a fire. The home must ensure that fire drills are carried out at six months intervals to promote the health and safety of the staff and to meet the requirements of the local fire officer. 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. 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4, The homes Statement of Purpose provides initial information for the prospective resident family to make a decision as to whether the home would be able to meet the needs of the resident. EVIDENCE: The homes Statement of Purpose provides information about the facilities and services offered at the home. The information is presented in pictorial format to enable the prospective service user to understand the information more easily. The homes Statement of Purpose has recently been reviewed to reflect changes in the home. The home has not had an admission for many years. However, discussion with the staff and the home’s admission procedures shows that the staff from the care home would assess the needs of the resident prior to admission to ensure that the home would be able to meet their needs. In addition the admission would be over a period of time to ensure that the move into the care home is least stressful as possible to the resident by ensuring that they visit the home several times, to get to know the other residents, the staff and to become familiar with the environment. The staff at the home commented that it is important that the existing residents compatibility with the new resident is taken in consideration when offering a place at the home. 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 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 standard(s) 6,7,9 The staff supports the residents to make decision over their daily lives to promote their well being and independence. EVIDENCE: Each of the residents have detailed care plans with individual protocols in place specific to the needs of the resident. The protocol gives staff clear guidance to staff on how to manage a particular situation and where to gain additional support and information. In many instances the protocols are developed with other health professionals involved in the resident’s care. The residents care plan are reviewed monthly by their key worker, with appropriate risk assessments in place. The residents’ health needs are reviewed formally every six months in the home and annually by the multi-disciplinary team at Ashton House. The resident’s care plans and risk assessments are amended to reflect the recommendations by the health team. The resident’s family are invited to the reviews and where possible the care plans are developed with the residents’ family. Restrictions placed on the residents are recorded in their care plan, which are in place to promote the safety of the residents. Observation during the inspection show that the residents make decision about their lives as 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 Page 10 evidenced by choice of holiday and one resident during the inspection wanted to go to Kentucky Fried Chicken for his lunch. The home has information on independent advocacy, which the staff or the resident family could access for the residents when necessary. The individual resident activity programme shows clearly that the residents engage in activities with others who do not have the same or similar disability. These include: swimming, rambling, bowling, going to restaurants etc. In addition the residents go to a disco once a week where people with similar disability attend. The activities that the resident’s participate in demonstrate that the residents are supported to take responsible risks after careful assessment of the risks identified. The staff accompanies the resident when they access various community facilities, as they are unable to do so independently. Discussion with staff indicated that assistance would be provided for residents to manage their own finances. Currently, the staff at the care home manages the residents personal allowance and detailed records are kept of all income and expenditure of the residents monies. The home’s financial records are externally audited at regular intervals. All of the residents have their own bank account. 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 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 standard(s) 12,13,14,15,16,17 The staff supports the residents to access community facilities and maintain relationships to promote their emotional well being. EVIDENCE: Inspection of the residents files and individual activities records show that the staff supports the residents to maintain their relationship with their family and friends. The home has an unrestricted visiting policy and the residents’ family could visit whenever they wish. The resident are able to choose where to see their visitors e.g. the communal lounge, dining room or in their bedroom. In addition the staff would take the resident to their family home and collect them at an agreed time. If the resident or the family are unable to cope, the staff would collect the resident earlier than the agreed time. If it the family or the resident wish staff to stay for the duration of the visit this is possible. The residents access a range of community facilities as evidenced in the resident individual activity programme and the daily entries in their diaries. However, the management of the home should review the activities to assess if the activities that the resident engages in meet fully their needs and aspirations as identified in their care plan, or are the activities designed around 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 Page 12 the home’s activity budget? The activities include visit to the leisure centre, walking, shopping trips etc. The home has its own transport enabling the residents to access community facilities when they wish. Inclusive in the weekly fee is a holiday to a certain value. Often, the residents have to make a contribution to enable staff to accompany them on holiday. The resident choose their holiday to reflect their interests. The holidays planned are: one resident is going to the Lake District, one to Butlins and the other to North Wales. Currently, none of the residents engage in any household tasks due to the level of their disability. However, residents’ rights are respected as they can choose to spend time on their own or with others and to participate in activities, which they enjoy such as listening to music, watching videos etc. on their own. Observation of the manner in which staff spoke to the residents and carried out various tasks for the resident such as: the manner in which the residents were spoken to; promoting resident respect by ensuring toilet doors are locked and knocking on doors when entering the resident’s bedroom. The service users have access to all parts of the home including the enclosed rear garden. The home has four weekly menu and a record is kept of all food provided to the residents. The residents are able to choose where to have their meal in the home and the mealtimes are flexible to reflect the resident’s daily activity. Currently, none of the residents required assistance at mealtime or a specific diet. Discussion with staff confirmed that these would be provided as required by the resident once the resident’s needs is assessed by the manager or dietician. 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 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 standard(s) 18,19,20 The staff monitors closely the health needs of the residents to ensure that they access appropriate support from other health professionals to maintain their physical and metal health. EVIDENCE: Currently, all of the residents are mobile and do not require any assistance with transferring. The home does not have any specialist aids to support the residents with activities of daily living, as the residents do not require any assistance. However, any aids and equipment necessary to promote the residents’ health and safety would be obtained as identified in their care plan according to the staff. The Community Psychairtric Nurse monitors one of the resident’s mental health through regular visits. In addition the residents receive three monthly health checks from their GP. Residents also have regular health checks from the dentist, optician and chiropodist. Each of the resident has a key worker that work more closely with the resident. The staff at the care home records the resident verbal and non verbal communication to enable staff to understand the needs of the resident as one of the resident has no verbal communication and the other uses some words and signs which is unique to them. 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 Page 14 The home maintains an accurate record of the residents’ medication received into the care home, its administration to residents and any medication returned to the pharmacist. Discussion with staff indicated that staff that have responsibility for administration of resident’s medication receives basic training. 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 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 standard(s) 22,23 The home has various policies and procedures relating to abuse to protect the residents. EVIDENCE: The home has various policies and procedures in place to protect the residents from all forms of abuse. These include Whistle Blowing Policy. These areas are covered with the staff during their induction as well the staff attending formal training courses on the Protection of Vulnerable Adults. All staff receives regular training on managing physical and verbal aggression to ensure that their knowledge and skills are current. Discussion with staff indicated that there are occasions when they have had to diffuse situations when the resident has been physically abusive. Following these incidents staff complete a full report of the events leading up to the situation and what action was taken to enable staff to learn from the situation and where necessary for the management team to review care practices. The home implements fully its procedures on allegations of abuse as evidenced by a recent incident in the care home. The home has a complaints procedure which families and others using the service are encouraged to use. The home has had no complaints since the last inspection. 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 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 standard(s) 24,26,30 The home is well maintained internally and out to promote the safety of the residents. EVIDENCE: The home is very in keeping with the other houses in the local community. It provides a homely environment for the residents and appropriate to meet their needs. The home is bright, clean and free from any malodour and suitable for its purpose. All parts of the home are easily accessible to the residents as all of the accommodation is on the ground floor as the house is a bungalow. The bathing and toilet facilities are suitable to meet the needs of the residents as they are all mobile and do not require any assistance with transferring. The furnishings in the home are domestic in characters and of a good quality. However, many of the items have been secured and kept in locked in cupboards when not in use for the safety of the residents as identified in their care plans. The home does have a planned renewal programme for decoration and refurbishment as well as routine maintenance work to ensure the safety of the residents. 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 Page 17 The dining and sitting room could be used for a variety of activities as required by the residents. The residents bedrooms are designed with furnishings specific to meet their needs. These include a wallboard in their bedroom, which they could write on, electrical appliances are secured to the wall in cupboards etc. The residents are supported in choosing the colour scheme for their bedroom and the purchasing of bedding to reflect their taste and preference. Observation of the residents bedroom show that their bedroom is personalised with posters, videos, CDs, books etc reflecting their likes/interests. The home has various policies and procedures in place to control the spread of infection. The homes laundry area is separate to the food preparation area. 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,35,36 The staffing level at the care home promotes the safety and independence of the residents. EVIDENCE: Discussion with staff and observation during the inspection show that the staff have the necessary skills and understanding in meeting the needs of the residents. Staff training is geared specifically to meeting the specific needs of the residents e.g. sexuality, seizures etc., as well as the required training of the National Minimum Standards. Inspection of the staffing rota and discussion with staff demonstrate that the staff have the time to work with individual residents without interruption as there are always three staff on duty throughout the day and one waking staff at night plus one staff that work a sleep in duty. The staff have a good rapport and are able to communicate effectively with the residents as observed during the inspection. Many of the staff have completed their NVQ level 2 Care qualification and all are working towards the LDAF award. Currently, over 50 of the staff are have an NVQ level 2 qualification or above. The staff informed the inspector that staff have attended the following training courses since the last inspection: Calm and Restraint, Fire Safety, Food Hygiene and Protection of Vulnerable Adults. 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 Page 19 Discussion with staff indicated that the registered manager has one to one supervision with the staff approximately every six weeks and a record is maintained of staff supervision. The staff said that the areas discussed in supervision would include staff performance and training and development needs are discussed. T 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,42 The home promotes the safety of the residents through regular maintenance of the home and staff training. EVIDENCE: The management of the home regular monitors the quality of the care provided at the care home through a comprehensive and detailed monthly audit in all aspect of the operation of the home. The Responsible Person forwards a copy monthly audit to the Commission. The areas covered in the audit include inspection of the premises, staff training, residents’ records residents’ monies, fire book etc. All staff are inducted into their role and work in accordance with the Sector Skills Council specifications. Discussion with staff indicated that all staff receives training on moving and handling, first aid, food hygiene and fire awareness. This could not be evidenced in staff training records, as the registered manager was not on duty. The home’s fire logbook showed that regular fire checks are undertaken. The registered manager should ensure that a fire drill is carried out as the last fire drill was in December 2004 according to the records seen. 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 Page 21 The home maintains a record of all accidents to residents and staff and where necessary would inform the appropriate body as evidence recently of an accident reported to the Commission. 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score 3 3 x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 88 Saughall Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 2 x F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 Page 23 yes 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 42 Regulation 23 Requirement The registered person must ensure that fire drills are carried out in accordance with the recommendation of the local fire officer. Timescale for action 20th October 2005 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 14 Good Practice Recommendations The registered person should review the homes activities budget to assess if the activities provided are determined by the budget or in accordance with the service user care plan. 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 3rd Floor 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 88 Saughall Road F52 F02 S000019004 88 Saughall Rd V247192 240805 Stage 4.doc Version 1.40 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!