CARE HOME ADULTS 18-65
Scope 1 and 3 Edward Street Widnes Cheshire WA8 0BW Lead Inspector
Maureen Brown Unannounced Inspection 22 & 27 February 2006 09:30
nd th Scope DS0000005178.V279636.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 Scope DS0000005178.V279636.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. Scope DS0000005178.V279636.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Scope Address 1 and 3 Edward Street Widnes Cheshire WA8 0BW 0151 420 3364 0151 420 3364 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) SCOPE Johanna Bunting Care Home 6 Category(ies) of Physical disability (6) registration, with number of places Scope DS0000005178.V279636.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. This home is registered for a maximum of 6 service users in the category of PD (Physical Disability). The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance issued through the Commission for Social Care Inspection. 4th November 2005 Date of last inspection Brief Description of the Service: 1-3 Edward Street is a purpose-built care home providing personal care and accommodation for 6 service users who have physical disabilities. The home is located in a residential area of Widnes and is within easy access of local amenities including shops, social and educational facilities. The premises consist of two bungalows (each accommodating three service users), which are managed by Scope. Each bungalow comprises of three single bedrooms, a kitchen/dining area, lounge, bathroom, separate shower room and a utility room. There is a separate office that is linked by a door to one of the bungalows. There are also pleasant and accessible garden areas to the side and rear of the home that are fully accessible to service users. Limited car parking space is available at the home. Parking on the road outside the home is available. Scope DS0000005178.V279636.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Maureen Brown carried out this unannounced inspection on 22nd and 27th February 2006. The total time at the home was four and three-quarter hours. Half an hour was spent planning the inspection by reviewing the previous inspection report and the service history. The inspection included a tour of the bungalows and an inspection of records. On the first day discussions with four residents, the senior care assistant and supporting staff on duty were held. On the second day discussions were held with the registered manager. Most of the inspection was completed on the first day however some information to which the manager only had access was required. An appointment was made to view this and a short visit was made on the second day. Fifteen out of forty-three standards were assessed and most were met. Two relatives, one GP and one social worker comment cards were received. Feedback from this inspection was given to the manager at the end of the inspection. What the service does well:
The home had an established staff team who were keen for high standards to be maintained at Edward Street. Residents’ plans of care and individual case notes were well documented and reflected each resident’s needs. Residents are actively involved in their care planning with support from the staff team. Relationships between residents and staff are good. Residents are able to approach staff for help with personal and other needs. The home provides sufficient numbers of staff to meet residents’ needs and there is always a senior person on duty. Staff are provided with an induction programme and ongoing training and development. Many of the staff had NVQ level II and others were working towards this award. One member of staff was working towards NVQ level III. All staff had completed the mandatory training. The home provides a good variety of relevant training and staff said that the training was good. Meals were varied and reflected each person’s preference. They offered choice and variety and the menus were well balanced. Residents said that they complete the shopping list and therefore choose what they want to eat. Also residents assist staff in the purchase of food on a weekly basis. Scope DS0000005178.V279636.R01.S.doc Version 5.1 Page 6 The home was clean and suitable and sufficient equipment is provided to meet the needs of the residents. The staff managed daily activities and entertainments well and provide a wide range of choice. Residents said they were pleased with the choices on offer. Relatives stated on comment cards that they were satisfied with the overall care provided at Edward Street. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Scope DS0000005178.V279636.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 Scope DS0000005178.V279636.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 Sufficient information is provided for residents to make a decision about moving into the home. EVIDENCE: The home had a statement of purpose and service users guide that contained all the information required for people to make a decision about moving into the home. These documents included general information about the home, a description of the facilities, the fees charged, a copy of the complaints procedure and the details of the registered provider, manager and staff. Each resident had a copy of the home’s statement of purpose and function and the service users guide and these were kept with the resident’s plan of care in their own bedrooms. A copy of the most recent inspection report was available in the office and staff were aware of this. Scope DS0000005178.V279636.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 & 10 The residents’ health, personal and social care needs are met by the staff team who enable them to maintain their privacy and dignity. EVIDENCE: Two residents’ care records were seen during this inspection. These were comprehensive and well presented in individual ring binders. Each contained sufficient information for staff to appropriately meet the needs of the residents. Monitoring sheets, 24-hour summary sheets, visiting professionals’ sheet and risk assessments were included in the care plans. The care plans were drawn up in consultation with the residents and family members and were based on their assessed needs and risks. Care plans were reviewed on a monthly basis, in conjunction with the residents. From a previous recommendation agreements with the GP’s with regard to homely remedies had been set up but were signed by the GP’s to show their knowledge and agreement of the document. New visiting professional sheets and weight record charts had been placed into the care plans in line with the new-year. It is recommended that the last
Scope DS0000005178.V279636.R01.S.doc Version 5.1 Page 10 record of the previous year be transferred to the new sheet to enable ease of reference of information. Daily record sheets seen showed that day-to-day activities were recorded. This enabled staff and family members to see what a particular resident was undertaking during the day. They were written clearly, easy to follow and were signed by carers. It was recommended that abbreviations be avoided in completing daily records. Risk assessments were carried out for moving and handling, self-medication, preferred activities and other identified risks to the individual resident. However some of these were not up to date. The home’s policy on confidentiality includes details about the Data Protection Act 1998, keeping information confidential and the sharing information. Also included was information about record keeping detailing how long records must be kept. A copy of this is included in the residents’ plan of care. See requirement No. 1 and recommendation Nos. 1, 2 & 3. Scope DS0000005178.V279636.R01.S.doc Version 5.1 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 & 15 Residents’ were able to take part in a range of activities of their choosing. Personal and family relationships were encouraged by the home and the staff team supported people with this. EVIDENCE: The residents’ plans reflect the range of activities undertaken which included attending “lifestyles” day centre where a programme of crafts, music, information technology, working on an allotment, cooking or flower arranging is available. Each resident has three or four sessions a week at the day centre. Residents spoken to said they enjoy going out and about in the community, to local shops, out for lunch, to the pub or cinema. The home has a wheelchairadapted vehicle, which all residents can access. Visits from family and friends were recorded in the care plans and case notes. Residents shared with the inspector the contact they had with family members
Scope DS0000005178.V279636.R01.S.doc Version 5.1 Page 12 and said they could choose to see visitors within their own room or in the shared lounge/dining area. Relatives also confirmed this. During the inspection staff spoke to residents in a friendly manner, using residents preferred names. Relatives said that they were kept informed about important matters relating to the residents. Scope DS0000005178.V279636.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 Residents received support from the staff for personal care in accordance with their stated preference. EVIDENCE: The sample 24-hour summary records seen described how the residents preferred to be supported in their daily routines. Times for rising and retiring, preferred moving and handling techniques and personal care preferences were recorded, as was choice of clothing and hairstyle. All residents were dressed differently according to their own choice. Residents tended to visit GP’s, chiropodists, opticians and dentists in the local community. These professionals would visit the home on request. Appointments with consultants and other hospital appointments were also undertaken. Records were kept of all these visits and they were up to date. Staff said that they supported residents on these visits. New visiting professional sheets had been put onto residents’ files and the transfer of the last entry should be made from the old to the new sheet. See recommendation No. 1. Scope DS0000005178.V279636.R01.S.doc Version 5.1 Page 14 GP’s confirmed that there is always a senior member of staff to confer with and that staff were able to demonstrate a clear understanding of the residents needs. Scope DS0000005178.V279636.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 The policies and practices of the home ensure that service users are safeguarded from abuse and harm. EVIDENCE: The home had Halton’s local authority “no secrets” policy available and the manager confirmed that they would follow these guidelines in the event of an alleged or suspected case of abuse. During discussions she was clearly able to demonstrate the process she would undertake in line with the “no secrets” guidance. The homes policy on protecting adults from abuse included information about reducing the risk, types of abuse and what to do in the event of witnessing abuse. Documentation confirmed that staff had received protection of vulnerable adults training. The manager is the Designated Adult Protection Advisor (DAPA) for the home. Relatives confirmed they were aware of the complaints procedure at Edward Court. Scope DS0000005178.V279636.R01.S.doc Version 5.1 Page 16 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 The home provided a clean and comfortable environment for the people to live in. EVIDENCE: Both bungalows were visited during this inspection. Each was furnished in a domestic style with additional equipment such as hoists and tracking provided as necessary to meet the residents’ needs. Residents said that bedrooms were decorated to their preferred style and staff stated that shared lounge and dining areas were decorated with residents’ involvement in the colour scheme chosen. Each bungalow was clean, tidy and free from any unpleasant smells. Records of menus and daily checks on fridge, freezer and hot food temperatures were kept. Cleaning materials were stored appropriately. Scope DS0000005178.V279636.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 35 & 36 Records were well maintained. Staff received support to enable them to meet residents’ needs. EVIDENCE: At the time of this inspection the agreed staffing levels were met. Five of eleven staff had obtained NVQ level II in Care. The manager said a further four staff were currently undertaking NVQ II and one staff was working towards NVQ III. The manager has completed the Registered Managers Award. Induction training is given to staff. A workbook format is used that has been developed in line with TOPPS training. Staff also attends Scopes one day induction training. Mandatory training includes moving and handling, adult protection, first aid and food hygiene. Other courses available include Cerebral Palsy, risk assessments, medication, infection control and personal development. From the previous requirement each staff member now has a training and development plan. Copies of which were seen. Staff supervision notes were seen on the staff files. These covered all aspects of the staff role within the home. However due to recent staff shortages these were not up to date. A new senior care assistant has been appointed and the
Scope DS0000005178.V279636.R01.S.doc Version 5.1 Page 18 manager anticipates that this should help the situation. From the previous requirement staff appraisals had been brought up to date and were seen on staff files. See requirement No. 2. Scope DS0000005178.V279636.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 41 & 42 Residents’ views were used in the planning for the home. Decisions are influenced by the information obtained from the surveys and from conversations with residents. Residents’ records were kept safe and secure. Most arrangements are in place to minimise the risk so that the safety and welfare of residents are promoted. EVIDENCE: Residents’ surveys had recently been completed and these confirmed that the residents felt well cared for in the home. The manager said that she was due to complete an analysis of this information, which would be shared with residents and other interested parties. All policies and procedures seen were up to date and accurate. Records were kept secure within the home. Residents confirmed that they had access to
Scope DS0000005178.V279636.R01.S.doc Version 5.1 Page 20 information kept about them. During discussions with the residents they said that the manager was easy to approach and that she visited them regularly. They confirmed the manager had an “open door” policy and they could visit her, as they liked. Residents said that they “liked living in the home” and “that the home was well run”. Safe working practices include fire safety in which all weekly checks are carried out and recorded and an up to date certificate for gas safety. Portable appliance testing had been carried out in November 2005 but no certificate had been received. Tests and servicing for all equipment for moving and handling had been completed. The electrical wiring had been checked in January 2006 however the certificate had not been received. Copies of certificates of work undertaken must be kept at the home to show that the residents are being protected by the procedures in place. See requirement Nos. 3 & 4. Scope DS0000005178.V279636.R01.S.doc Version 5.1 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 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 X X X X 3 X 3 2 X Scope DS0000005178.V279636.R01.S.doc Version 5.1 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. 4. Standard YA6 YA36 YA42 YA42 Regulation 12 18 16 16 Requirement Timescale for action 30/03/06 The registered person must ensure risk assessments are kept up to date. The registered person must 30/06/06 ensure that staff receives supervision every three months. The registered person must 30/03/06 ensure that the electrical safety certificate is obtained. The registered person must 30/03/06 ensure that Portable Appliance Test certificate is obtained. Scope DS0000005178.V279636.R01.S.doc Version 5.1 Page 23 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 YA6 YA6 YA6 Good Practice Recommendations The registered person should ensure that the last entry on the old visiting professional sheet is carried forward to the new sheet for ease of reference. The registered person should ensure that the last entry on the old weight record is transferred to the new sheet for ease of reference. The registered person should ensure that abbreviations are avoided on the daily record sheets. Scope DS0000005178.V279636.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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