Inspection on 13/12/05 for Scope - Warrington Road

This inspection was carried out on 13th December 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Scope - Warrington Road 17/04/07

Scope - Warrington Road 21/11/06

Scope - Warrington Road 22/06/05

Scope - Warrington Road 10/01/05

Scope - Warrington Road 23/07/04

Scope - Warrington Road 12/03/04

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Ruskin Lodge

Dystlegh Grange

The Good Companions

Springfield Cottage

Cuerden Grange Rest Home

Cornmill Nursing Home

Vitalise Sandpipers Centre

Sue Ryder Care Birchley Hall

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Scope 102 to 108 Warrington Road Widnes Cheshire WA8 0AS Lead Inspector Maureen Brown Unannounced Inspection 13th December 2005 09:30 Scope DS0000005181.V262597.R01.S.doc Version 5.0 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 DS0000005181.V262597.R01.S.doc Version 5.0 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 DS0000005181.V262597.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Scope Address 102 to 108 Warrington Road Widnes Cheshire WA8 0AS 0151 495 1256 0151 423 3621 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 Ms Paula Smith Care Home 12 Category(ies) of Physical disability (12) registration, with number of places Scope DS0000005181.V262597.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home is registered for a maximum of 12 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 22nd June 2005 3. Date of last inspection Brief Description of the Service: 102 -108 Warrington Road is a residential care home providing personal care and accommodation for 12 young adults with a physical disability. The premises are owned by Liverpool Housing Trust, and are managed by Scope, a national organisation for people with cerebral palsy. All of the service users have their own individual tenancy agreements. The home is located approximately three quarters of a mile from Widnes town centre and is close to a church, shops and a pub. There are limited car parking facilities at the home. On the road parking is available in front of the property. Warrington Road comprises four purpose built bungalows, each with a kitchen/dining area, lounge, three bedrooms, bathroom, shower room and a utility area. 104 and 106 each have one additional room set off the main areas of the bungalows. The room in 104 is used as an office and the room in 106 has been used for sleep in purposes in the past; it is currently being used as a storeroom. The home has patio and garden areas, which are and easily accessible. Scope DS0000005181.V262597.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out during the morning of 13th December 2005. The total time on site was six hours. The inspector spent half an hour planning the inspection by reviewing previous inspection reports and the service history. The inspection included a tour of the home, inspection of records and discussions with eight service users, the registered manager and the staff on duty. Seventeen out of forty-three standards were assessed and all were met. Feedback from this inspection was given to the registered manager at the end of the inspection. What the service does well: What has improved since the last inspection? What they could do better: Completion of care plans must be improved. The resident or their representative and the manager must sign the contract. The care plan should be reviewed on a monthly basis. Risk assessments must be kept up to date and residents daily records should be clear and accurate in their description. The social service annual reviews and residents’ healthcare needs must also be kept up to date. Scope DS0000005181.V262597.R01.S.doc Version 5.0 Page 6 The standard of the furnishings needs to be addressed. The carpets in bedrooms and corridors must be deep cleaned as necessary on a regular basis. The lounge carpet in Bungalow 102 must be replaced. The bath panel must be replaced and the marks on the kitchen floors must be removed. To ensure that residents are looked after by suitably qualified staff a plan to show how 50 of care staff will be trained to NVQ level II or above should be produced. To show that residents are receiving care from staff that have been properly vetted all pre-employment checks must be completed. The educational needs of residents should be fully explored. To ensure the ongoing welfare and safety of residents the emergency lighting should be checked on a monthly basis. 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 DS0000005181.V262597.R01.S.doc Version 5.0 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 DS0000005181.V262597.R01.S.doc Version 5.0 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): 2&5 Full assessments of needs are carried out to ensure that the home can meet the residents’ needs. EVIDENCE: Care plans examined showed that assessments had been carried out with each person before moving into the home. Residents had visited the home prior to admission and trial overnight visits were encouraged. Admissions were planned and ranged from a short visit to overnight stays, dependent on the needs and wishes of the person. Each resident has a tenancy agreement. This includes information on the terms and conditions of residence, fees charged and the rights and responsibilities of both parties. The resident or their representative and the registered manager must sign the contract. See requirement No. 1. Scope DS0000005181.V262597.R01.S.doc Version 5.0 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 The residents’ health, personal and social care needs are met by the staff team who enable them to maintain their privacy and dignity. EVIDENCE: Three residents’ care files were seen during this inspection. These were comprehensive and well presented in individual folders. Each contained all the information required by staff to adequately care for the residents. Included were care plan monitoring sheets, 24-hour summary sheets and visiting professionals sheets. Risk assessments were not up to date. The care plans were drawn up in consultation with the residents and family and were based on their assessed needs and risks. The care plans reviewed on an annual basis by social services and in conjunction with the residents, were not up to date. Staff should review the care plans on a monthly basis and keep records. 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. Carers signed them. Some recordings were not clear as to the meaning. Clear and factual records should be kept. Scope DS0000005181.V262597.R01.S.doc Version 5.0 Page 10 Residents confirmed they had chosen the décor and furniture within their own bedrooms and it was seen that each bedroom reflected residents’ personality and preferred taste of décor. The staff said that all service users had been involved in choosing the décor of the shared rooms. Residents’ meetings were not held at this time. Since the previous inspection the manager had discussed this with the residents who stated they didn’t want meetings. However, it was agreed that the manager would get together with the residents on a monthly basis to pass on relevant information and be available if residents wished to discuss and issues. It was agreed that the manager could take brief notes. Residents confirmed this during discussions. See requirement Nos. 2 & 3 and recommendation Nos. 1 & 2. Scope DS0000005181.V262597.R01.S.doc Version 5.0 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): 12, 13, 15 & 16 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 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. The residents also use a local gym for trampoline, boules and snooker. 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 wheelchair-adapted vehicle, which all residents can access. From the previous inspection educational needs were not fully met. The manager had contacted the local college and some residents had chosen courses to attend. However following assessments residents were unable to attend the courses. The manager has agreed to re-look at this issue. Scope DS0000005181.V262597.R01.S.doc Version 5.0 Page 12 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 and said they could choose to see visitors within their own room or in the shared lounge/dining area. See recommendation No. 3. Scope DS0000005181.V262597.R01.S.doc Version 5.0 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 health 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 resting preferred moving and handling techniques and personal care preferences were recorded, as was choice of clothing, hairstyle and makeup. All residents were dressed differently according to their own choice. Visits to health professionals were recorded in the care plans, including visits to GP’s, opticians, chiropodists and dentists. These were not up to date. The manager said a carer always attended appointments with residents. See requirement No. 4. Scope DS0000005181.V262597.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Clear policies and procedure were in place to ensure that residents were protected from abuse, neglect and self-harm. EVIDENCE: The home’s Protection of Vulnerable Adults Policy was consistent with the “No Secrets” guidance from the Department of Health. A copy of Halton Social Services’ policy on Adult Protection was available within the home and was accessible to staff. Policies on whistle-blowing and challenging behaviour were also available. Discussions were held with the manager about Adult Protection procedures and she was able to demonstrate the procedure to be followed in this situation. She is also the Designated Adult Protection Advisor (DAPA). Scope DS0000005181.V262597.R01.S.doc Version 5.0 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 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 generally comfortable environment for the people to live in. EVIDENCE: All four 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 generally clean, tidy and free from any unpleasant smells. However, some areas of bedroom and corridor carpets needed deep cleaning. The lounge carpet in Bungalow 102 needed replacing and also the bath panel needs replacing. The flooring in most kitchens were badly marked and needed attention. See requirements Nos. 5, 6, 7 & 8. Scope DS0000005181.V262597.R01.S.doc Version 5.0 Page 16 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 & 34 Staff received support to enable them to meet residents’ needs. Recruitment policies have not been consistently followed resulting in residents receiving care from staff that have not been properly vetted. EVIDENCE: At the time of this inspection the agreed staffing levels were met. Three care staff and the home’s manager were on duty. During this inspection staff were seen providing care for residents in a dignified manner. Whilst assisting with mealtime’s food was offered to residents at their particular pace and staff interacted well with residents. Five staff had obtained NVQ level II in Care and four staff were due to start NVQ level II in Care in January 2006. Mandatory training included moving and handling, first aid, fire awareness, food hygiene and medication training. All staff had completed mandatory training. Health and Safety and Adult Protection were other courses most staff had undertaken. Scope DS0000005181.V262597.R01.S.doc Version 5.0 Page 17 If the recruitment procedure had been followed this would have ensured that the staff were suitable to work with vulnerable people. Three staff files were examined and these showed that some pre-employment checks were carried out. However files indicated that proof of identity and health declarations had not been consistently sought. All staff had application forms, two references and Criminal Record Bureau checks in place. However it was noted that some staff who had worked at the home for a long time did not have the same level of checks that are now required. Full employment checks are carried out for all new staff members. See requirement No. 9 and recommendation No. 4. Scope DS0000005181.V262597.R01.S.doc Version 5.0 Page 18 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): 40 & 42 Arrangements are in place to minimise the risk so that the safety and welfare of the residents is promoted. EVIDENCE: All policies and procedures seen were up to date and accurate. During discussions with the residents they said that the manager was easy to approach and that she visited each bungalow regularly. Residents said that they “liked living in the home” and “that the home was run well”. Safe working practices included visits from the fire safety officer and the environmental health officer, which had been completed satisfactorily. The gas safety, electrical safety and insurance certificates were in place and up to date. Fire alarm tests were being undertaken on a weekly basis and records kept. The emergency lighting tests should be carried out on a monthly basis with records kept. See recommendation No. 5. Scope DS0000005181.V262597.R01.S.doc Version 5.0 Page 19 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 X 3 X X 2 Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 3 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 2 LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 X 2 X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Scope Score X 2 X X Standard No 37 38 39 40 41 42 43 Score X X X 3 X 2 X DS0000005181.V262597.R01.S.doc Version 5.0 Page 20 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. Standard YA5 Regulation 5 Requirement The registered person must ensure that the resident or their representative and the manager sign the contracts. The registered person must ensure that social services reviews are kept up to date. The registered person must ensure that risk assessments are kept up to date. The registered person must ensure that residents’ healthcare needs are kept up to date. The registered person must ensure that the carpets in bedrooms and corridors are deep cleaned as necessary. The registered person must ensure that the lounge carpet in 102 is replaced. The registered person must ensure that the bath panel is replaced. The registered person must ensure that the marks on the kitchen floors are removed. The registered person must ensure that all pre-employment checks are undertaken for all staff. DS0000005181.V262597.R01.S.doc Timescale for action 31/01/06 2. 3. 4. 5. YA7 YA9 YA19 YA30 15 15 13 16 31/03/06 31/01/06 31/03/06 31/01/06 6. 7. 8. 9. YA30 YA30 YA30 YA34 16 16 16 19 31/01/06 31/01/06 31/01/06 31/03/06 Scope Version 5.0 Page 21 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. 4. 5. Refer to Standard YA6 YA6 YA12 YA32 YA42 Good Practice Recommendations The registered person should ensure that staff review the care plans on a monthly basis with records kept. The registered person should ensure that residents daily records are clear and accurate in their description. The registered person should ensure that the educational needs of residents are fully explored. The registered person should produce a plan to show how 50 of care staff will be trained to NVQ level II or above. The registered person should ensure that the emergency lighting is tested on a monthly basis. Scope DS0000005181.V262597.R01.S.doc Version 5.0 Page 22 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 © 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 Scope DS0000005181.V262597.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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