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Inspection on 22/06/05 for Scope - Warrington Road

Also see our care home review for Scope - Warrington Road for more information

This inspection was carried out on 22nd June 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home had an established staff team who were keen for high standards to be maintained. Residents` plans of care and individual case notes were well documented and reflected each resident`s needs. Supervision of staff was recorded and completed on a regular basis. Meals were varied and reflected each person`s preference. They offered choice and variety. 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.

What has improved since the last inspection?

New flooring had been provided in the bathrooms and shower rooms. The vacancy for senior care assistant had been filled.

What the care home could do better:

Care plans should be reviewed on a monthly basis and a record kept. Residents` meetings should be held on a regular basis with records kept. More could be done to ensure that the residents` educational needs are fully met.Some of the bathrooms and lounge/dining areas are in need of redecoration and the flooring in some kitchens, which were badly marked, needed attention. The cleaning cupboards should have locks fitted to them, as a health and safety precaution. The grass and garden should be appropriately maintained. Grass needed cutting and hedges and borders needed cutting back and weeding. Recommendations have been made regarding each of the above points.

CARE HOME ADULTS 18-65 SCOPE 102 Warrington Road 102-108 Warrington Road Widnes Cheshire WA8 0AS Lead Inspector Maureen Brown Unannounced 22 June 2005 10:00am 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. SCOPE 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service SCOPE 102-108 Warrington Road Address 102 to 108 Warrington Road Widnes Cheshire WA8 0AS 0151 495 1256 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) SCOPE Ms Paula Smith Care Home 12 Category(ies) of Physical disability (12) registration, with number of places SCOPE 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 This home is registered for a maximum of 12 service users in the category of PD (Physical disability) 2 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 3 Date of last inspection 10 January 2005 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; this is a national organisation for people with cerebral palsy. All of the service users have their own individual tenancy agreements. It is located approximately three quarters of a mile from Widnes town centre and is close to a church, shops and a pub. There are adequate car parking facilities available adjacent to the home. 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 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out during the morning of 22nd June 2005. The total time on site was five and a half hours. The inspector spent an hour planning the inspection by reviewing previous inspection reports and the service history. The inspection included a full tour of the home, inspection of records and discussions with seven service users, the registered manager and the care assistants on duty. Twenty-two 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: Care plans should be reviewed on a monthly basis and a record kept. Residents’ meetings should be held on a regular basis with records kept. More could be done to ensure that the residents’ educational needs are fully met. SCOPE 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 Page 6 Some of the bathrooms and lounge/dining areas are in need of redecoration and the flooring in some kitchens, which were badly marked, needed attention. The cleaning cupboards should have locks fitted to them, as a health and safety precaution. The grass and garden should be appropriately maintained. Grass needed cutting and hedges and borders needed cutting back and weeding. Recommendations have been made regarding each of the above points. 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 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 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 SCOPE 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 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, 3 & 5 Sufficient information is provided for residents to make a decision about moving into the home. Full assessments of needs are carried out to ensure that the home can meet the residents’ users needs. EVIDENCE: Each resident had a copy of the home’s statement of purpose and function and the service users guide and they were kept with the residents’ plan of care. A copy of the most recent inspection report was available in the office and staff were aware of this. 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. The staff team was well established and the current vacancies were being covered by the team and by using regular agency staff. The manager said that they only used a small group of agency staff that know the residents and how the home is run. It was seen that all staff had completed mandatory training such as moving and handling, food hygiene and first aid courses. Many staff had also completed other courses. SCOPE 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 Page 9 The manager said that an advocacy service was available to residents. One resident had an advocate and he confirmed he used this service. SCOPE 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 Page 10 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, 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 records were seen during this inspection. These were comprehensive and well presented in individual folders. Each contained care plan monitoring sheets, personal information, 24-hour summary sheets, visiting professionals sheet, risk assessments, statement of purpose and function, service delivery agreement and service users guide. The care plans seen were drawn up in consultation with the residents and family and were based on their assessed needs and risks. The care plans were reviewed on an annual basis by social service and in conjunction with the residents. Staff should review the care plans on a monthly basis and keep records. (See recommendation No 1). 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. SCOPE 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 Page 11 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. It is recommended that these take place on a regular basis with records kept. This would allow residents the opportunity to raise issues of concern or problems. (See recommendation No 2). The home had a policy on missing persons and the manager was able to demonstrate her understanding of what to do in this situation. SCOPE 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 Page 12 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) 11, 12, 14 & 17 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. Residents’ dietary needs were well catered for with a balanced and varied selection of food that met peoples’ tastes and choices. 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. 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 wheelchairadapted vehicle, which all residents can access. SCOPE 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 Page 13 It was seen that educational needs were not fully met. The manager said there were problems with accessing the local college. It is suggested that this situation be reassessed. (See recommendation No 3). 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. Residents liked to visit friends in the other parts of the home and said staff helped them with access if necessary. The menus for the four bungalows were seen and these reflected peoples’ personal choices. Special diets were catered for such as soft diets. Residents’ meals were recorded in the diary in each bungalow and the staff encouraged a healthy eating regime. Fridge, freezer and hot food temperatures were recorded which were kept in each bungalow. The four kitchens were maintained in a clean and tidy condition. SCOPE 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 Page 14 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 & 20 Residents received support from the staff for personal care in accordance with their stated preference. Administration and control of medications were appropriate for the needs of the service users. 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. In each bungalow a locked steel cupboard was available for storage of medication. This was located within the bathroom. A monitored dosage system was used and all medication was stored appropriately. The medication administration sheets seen were signed and up to date. No controlled drugs were used at this time, however appropriate facilities were available if required. SCOPE 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 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 Clear policies and procedure were in place to ensure that residents’ views were listened to and acted upon. Residents were satisfied with the support they received from the manager and staff. No complaints had been made since the last inspection. EVIDENCE: The home’s policy on complaints was seen and also the full complaints procedure produced by Scope. The complaints procedure included timescales for response to the complainant and to whom you can complain to. Residents said that they would speak to the staff or manager if they had a complaint. Staff confirmed that they were aware of the procedure and would pass concerns onto the manager. No complaints had been received since the previous inspection and a compliant book and relevant paperwork was available in the event of a complaint being received. The residents’ satisfaction survey, which was recently undertaken, showed that many residents were pleased with the care they received. Other residents said “they didn’t want a care plan I take it as it comes” or “I don’t need a key worker, I go to a member of staff if I need one.” Residents raised concerns about transport not being available when they wanted to go out and one resident said, “I would like to go back to college”. The manager said that she would address the issues raised with each individual as required. SCOPE 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 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 & 30 The home provided a clean and 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 clean, tidy and free from any unpleasant smells. Records of menus and daily checks on fridge, freezer and hot food temperatures were kept. Each bungalow has a separate laundry room with domestic style washing machines. Cleaning materials were kept in a high level cupboard along with basic information sheet on hazardous materials. SCOPE 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 Page 17 The grass and garden were in need of attention. The grass needed cutting and hedges and borders needed cutting back and weeding. The manager said that she was looking for a local gardener. A recommendation was made that this be completed as soon as possible as the residents enjoyed using the garden area. (See recommendation No 4). It was seen that some areas in the bathrooms and lounge/dining areas needed redecoration. Also the flooring in some kitchens was badly marked and needed attention. (See recommendations No 5 & 6) SCOPE 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 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) 32, 33, 35 & 36 The manager provided clear leadership. 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. Four care staff and the home’s manager were on duty. Observed day-to-day supervision of staff was good and the staff team confirmed that they were supported by the manager and two senior staff in their delivery of care to residents. The staff said that formal supervision was conducted on a regular basis and records were kept. Supervision records were seen and covered areas such as training, aspects of care practice, key working with individual residents and policies and procedures. 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. Four staff had obtained NVQ level II in Care and four staff were currently undertaking NVQ level II in Care. Mandatory training included moving and handling, first aid, fire awareness, food hygiene and medication training. All SCOPE 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 Page 19 staff had completed mandatory training. Health and Safety and Adult Protection were other courses most staff had undertaken. SCOPE 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 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) 37, 39 & 41 Residents’ views are used to inform future planning within the home. Decisions about changes to the service are influenced by the information obtained from satisfaction surveys and conversations with each resident. Residents’ and relatives views were used in the planning for the home. Decisions are influenced by the information obtained from the completed satisfaction surveys and from conversations with residents. EVIDENCE: Residents’ surveys were conducted recently and the manager said the information gathered would be used to improve the service provided. A copy of this would be kept in the individual care plans. Records seen were kept in good order. These were in line with the Data Protection requirements. The manager said that residents had access to SCOPE 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 Page 21 information stored about them. Residents said they were aware of information kept about them. The registered manager has four units to complete for her NVQ level IV Registered Managers Award. She said she was due to complete this within three months. SCOPE 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 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 x 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 x 3 x x 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 SCOPE 102 Warrington Road Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x 3 x x v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 Page 23 None 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 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. 4. 5. 6. 7. Refer to Standard 6 8 12 24 24 24 Good Practice Recommendations The registered person should ensure that staff review the care plans on a monthly basis and a record kept. The registered person should ensure that residents’ meetings are held on a regular basis and that records are kept. The registered person should ensure that the educational needs of residents are fully met. The registered person should ensure that the grass and garden was in need of attention. Grass needed cutting and hedges and borders needed cutting back and weeding. The registered person should ensure that some areas in the bathrooms and lounge/dining areas are redecorated. The registered person should ensure that the flooring in some kitchens which were badly marked needed attention. SCOPE 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 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 102 Warrington Road v233892 f51 f01 s5181 scope 102 warrington road v233892 220605 stage 4.doc Version 1.30 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!