Inspection on 01/07/05 for Speke Care Home

This inspection was carried out on 1st July 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Speke Care Home 30/06/09

Speke Care Home 16/06/08

Speke Care Home 03/07/07

Speke Care Home 25/01/07

Speke Care Home 23/05/06

Speke Care Home 31/10/05

Speke Care Home 26/11/04

Speke Care Home 13/05/04

Speke Care Home 29/01/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Speke Care Home 96-110 Eastern Avenue Speke Liverpool L24 2TB Lead Inspector Mr Les Hill Unannounced 1 July 2005 9:30 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 Older People. 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. Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Speke Care Home Address 96-110 Eastern Avenue Speke Liverpool L24 2TB 0151 425 2137 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) Mr Abid Y Chudary Joan Lorraine Vernon CRH PC 53 Category(ies) of OP registration, with number of places Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 26 November 2004 Brief Description of the Service: Speke Care Home is registered with CSCI to provide care and support to 53 residents within the category of old age. The home was purpose built and is situated in the heart of a residential area of Speke, Liverpool. The home is close to a range of local community amenities including local shopping, bus and road links to other areas of Merseyside. The home is constucted on two levels with access to the floor via stairs or a passenger lift. The home has 51 bedrooms that are mostly single. Bedrooms to the first floor have en-suite toilet and wash hand-basin facilities. Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on Friday 1st July 2004. It took place over 5 hours and involved the examination of records, a tour of the building and discussions with six residents. The inspection was part of the Commissions requirement to visit and report on every registered care home on two occasions each year. What the service does well: What has improved since the last inspection? What they could do better: Contracts/statements of terms and conditions of residency should be introduced. The manager should ensure that a record of all health care interventions is placed on the resident’s main file. Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 6 Care should be taken to ensure audits of medicines are accurate and the GP should confirm in writing any changes to the dosage or frequency of prescribed medicines. The homeowner should consider the need to upgrade the decoration in communal areas around the home. The Smoking room and the garden are in need of some remedial attention. The homeowner should introduce a formal system of quality assurance to include feedback from residents, their relatives, staff and visiting professionals. The manager should introduce professional supervision for all staff to support the work with service users. 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. Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 and 5. The home had a comprehensive Statement of Purpose that described the role and function of the home; Carried out adequate assessments of prospective residents and offered the opportunity for pre-placement visits and stays. Contracts/statements of terms and conditions of residency were not in place. The home does not provide Intermediate Care. EVIDENCE: The home has a Statement of Purpose that includes all matters required in Schedule 1 of the National minimum Standards, Care Homes for Older People and a service users guide to the home. Both documents are available in the office on request. The home’s contracts were being re-written as they did not contain enough appropriate information. At the time of this inspection new contracts had not been introduced. The majority of admissions to the home are through social worker referrals. An inspection of three files for the most recent admissions to the home confirmed that a social work assessment had been completed prior to referral to the Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 9 home. The manager or a senior representative from the home visits the prospective resident in their current placement to carry out the homes assessment and confirm whether or not they are able to provide the levels of care and support required. The manager told the inspector that the home offers prospective residents the opportunity to visit the home and to spend time there before deciding to stay. However, in practice most residents come from hospital or are admitted from home in an emergency placement situation. The home offers respite care and many of the residents who receive respite care eventually move into Speke Care Home on a longer term basis. The home does not provide Intermediate Care. Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10. Care planning arrangements had improved. Care needs to be taken to ensure the safe auditing of medicines at the home. EVIDENCE: Two of the case files examined during the inspection had care plans in place that contained detailed information about needs and how they should be met. The third case file was for a resident recently admitted and had no care plan. The manager told the inspector that staff allow residents to settle into the home before reviewing their pre-admission assessment and producing a plan of care. Whilst this can be helpful in the longer term, staff need to know what they should be doing to assist any resident newly admitted to the home and an interim care plan should be put in place. There was evidence on the care plans seen to confirm that they were being reviewed. Residents are listed with local GP’s unless the GP who supported them in their own home is prepared to offer continued support. The manager told the inspector that residents get a good service from GP’s in the area and the home benefits from the advice and support of the District nurses. The home-owner pays for Chiropody services for all residents who need the service. At the time of this inspection the Optician visited the home and Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 11 attended to residents who required their services. Like other homes in the area Speke Care Home is having difficulty accessing a NHS dentist. The CSCI inspection report from 26th November 2004 recommended that health care interventions should be recorded in the main file. This recommendation is repeated to ensure that all essential information is stored in one place. The home has adequate policies and procedures in place for the receipt, storage, management and disposal of medicines. Staff who administer medicines have received appropriate training. Records relating to the receipt and disposal of medicines were clear and had been signed by the supplying pharmacist. A sample check of medicines kept in the home showed that most were supplied in “blister” pack form and were being managed appropriately. However an audit of records for two of the controlled drugs showed discrepancies through counting errors and a failure to include new stock. In another case staff had reduced the dosage of one medicine at the request of the resident’s family without reference to and confirmation from the residents GP. Staff should only give out medicines as prescribed by the GP and must not change any dosage or frequency of administration without written confirmation from the relevant GP. The home has policies and procedures in place in relation to privacy and dignity. The inspector spoke with several residents who complementary about the hard work and care provided by staff at the home and praised them for their kindness. The inspector observed staff spending some of their time sitting and talking with residents at the home. Residents told the inspector that they enjoyed the times that they spent talking with staff. During a tour of the building the manager knocked on resident’s bedroom doors before entering. Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15. Some activities were being provided and staff were spending valuable time with the residents. The employment of an Activities Organiser would assist the social interactions within the home. Visitors were welcomed at any time and resident’s had the opportunity to choose something different to the main menu at mealtimes. EVIDENCE: The home provides some activities including a bi-monthly cinema show, Bingo and outside entertainers. Staff will spend time talking with residents and will take them out into the local community whenever possible. The manager told the inspector that she had recently lost the support of an Activities Organiser and was experiencing difficulties in finding a replacement. The introduction of a member of staff who could engage individual or groups of residents in meaningful activity would enhance the social experiences in the home and provide stimulation. Throughout the period of time the inspection was taking place there was a constant flow of visitors to the home. Some of the visitors took the resident out. It was clear that this was an everyday situation and gave support to the manager’s claim that visitors are welcomed at any time. Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 13 Through observations and discussions it was clear that residents are able to spend their time in the home as they wish. The cooks at the home write up the day’s menu on a white board in the dining room. If residents don’t want the meal on offer then the cook will prepare them something different. The menu identified a range of plain dishes that were appreciated by the residents who spoke with the inspector. The home provides a choice of breakfast (including hot dishes), a snack lunch and a cooked evening meal. Residents can choose to eat their meals in the dining room or in their own bedroom. Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17 and 18. Policies to deal with complaints and with adult protection matters were in place. The home must ensure that all staff are trained in adult protection procedures. EVIDENCE: The home has a complaints policy in place and a system for recording the process of any investigation. The home also has adult protection policies and procedures in place although they did not have a copy of Liverpool City Councils procedures. New staff who undertake the organisations induction programme are provided with some training in adult protection but longer serving staff should receive some formal guidance on the management of adult protection concerns. The organisation has acted responsibly in referring concerns to the appropriate authorities. Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 23, 24, 25 and 26. The home is suitable for its intended purpose but standards of decoration and the maintenance of outdoor space require some remedial attention. EVIDENCE: Speke Care home is a purpose built facility that is suitable for its stated purpose. 32 of the 51 bedrooms have an en-suite WC and wash hand-basin and all are of a good size. Individual bedrooms are personalised according to the needs and wishes of the residents. There is a large lounge/ dining area and small lounges on each of the corridors. Communal space within the home meets the required standards. The home was equipped with adequate heating, ventilation, lighting and hot water supplies. Emergency lighting is fitted throughout the home. Several matters identified in the CSCI inspection on 26th November 2004 are still outstanding: Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 16 A damaged Parker bath has been removed and the inspector was told that the owner intends to replace it with a walk-in shower. The WC next to the upstairs lounge had been fitted with a door handle. Three lights in the lounge had been mended. However, The bath next to room 25 still had mould to the sealant and the hoist stand is showing rust to the floor plate. Temperatures of the fridge in the first floor lounge are still not being recorded. The inside of the bath next to room three is still marked. As identified in earlier reports, much could be done to improve the dining room furniture and appearance of this room. In addition the smoking room (conservatory) was in need of urgent attention. A radiator cover was hanging off; the carpet had cigarette burns the paintwork was dirty and the window blinds were broken. The inspector identified two armchairs where the covering fabric was broken and the foam padding exposed. These chairs should be removed from use. The manager should check to identify any other chairs that may be in a similar condition. Outside garden space to the rear of the home was unkempt. Flowerbeds were overgrown with weeds and the lawns were in need of cutting. Weeds were growing between the paving flags. There was an unpleasant smell in the entrance to the home and in a small number of identified locations around the building. Staff have painted one of the corridors in the home and the levels of light have been improved. However, there is a need to professionally upgrade the decoration in all the communal areas to improve the general appearance of the home. Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30. Good staffing levels were being maintained in the home. Over 50 of the care staff have an award at NVQ level 2 or above. EVIDENCE: Good staffing levels were being maintained. The staff rota provides for one senior carer and six care staff each morning and one senior and five care staff during the afternoon. A senior carer and three care staff are on duty through the night. The manager checked the staff list and identified that 13 of the 20 care staff had gained an award at NVQ level 2 or above. The home is therefore meeting the standard of 50 of its care staff with an NVQ award at this level. An examination of staff records confirmed that two references were being taken up and that CRB and POVA checks were being undertaken for new staff. The home is awaiting the confirmation of CRB checks for three of its longer serving members of staff. It is important that full and comprehensive records are made of the recruitment and selection processes to ensure the continued safety of residents at Speke Care Home. Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35, 36 and 38. The manager is experienced and qualified to run the home. Quality monitoring systems should be introduced and the organisation must change its arrangements so that interest on resident’s savings can be credited into their own account. Required safety checks were being undertaken. EVIDENCE: The manager has approximately four years experience of managing care homes and informed the inspector that she has recently completed a course of training leading to the Registered Managers Award. The manager has also been registered with the Commission. The manager told the inspector that a representative of the organisation undertakes monthly monitoring visits to Speke Care Home and that copies of the report are forwarded to CSCI. However a system to regularly review the Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 19 function of the home using feedback from residents, their relatives, staff and other professionals visiting the home is not yet in place. The owners have made progress in dealing with the matters regarding the appointee arrangements in the home. However, the manager told the inspector that she has had considerable difficulty in finding a bank or building society that will open an account for a resident who cannot attend the bank and sign their own name. The Commission will discuss ways of managing the personal savings of residents so that any interest is paid into the residents account. The manager told the inspector that she has arranged for two senior staff at the home to be enrolled on a “mentoring” course. It is expected that they will then provide one-to-one professional supervision to all care staff n the home. The owners have also introduced a programme of six-monthly staff appraisals. The manager should ensure that all staff in the home receive appropriate support and supervision. A number of certificates of worthiness were examined during the inspection. A fire risk assessment has been undertaken and a package of fire training for staff has been purchased. Recommendations from the report in relation to building repairs and maintenance were to be implemented in the week of this inspection. A fire drill was held in April 2005. The electrical installation in the home was tested in April 2005. PAT testing of small electrical appliances was carried out in April 2005. A gas safety certificate was issued in October 2004. The manager will be asked to confirm all the required safety checks at the next announced inspection. Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 2 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 x 3 3 3 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 2 3 x 2 x 2 2 x 3 Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 21 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 OP2 Regulation 5(1)(b) Requirement The home must provide residents with a contract/statement of the terms and conditions of their residency The manager must ensure that medicines are audited and accounted for appropriately The manager must ensure that the GP confirms in writing any changes to the dosage or frequency of medicines prescribed for residents. The manager should ensure that matters identified in the report relating to state of the premises including the smoking room and garden area, are dealt with appropriately. The home owner must introduce a system to review the quality of care provided at the home taking account of the views of residents, their relatives, staff and visiting professionals. The home owner must ensure that any interest earned on residents savings is paid directly into their own account. The manager must ensure that all staff are receive professional supervision to support them in Timescale for action 31/08/05 2. 3. OP9 OP9 13(2) 13(2) 01/07/05 01/07/05 4. OP19 23 31/08/05 5. OP33 24 31/08/05 6. OP34 20 31/07/05 7. OP36 18(2) 31/08/05 Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 22 their work with residents. 8. 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. Refer to Standard OP8 OP12 18 19 Good Practice Recommendations The manager should ensure that all health interventions are recorded in the residents main file. The manager should appoint an activities organiser to encourage and stimulate the social interactions between residents in the home. The manager should arrange for all staff to receive training in adult protection matters. The home owner should make arrangements for the professional upgrading of decoration to the communal areas of the home. Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Liverpool Area Office 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 Speke Care Home F52_F02_s25180_Speke_v230540_010705_Stage 4.doc Version 1.30 Page 24 - 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!