Inspection on 29/11/05 for Spring Gardens, 9

This inspection was carried out on 29th November 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Spring Gardens, 9 31/05/07

Spring Gardens, 9 19/07/06

Spring Gardens, 9 24/06/05

Spring Gardens, 9 24/11/04

Spring Gardens, 9 20/05/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Spring Gardens, 9 9 Spring Gardens Maghull Liverpool Merseyside L31 3HA Lead Inspector Mrs Janet Marshall Announced Inspection 28th November 2005 09:00 Spring Gardens, 9 DS0000005275.V271186.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 Spring Gardens, 9 DS0000005275.V271186.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. Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Spring Gardens, 9 Address 9 Spring Gardens Maghull Liverpool Merseyside L31 3HA 0151 520 0185 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) Expect Limited Mrs Shirley Tinsley Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 3 LD. Date of last inspection 24th June 2005 Brief Description of the Service: 9 Spring Gardens is registered as a care home for three people with a learning disability. There are currently two women in residence. The registered provider for this home is Expect, formerly Sefton Support Services, which is a voluntary organisation. The registered Landlord for the property is Liverpool Housing Trust. The home is a three-bedroom bungalow, which is located in a quiet cul de sac in Maghull. The home is in keeping with others in the area and is indistinguishable as a care home. The premises are fully accessible and fitted with aids and adaptations. The home has large gardens and is located close to a train station and local shops. Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspection visits are required at the home each year, this was the second. There has been no cause for any visits to the home since the last routine inspection in June 2005. This was an unannounced inspection that took place over 5 hours. A partial tour of the home was conducted. All parts of the home were clean and tidy. The nature of the disability of the residents is such that it is not always possible to obtain direct views about their experiences, however, discussions were held with two members of staff as well as general observations and compliance with standards in order for a conclusion about the service to be made. Both residents were at home throughout the inspection during which time they were encouraged to continue with their routines and activities as usual. A selection of care records and other required records were inspected. Records that were examined included residents care plans, Essential Lifestyle Plans (ELPS), daily diaries, medical notes, medication sheets, staff rotas and records of health and safety checks. The certificate of insurance showing the correct information was displayed at the home. The requirements and recommendations from the last inspection were discussed and examined. Not all of those requirements have been met. Those that have not been met have been raised again as part of this report. What the service does well: Before admitting a new resident to the home the service carried out a full and proper assessment involving the resident, her representative and other social care and health professionals. This process ensured that the home was able to meet the resident’s needs prior to her admission. The service offered a clear and structured introduction period prior to admitting the new resident to the home. This gave the prospective resident the opportunity to ‘test drive’ the service before making a decision about living at the home. The service provides all residents with a contract so that they benefit from having a statement of terms and conditions of their occupancy. Staff were seen encouraging residents to make choices and decisions therefore promoting their independence. They offered and provided the assistance, which is consistent with the resident’s plan of care. The atmosphere in the home is warm and welcoming the residents appeared relaxed and contented. Staff appear to have a good understanding of residents needs they were seen interacting well with them. The service is good at providing the required training which enable staff to carry out their jobs. Staff are encouraged to undertake mandatory and National Vocational Training (NVQ). Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Some information in care files should be dated when it is written and following each review to show that it is up to date and relevant. The contract for one resident needs to be signed and dated to show that they agree with the terms and conditions of their occupancy. If the resident is not able to do this then it must be done by a family member/representative or advocate. A risk assessment for the use of bedrails has been carried out, however it is not as detailed as it needs to be to ensure the safety of the resident. The risk assessment must identify all the risk factors associated with the use of bedrails and the action that must be taken to minimise the risk. The décor in some parts of the home, particularly the communal areas is showing signs of wear and tear. Consideration should be given for the redecoration those areas so improving the comfort and dignity of the residents who live there. A more appropriate method of disposing cigarette butts needs to be provided at the home. Staff and visitors use the designated smoking area, which is outside at the back of the house. There is no facility for disposing finished cigarettes so they are littered around the paving areas making it look untidy and dirty which compromises the respect and dignity of the residents who live there. A wheelchair, which was being used to transport a resident about the home, was not fitted with footplates. Wheelchairs must always be fitted with footplates when in use unless otherwise agreed in the residents care plan. Please contact the provider for advice of actions taken in response to this Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 Page 8 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 Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 Page 9 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, 2, 3, 4 & 5 Information about the home has been improved so that residents can easily access it. A full and proper assessment was carried out prior to the admission of a new resident, which shows that the home is able to meet her needs. All residents have a contract so benefit from having a statement of terms and conditions of their occupancy. EVIDENCE: One new resident has been admitted to the home since the last inspection. The new residents care file contained copies of assessments carried out by the home and the care management team. There was also evidence that the resident was introduced to the home prior to making a decision to live there. The introduction process involved short visits to the home and overnight stays. At the last inspection the homes information pack was a little tatty and disorganised making it difficult to access. A recommendation was made as part of the last inspection report for the information to be better presented and made more accessible to residents. The manager has responded to this by renewing and reorganising all parts of the homes information pack. The pack is near to the front entrance of the home so that it can be easily accessed. Residents have been provided with a contract/statement of terms and conditions. The contracts are available in resident’s individual files. They set out the services and facilities offered by the home, terms and conditions of occupancy, fees, rights and responsibilities of parties and other issues as outlined in the National Minimum Standards. The contract for the new resident Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 Page 10 has not been signed. The contract must be signed by the resident and/or their representative to show that they agree with the terms and conditions of the home. Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 Page 11 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): 7, 9 & 10 Residents care plans reflect they are encouraged to make decisions with the assistance that they need. Some information in care files was not dated to show that it is relevant and up to date. Risk assessments are carried out which show that residents take responsible risks, however they are not always as detailed as they should be to ensure the safety of residents. EVIDENCE: A requirement was given at the last inspection for a risk assessment to be carried out for the use of bedrails that are used to minimise the risk of a resident falling out bed. A risk assessment is now available, however it does not identify all the risk factors associated with the use of the bedrails that are in place. For example, when, why and how they must be used. To ensure that the equipment is safe and effective the risk assessment must also include what action is taken to ensure that staff are appropriately trained in the use of it and how it is maintained. Case tracking showed residents needs are recorded in their care plan and are being met. Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 Page 12 Staff said they encourage and support residents to take part in aspects of live in the home in accordance to their ability and understanding. Residents level of involvement, and ability is recorded in their plans of care. Through discussion and observation staff showed they respect resident’s rights to make decisions. Choices and decisions made for residents by others and why are well recorded in their care plans. For example, none of the residents have a key to the front door of the house, the reason for this was recorded in their individual care plans. Most protocols and support guidelines that were viewed for residents showed they have been reviewed and updated at the required intervals, however some were not dated so did not evidence this. All care records should be dated following reviews to show that they are relevant and up to date. Medication and records that were examined were in good order and kept securely in a locked cabinet. Care plans for all residents were kept securely in the office. Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 Page 13 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): 16 Residents are given choices and are able to move freely around the house as part of an independent lifestyle. EVIDENCE: Both residents were seen using communal areas of the home. Staff provided the help and assistance as requested to enable residents move around the home. A good sized lounge area and dining room, which is separate to the kitchen, provides residents with a good amount of shared and private space apart from their own bedrooms. Staff were seen offering residents with choices and respecting the decision that they made. Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 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 the following standard(s): None of these standards were assessed on this occasion. The key standards 18, 19, and 20 were all inspected during the first inspection of this year. EVIDENCE: Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 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): None of these standards were assessed on this occasion. The key standards 22 and 23 were inspected during the first inspection of this year. EVIDENCE: Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 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, 28, 29 & 30 Parts of the home that need attention compromise the safety and comfort of the residents who live there. Equipment, which is not being used appropriately, compromises the safety of residents. EVIDENCE: A partial tour of the home was carried out. All parts of the home that were seen were clean and tidy. The hall, lounge and kitchen areas would benefit from redecoration as they are showing signs of wear and tear, this lets the overall appearance of the house down. Since the last inspection some of the paving at the back of the house has been replaced. The paving directly outside the lounge is in need of replacing, as it is uneven in parts posing a risk of falls to residents and staff. Several large bags of rubbish and other unwanted items that were seen stored at the side of the house at the last inspection have been removed. A small part of the floor in the main bathroom has lifted near to the doorway causing a potential trip hazard. The floor must be repaired to minimise the risk of falling. None of the residents smoke. There is a no smoking policy restricting staff and visitors from smoking inside the home. The designated area for smoking is Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 Page 17 outside at the back of the building. A large amount of cigarette butts were seen littered around the paving areas making the garden area look dirty and untidy. This compromises the dignity and respect of the residents. The area must be cleared up of cigarette butts and an appropriate facility for the collection and disposal of them must be provided. For example a metal bin filled with sand. A wheelchair, which was being used to transport a resident about the home, was not fitted with footplates. The hazards associated with this were discussed with a member of staff who immediately fitted the footplates onto the wheelchair. Wheelchairs and all other specialist equipment must be used appropriately ensuring the health, safety and welfare of residents at all times. Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 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 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): 35 Staff complete training that is required for them to carry out their work and which enables them to meet the needs of residents. EVIDENCE: Records examined and staff spoken with confirmed that staff complete training that is required as well as training that is specific to the needs of the residents. Training courses that staff have completed include Handling of Medication and Moving and Handling. One member of staff has recently completed NVQ Level 3. Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 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): 37 The appointed manager has not yet been approved by the commission as the registered manager of the home. EVIDENCE: The manager has forwarded onto the Commission an application for her approval as the registered manager of the home. The process of approving her is ongoing. Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 2 Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X 2 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X 2 2 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Spring Gardens, 9 Score X X X X Standard No 37 38 39 40 41 42 43 Score 2 X X X X X X DS0000005275.V271186.R01.S.doc Version 5.0 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 YA37 Regulation 8 Requirement The manager of the home must complete the application made to the Commission for a registered manager. All the paving at the rear of the house must be made safe. A more detailed risk assessment must be carried out for the use of bedrails. Cigarette butts must be removed from the outside of the house. A more suitable method for disposing of cigarette butts must be provided. The floor in the main bathroom must be repaired. Footplates must be appropriately used on wheelchairs at all times. Timescale for action 31/01/06 2. 3. 4. YA24 YA9 YA24 13(4)(a) 13(4) 23(2)(o) 28/02/06 31/01/06 31/01/06 5 6 YA24 YA29 23(2)(b) 13(4)(c) 31/01/06 29/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations All records kept in residents care files should be signed DS0000005275.V271186.R01.S.doc Version 5.0 Page 22 Spring Gardens, 9 2. 3. YA24 YA40 and dated. Consideration should be given for the redecoration of some areas of the home. The manager should make the homes policies and procedures more accessible to residents. Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Spring Gardens, 9 DS0000005275.V271186.R01.S.doc Version 5.0 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. 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