Inspection on 31/05/07 for Spring Gardens, 9

This inspection was carried out on 31st May 2007.

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.

Other inspections for this house

Spring Gardens, 9 19/07/06

Spring Gardens, 9 29/11/05

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 Key Unannounced Inspection 31st May 2007 10:00 Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 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.V332873.R01.S.doc Version 5.2 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.V332873.R01.S.doc Version 5.2 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 Colette Culshaw Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 3 LD. The Manager should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 19th July 2006 Date of last inspection Brief Description of the Service: 9 Spring Gardens is registered as a care home for three people with a learning disability. There are currently three 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 blends in well with other properties 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. It cost £318.00 per week to live at the home. Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection. The Commission considers 22 standards for Care Homes Adults as Key Standards, which have to be inspected during a Key Inspection. The report has been put together using information gathered from a number of sources including information that the commission have received about the service since the last inspection and details provided in the pre-inspection questionnaire. “Have your say” Surveys were sent out by the Commission to people before the inspection, however none of them were completed. A site visit to the home was also carried out as part of the inspection. Records examined, people’s comments and observations made during the visit have also been used as evidence for the report. People spoken with during the visit, included a resident, the manager and a number of staff. It was not possible to obtain the views of other residents because of the nature of their disability however case tracking and observations made during the inspection visit enabled the inspector to get an idea of what is like for the people to live at the home and how their needs are being met. What the service does well: Available at the home were a number of policies and procedures, which aim to ensure that people make a positive choice about living there. The manager showed a good understanding of the companies needs assessment document and was able to describe in good detail the areas it covers. An individual care plan and support guidelines were in place for each person. The documents clearly set out how staff need to meet the persons health, personal, and social care needs enabling them to live independent, healthy and enjoyable lifestyles. During the inspection visit staff were observed treating residents with respect and carrying out personal care in a flexible and sensitive way. One service user said that staff are always polite and treat them well they made the following comments to support this: “I get on well with all the staff” “The staff know I like to do a lot for myself and they encourage me to do this” “The staff talk to us all in a nice way” Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 6 The home has in place appropriate procedures for responding to concerns and complaints and for ensuring that residents are safe from abuse, harm or neglect. The commission have not received any complaints about the home since the last inspection. The company have received two allegations about the home since the last inspection. Records show that the correct policies and procedures were followed in response to these. Everybody spoken with during the inspection said that they have access to information about how to make a complaint if they needed to. People were confident that their complaints would be listened to and dealt with in the correct way. More than half of the staff team have achieved or are working towards a National Vocational Qualification in Care level 2 and above. Staff are involved in an ongoing programme of training, which is relevant to the work that they carry out. The newly appointed manager showed great enthusiasm for ensuring high standards of care, she also showed a commitment to the training and development that is required of her to maintain and update her knowledge, skills and competence while managing the home. What has improved since the last inspection? A requirement was given as part of the last inspection report because there were a number of discrepencies identified with the recording of medication which had the potential to put residents at risk. During this inspection visit all medication and medication administration records were examined. They were appropriately stored and records were up to date and accurate. During the last inspection visit there were parts of the environment, which showed signs of wear and tear a number of requirements and recommendation, were given for this. This inspection visit showed that a significant amount of work has been carried out on the home making it more comfortable for the people that live there. Improvements include: New UVPC replacement windows through out the property Redecoration of the lounge, hall way and office Repairs and redecoration to a resident’s en suite bathroom Repainting of the outside of the property Replacement carpets in residents’ bedrooms Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 7 Records showed that staff have completed mandatory training, which is required of them to ensure the health, safety and welfare of the residents. Recent training includes health and safety, medication awareness, lifting and handling and protection of vulnerable adults. What they could do better: On the day of the visit there was some discussion with neighbours who said that relationships with the home are generally good however they did have some concerns about parking arrangements. It seems that visitors to the home and on occasions staff park on the road, which has the potential to obstruct other people from accessing their drives. It is in the best interests of the residents to maintain good relationships with neighbours it is therefore highly recommended that additional parking space be created as described in the main body of the report. The home has good sized front and back gardens however paving flags, which are broken and uneven, pose a trip hazard to residents and staff. These should be repaired or replaced to minimise this risk. Lawns and borders were overgrown and full of weeds making the gardens look untidy. The manager said that the regular gardener employed by the company had left and they are actively seeking to employ another. The gardens should be tidied up and better maintained so that the residents have full use of a safe and pleasant environment. Some personnel records for new staff that have started work at the home since the last inspection were not available for inspection. The manager said that they were held at head office. She was advised that they should be kept at the home so that are available for inspection to show that show that the homes recruitment procedures are robust. Miss Birch has obtained an application for her approval as the Registered manager of the home but has not yet completed it. The manager was advised to complete and forward onto the Commission her application to ensure that the home has a registered manager as soon as possible. Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 8 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. The summary of this inspection report can be made available in other formats on request. Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 9 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.V332873.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service had available policies and procedures, which aim to ensure that prospective residents needs are fully assessed so that they can be sure of meeting the person’s needs. EVIDENCE: There have been no new residents admitted to the home since the last inspection. Available at the home were a number of policies and procedures, which aim to ensure that people make a positive choice about living there. Policies included needs assessments, introductory and trial visits. The manager was familiar with the companies needs assessment document and was able to describe the areas it covers which includes, personal and healthcare, communication, relationships, finances, management of risk, diet, religion and culture. Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service encourages residents to make choices and take responsible risks as part of an independent lifestyle. EVIDENCE: Detailed individual care plans were available for each of the residents. The care plan document, which is used throughout the companies residential services is made up of a number of sections covering all aspects of the health, personal, and social care needs of the person. Areas of need covered include communication, medication, relationships, religious belief, behaviour management and financial. Care plans for two people were looked at in detail as part of the case tracking process. This showed that both have been developed on the basis of assessments made. Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 12 The manager explained that a review of each persons care plan takes place monthly with the involvement of the resident/representative, the manager and key workers. As part of the review a care plan summary document is completed, which reflects current objectives and any change in needs and the action to be taken, to meet those needs. The main care plan document is then updated. Records evidenced regular reviews of both care plans. During discussion a member of staff explained in good detail the purpose of care plans and how they use them to support residents. Daily records were kept for each person, they were also looked at as part of the case tracking process. This showed that staff support residents in accordance to their individual plan of care. Two residents have limited verbal communication skills, however they are supported to communicate by use of other methods for example, gestures, sounds, and body language. Staff explained how they assist residents to make choices about all aspects of their lives. Information about each persons preferred means of communication was available in good detail. During the visit staff were seen communicating effectively with residents they were seen offering residents choices and encouraging them to make decisions about things such as food and activities. Due to limitations a number of residents are unable to manage their own finances. Financial support that residents need was recorded in their individual plan of care. Residents money and financial records that were examined were well kept and in good order. One resident is totally independent in managing their finances, which is encouraged and supported by staff at the home. Records showed that each resident has a bank account in their own name and address. Statements of all transactions made were available at the home. A resident said: “I look after all my own money and spend it as I like” For safety reasons there are certain restrictions placed on residents for example access without support to certain parts of the home and the community. There are also instances when some decisions and choices have to be made for residents by others. Restrictions placed upon people and choices, which need to be made by others and the reasons why, were recorded in each person’s plan of care. Risk assessments were part of each persons care plan. They have been carried out for tasks and activities which residents are involved in that are likely to pose a risk to them. Risk assessments that were seen identified potential risks and hazards and detailed the action that Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 13 staff need to take so that residents are able to take risks safely as part of an independent lifestyle. Risk assessments that were viewed showed that they have recently been reviewed and updated. Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to live active and healthy lifestyles. EVIDENCE: Each persons care plan provided a good amount of information about their preferred activities, leisure and daily routines. A structured timetable of activities was available for each of the residents. Case tracking showed that they have been developed around the needs and wishes of the individual. One resident attends day care for part of the week. On other days they are supported by staff to take part in a variety of tasks and activities both in and outside the home. Other residents day time activities include, cleaning and tidying the home, laundry, walks, shopping and lunches out at local pubs and Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 15 cafes. Evening activities include trips to the cinema, bowling and social evenings. Daily records for each resident showed that they have been supported to take part in indoor and outdoor activities that they prefer and which are set out in their plans of care. Discussion with staff and records viewed showed that staff support residents to maintain family links and friendships inside and outside the home. One service user said,” I keep in touch with my dad, I visit him occasionally”. Discussion with people and records such as the visitors’ log and residents daily notes evidenced that family and friends are welcomed at the home. Each person’s care plan included information about relationships and how they need to be supported. Care plans included information about residents likes and dislikes with regard to food. Residents make choices about what food they eat and are offered drinks and snacks outside of usual meal times. The special dietary needs of one resident are clearly documented in their individual plan of care Staff undertake specialist training on a regular basis so that they have the knowledge, skills and competence to meet the residents special dietary needs. One resident who is more able helps with general tasks around the house. She was seen attending to laundry and making drinks for herself and others. Care plans provided information about the things that residents are able to do and the help and assistance they need. There is a family sized dining set at one end of the main lounge. The kitchen was equipped with domestic style appliances. Food stores that were examined were well stocked with fresh frozen and dried goods. A member of staff said that residents are involved in shopping for food. This was confirmed during discussion with a resident who said, “I go shopping because I like to choose my own food”. A new microwave, pots and pans have been purchase since the last inspection. They were of good quality. Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with a good level personal and healthcare support which ensures their emotional and physical well being. EVIDENCE: Care plans provided detailed information about the type and level of personal and healthcare support that each person requires. The persons preferred routines with regards to personal care were also available in very good detail. Information was available in a way, which ensures residents privacy, dignity and independence. Staff were seen providing personal support for one resident. They were seen treating the resident with respect by ensuring that the care was carried out in private. During discussion staff showed that they provide sensitive and flexible personal support which ensures residents privacy and dignity. The following comments supported this: “When assisting residents with personal care it is important to make sure doors and blinds are shut”. Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 17 “I always talk to residents when helping them and explain what I am doing”. “I always make sure that personal care is given in private”. “It is important to ask people what they want and to tell them what you are doing”. Care plans clearly set out the person’s healthcare, needs and procedures that are in place to address them. Records within this section showed that residents are offered minimum annual checks and that there health is regularly reviewed and monitored and dealt with appropriately. As well as visits to primary healthcare services such as dentist, opticians and doctors residents are also supported to attend specialist services. Records detailing the visits were available in good detail as was information about specialist health care needs and requirements. Health plans provided good information about how residents communicate when they are unwell or in pain. These are particularly important for a number of residents that have limited verbal communication skills. A requirement was given as part of the last inspection report because there were a number of discrepencies identified with the recording of medication which had the potential to put residents at risk. During this inspection visit all medication and medication administration records were examined. They were appropriately stored and in good order. The manager said that medication is only administered by staff that have completed medication awareness training. discussion with staff and records that were seen evidenced this. A weekly stock check of all medication is carried out by the manager records seen evidenced this. A policy for the safe handling and administration of medication was availble at the home. The manager showed a good awareness of the homes medication polices and procedures. Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the homes procedures for responding to concerns and complaints. EVIDENCE: There has been no complaints received by the Commission about the home since the last inspection. Information provided in the pre-inspection questionnaire and records held by the Commission show that the provider has received two separate allegations about the conduct of staff at the home. One incident has been fully investigated and resolved and the other is ongoing. All the appropriate records relating to the incidents have been forwarded onto the commission. They show that appropriate polices and procedures were followed in ensuring the protection of residents. The home had available a complaints procedure in written and picture format. Both included clear information about the stages and timescales involved in the process so that residents and other people are clear about how to make a complaint if they wish to. Discussion with the manager and staff showed that they are confident about telling somebody if they were uphappy and that something would be done. Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 19 The following comments supported this: “Yes I would make a complaint if I needed to” “I am sure that any complaint would be dealt with in the right way” “I about the homes complaints procedure” one resident said “I know how to complain and I would make a complaint if I needed to”. A copy of the local authorities protection of vulnerable adults procedure was avaialbe at the home. A member of staff spoken with was able to describe confidently what action they would take if they thought a resident was being abused. A new member of staff was unsure of what to do. The manager confirmed that protection of vulnerable adults training has been arranged for this person. Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The inside of the home provides a comfortable and safe place for people to live however the outside which is untidy and unsafe in parts lets the overall appearance of the home down as well as compromising peoples health and safety. EVIDENCE: The home is a three-bedroom bungalow, which is located in a quiet cul de sac in Maghull. There is a large garden at the back of the house and garden areas and a large driveway with off road parking for a minimum of three cars at the front. 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. Public transport links are close by. The pre-inspection questionnaire detailed a number of improvements made to the environment since the last inspection, which includes: Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 21 New UVPC replacement windows through out Redecoration of the lounge hall way and office Repairs and redecoration to a resident’s en suite bathroom including new tiles Repainting of the outside of the property – sills, front and garage doors Replacement carpets in residents’ bedrooms – one service user said she chose the carpet in her room. A tour of the premises showed that the work has been carried out to a good standard. The back garden, which can be accessed from the home, has patio areas, which lead, onto a very large lawn area. A number of flags, which make up the patio are uneven and pose a trip hazard to residents and staff. It is therefore a strong recommendation of this report that the uneven flags be repaired or replaced to minimise this risk. Both the front and back gardens were untidy. Lawns and borders were overgrown and full of weeds. The manager said that the regular gardener employed by the company had left and they are actively seeking to employ another. Arrangements should be made as soon as possible to repair the patio and maintain the gardens so that the residents have full use of a safe and pleasant environment. On the day of the visit there was some discussion with neighbours who said that relationships with the home are generally good however they did have some concerns about parking arrangements. It seems that visitors to the home and on occasions staff park on the road, which has the potential to obstruct other people from accessing their drives. This was discussed with the manager and staff who advised that too many cars parked on the driveway makes it difficult to get wheelchairs in and out the house, this means parking at least one car on the road although only for a short period of time. The manager went on to say that she had made a request to the company for the removal of some large hedges at the front of the home, the removal of them would solve the parking issue by providing space for at least one vehicle. It is in the best interests of the residents to maintain good relationships with neighbours it is therefore highly recommended that additional parking space be created as suggested by staff or by other means. All parts of the home were clean and hygienic on the day of the visit. Were possible residents help to keep their home clean and tidy. Cleaning routines and the people responsible for carrying them were in place. Detailed in the pre-inspection questionnaire were a number of policies and procedures for ensuring a clean and hygienic environment for all. Related policies and procedures, which were also seen at the home included, Infection control, the use of protective clothing and disposal of waste. Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is no guarantee that all staff is competent and have the qualities that they need to work at the home. EVIDENCE: Discussion with the manager and details provided in the pre-inspection questionnaire showed that one staff member has left the home since the last inspection. Records held by the Commission show that two staff members were suspended following an allegation of misconduct. One member of staff has since returned to work. An investigation is ongoing for another. The pre-inspection questionnaire showed that two new staff have started work at the home since the last inspection. Personnel records for these people were seen. They showed that appropriate recruitment procedures were carried out before the people were allowed to start work at the home. A new member of staff was on duty and spoken with during the inspection visit she described the Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 23 process that she went through before being allowed to start work at the home. This included, completing an application form, an interview and CRB check. Personnel records for some staff were not available at the home the manager explained that they were at head office being updated. She was advised that all staff records required by regulation should be kept at the home so that they are available for inspection to show that the person is fit to work at the home. Staff spoken with showed a good awareness of equal opportunity policies which were available at the home. Records viewed and information provided in the pre - inspection questionnaire show that staff of various age, gender, culture and religion are recruited and made to feel welcome at the home. At the time of the visit there were two support workers and the manager on duty. These staffing levels appeared appropriate to the needs of the residents. Copies of staffing rotas, which were provided with the pre – inspection questionnaire were examined and showed that there are sufficient staff on duty at all times throughout the day and the night. Staff spoken with stated that they were happy with the staffing levels at the home. At intervals throughout the visit staff were seen interacting well with residents. They were flexible and positive in their approach and appeared to have a good understanding of the needs of the residents. Discussion with staff showed that they are interested, motivated and committed to their work. Comments made by staff which supported this included: “I really enjoy working here job”. “I enjoy the training”. “It is important that we all get on ”. “The residents are the most important”. A new member of staff said that she had completed an induction programme at the start of her employment. She said that the induction lasted for approximately six weeks and covered areas such as the structure of the company, workers roles and responsibilities, policies and procedures, the main principles of care and emergency procedures. The worker also said that they were on shift with a senior member of staff throughout their induction. Both support workers spoken with said that they have completed training including fire awareness, first aid, and health and safety and medication awareness. Other training completed by staff, which was detailed in the preinspection, includes food hygiene valuing people, mental health awareness and epilepsy. More than half of the staff group have achieved or are working towards a National Vocational Qualification (NVQ) in care level 2 or above. Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run well to the benefit of the residents and staff, however the manager has not been approved by the Commission so the home does not have a registered manager. EVIDENCE: Since the last inspection Colette Culshaw has resigned as the registered manager of the home. Loretta Birch is the newly appointed manager. Prior to becoming the manager Miss Birch worked at the home for a number of years as a senior support worker. During her time as a senior support worker Miss Birch gained some managerial experience including supervision of staff and decision making. Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 25 Records held by the commission show that the company notified of this change. Miss Birch has obtained an application for her approval as the Registered manager of the home but has not yet completed it. The manager was advised to complete and forward onto the Commission her application to ensure that the home has a registered manager as soon as possible. Since her appointment Miss Birch has addressed most of the requirements given as part of the last inspection report. Examination of a selection of records showed that she has improved and maintains records required by regulation. She showed a real enthusiasm and a commitment to ensuring high standards of care. The following comments were made by staff about the manager: “The manager is always there for you” “She is approachable and reliable” “She is understanding and I get on well with her” Discussion with Miss Birch evidenced that she undertakes regular training and development to update her knowledge, skills and competence while managing the home. As part of the homes quality monitoring system residents, relatives and advocates are invited to complete surveys, which gives them the opportunity to put forward their views and make comments about aspects of the service for example, the manager and staff, the quality and choice of food, and the environment. The manager explained that the results of the surveys are used to monitor the quality of the service. Also As part of the homes quality assurance process and in accordance with Regulation 26 of the Care Homes Regulations a representative for the home visits the premises monthly. They interview residents and staff, check records and inspect the environment. It is important that this is done to check the standard of care in the home. Following the visit a report detailing the visit is written. Records show that the visits and reports are being carried out each month as required. The health safety and welfare of residents are well protected this was supported by a comprehensive set of policies and procedures, which were detailed in the pre-inspection questionnaire and available at the home. A number of the homes policies and procedures have recently been reviewed and updated. Information provided in the pre-inspection questionnaire and examination of a selection of health and safety records showed that the required health and safety checks have been carried out on the environment at the required Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 26 intervals, for example fire system checks, gas and electricity checks and environmental risk assessments. Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 28 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. 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. Refer to Standard YA24 YA24 YA24 YA34 Good Practice Recommendations Gardens, which are untidy, should be better maintained so that residents have an opportunity to sit out in a safe and comfortable environment. Paving flags on the patio, which are broken and uneven, should be repaired or replaced to reduce the risk of people tripping and falling. Serious consideration should be given to providing more off road parking for staff and visitors to limit the Staff personnel records should be kept at the home at all times to show that recruitment procedures are robust and people are fit to work at the home. The manager should complete and put forward to the commission her application to be registered manager of home to be sure that the home is being managed by the right person. YA37 Spring Gardens, 9 DS0000005275.V332873.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Merseyside Area Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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