Random inspection report
Care homes for adults (18-65 years)
Name: Address: St Annes Road East (85) 85 St Annes Road East St Annes Lancashire FY8 3NF one star adequate service 13/01/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Phil McConnell Date: 0 4 0 9 2 0 0 9 Information about the care home
Name of care home: Address: St Annes Road East (85) 85 St Annes Road East St Annes Lancashire FY8 3NF 01253789074 Telephone number: Fax number: Email address: Provider web address: Steve.Turner@unitedresponse.org.uk None Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : United Response care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 6 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 6 Date of last inspection Brief description of the care home 85 St Annes Road East is a small care home for adults with learning disabilities, registered for six people. The well-established national charitable organisation United Response is the registered provider. The home is a semi-detached three-storey house providing good access to local services and amenities. The organisation provides a vehicle to enable people living at the home to take part in leisure activities and access amenities. The staff team support individuals in all aspects of daily living according to their assessed needs and as identified via the care planning process. Individuals are supported and encouraged to develop their independence and take part in all aspects of community living. The service adopts an active support approach, providing people
Care Homes for Adults (18-65 years) Page 2 of 9 1 3 0 1 2 0 0 9 Brief description of the care home with practical day-to-day support, in order that individuals can take as much control of their lives as possible. Care Homes for Adults (18-65 years) Page 3 of 9 What we found:
A Random Inspection was carried out on the 4th of September 2009. This was in order to assess if any progress had been made, regarding the requirements and recommendations that had been made, following the Key Inspection on the 13th January 2009. The registered manager (Steve Turner) was present throughout the Random Inspection, which was carried out by the Care Quality Commission (CQC). Peoples files were examined and it was apparent that new files had been compiled since the previous site visit. The files were observed to be very well organised, neat and tidy and it was apparent that individuals support / care plans are being regularly reviewed. However some of the documents in peoples files were undated, including the Listen to me booklets. Some of the information regarding medication in two of the support plans and in two of the Listen to me booklets was inaccurate. The information recorded was inconsistent with what was recorded in individuals medical administration records (MAR). For example, one person was receiving six items of medication as listed in their MAR sheet, but the support plan listed five items and the Listen to me booklet listed only one. The other persons MAR sheet had six items listed, with the Listen to me booklet, stating only Vitamins and the support plan, which had been reviewed in August 2009 did not list any medication at all. The MAR sheets for the two people receiving medication, were also undated for the day of the inspection. One person had two MAR sheets for the same period and on both of the records the medication had been signed for twice, however one other medicine was not signed for on either sheet. The explanation given by the person who been responsible for giving the medication that morning was, a mistake had been made so another MAR sheet was done and regarding the unsigned medication, I have given it, but I havent signed for it. The medication procedures for United Response clearly state that an explanation should be written regarding any mistakes or errors on the MAR sheet and signed by the member of staff and that all administered medication should be signed for immediately. It was suggested to the registered manager that it would be beneficial to ensure that all documents, especially care planning documentation is dated. This would give an assurance for inspection purposes that peoples assessed needs are being reviewed and updated when necessary. It was also suggested to use the MAR sheets provided by the pharmacist, instead of the ones that have been compiled by the home. It is also necessary to ensure that all staff who administer medication are familiar with the organisations own medication policy and procedures. It would be beneficial for staff to receive refresher medication training as soon as possible. This will help ensure that people are sufficiently trained, which would help ensure that any potential mistakes or errors of medication administration are eliminated and help give the assurance that vulnerable people are protected from harm. These concerns were discussed with the registered manager and there was an acceptance that the medication procedures were not being correctly followed. An assurance was
Care Homes for Adults (18-65 years) Page 4 of 9 given that the issues raised will be quickly addressed. A tour of the premises was carried out and it was evident that considerable work has been carried out, which has improved the environmental standards. The decor is of a good standard, with some work having been completed since the last inspection visit carried out by the CSCI including, a fully refurbished redecorated kitchen and a newly retiled and renovated bathroom. Overall the home is well decorated, clean, hygienic and comfortable for the people who live at St Annes Road and for the staff who work there. Staff supervision records were examined and it is evident that staff are now receiving regular sessions, with some of the staff comments being, supervisions are now more frequent and very productive. You feel when having them, that things will get done supervisions are now every eight weeks Things have vastly improved here, its nice working here. I love my job since the new team leader took over, its been absolutely brilliant. There is a different feel in the house and we all know what we are doing now. Theres a much better atmosphere in the home. What the care home does well:
There is an established, dedicated and committed staff team. In the feedback received and in observation during the site visit, it was apparent that good and trusting relationships exist between the staff team and the people who use the service. People commented about going on holiday with support workers and photographs were seen of another person who had been on holiday. People appeared to be much more relaxed and confident. Some of the comments from staff were, Service users have a much better rapport with each other Its a really happy working environment and when you come in people always ask now, what are we doing today?. There is a good Key worker system in place, which helps to give the assurance that peoples changing needs will be quickly identified and appropriate action would be taken. In discussion and observation with the staff, it was evident that the staff really do enjoy working at the home and are committed to the people who live at St Annes Road. As already mentioned the home was observed to well decorated and clean in all areas. There is now a more detailed and specific cleaning rota, which helps to give the assurance that the cleanliness of the home will be well satisfactorily managed. It was apparent that there is an ongoing programme for redecoration and maintenance. The registered manager said, we are going to redecorate the hall stairs and landings. Although it was evident that the present decoration is satisfactory, it is clear that the organisation is committed to ensuring that the environmental standards in the home are maintained to a good standard. The training being provided to staff is of a good standard including the national vocational qualification (NVQ), with 100 having achieved the award at level two or above. It was also evident that all staff have recently attended a Dementia Awareness one day course. This training was previously requested by some of the staff. In providing this training, the organisation has positively responded to the staffs request for specific training. Some shortfalls regarding staff supervisions were also identified at the last inspection visit. In discussion with staff and examining the supervision records, it is apparent that
Care Homes for Adults (18-65 years) Page 5 of 9 staff are now receiving regular formal supervisions. The recruitment of a permanent team leader in the home has been a positive development. This was evident in the feedback received, the atmosphere in the home and the observed relationships and rapport between service users and staff. The presence of a day to day leader in the home is a contributing factor to the ongoing improvements, which have already been mentioned. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 6 15 The registered person shall keep peoples care plans up to date and under review. There is a need to ensure that the care planning process is satisfactorily maintained, with sufficient information for the staff to be able to provide the persons assessed needs. 31/03/2009 2 35 18 The registered person shall ensure that the persons employed at the home receive training appropriate to the work they are to perform. Staff need to have the necessary training, in order to be able to support people to the best of their ability. 30/04/2009 Care Homes for Adults (18-65 years) Page 7 of 9 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 20 13 The recording and 11/09/2009 administration of all medication must be compliant with the policy and procedures of the organisation. Mistakes or errors with the administration of medication, could potentially place people at risk of harm. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 6 The information contained in all care planning documentation should be consistently recorded in each document. The regular auditing and monitoring of these documents would help ensure that potential errors or mistakes would be reduced. Care Homes for Adults (18-65 years) Page 8 of 9 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 9 of 9 - 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!
