Inspection on 09/08/05 for St Annes Road East (85)

This inspection was carried out on 9th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

St Annes Road East (85) 04/09/09

St Annes Road East (85) 13/01/09

St Annes Road East (85) 11/08/06

St Annes Road East (85) 01/12/05

St Annes Road East (85) 16/12/04

St Annes Road East (85) 11/05/04

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 St Annes Road East (85) 85 St Annes Road East St Annes Lancashire FY8 3NF Lead Inspector Lesley Plant Unannounced 9 August 2005 11.30 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Annes Road East (85) F57 F09 S9887 St Annes Rd East (85) V216202 090805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service St Annes Road East (85) Address 85 St Annes Road East, St Annes, Lancashire, FY8 3NF 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) 01253 712547 United Response Mr Stephen Turner Care Home 6 Category(ies) of Learning disability (6) registration, with number of places St Annes Road East (85) F57 F09 S9887 St Annes Rd East (85) V216202 090805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16.12.04 Brief Description of the Service: 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 with practical day to day support, in order that individuals can take as much control of their lives as possible. The staff team are supported by an experienced management team and an organisation, which clearly values its employees and the people who use their service. St Annes Road East (85) F57 F09 S9887 St Annes Rd East (85) V216202 090805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced, started at 11.30 am and took place over five and a half hours. The inspector spoke with three members of staff and spent time with three of the four people living at the home. Some individuals have specific communication needs and therefore discussion was limited. The inspector was able to have a more lengthy discussion with one person living at the home. The registered manager of the home was not present. Care records and some of the written policies were viewed. A tour of the building also took place. What the service does well: What has improved since the last inspection? What they could do better: The main areas for improvement relate to care plans, protocols and risk assessments. Regular reviews would improve opportunities for people at the home and would also promote a consistent approach to challenging situations. Care plans need to be fully reviewed at least every six months. It is anticipated that the strengthening of the key worker role will help this to happen, but it is the responsibility of the registered manager to ensure progress in this area. St Annes Road East (85) F57 F09 S9887 St Annes Rd East (85) V216202 090805 Stage 4.doc Version 1.30 Page 6 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. St Annes Road East (85) F57 F09 S9887 St Annes Rd East (85) V216202 090805 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection St Annes Road East (85) F57 F09 S9887 St Annes Rd East (85) V216202 090805 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2 and 5 Good information is provided and full assessments ensure that needs can be met. EVIDENCE: The Statement of Purpose and Service User Guide have been reviewed, with copies being sent to the Commission for Social Care Inspection and copies also available at the home. These updated documents meet the required standard and provide useful information. Files show that good pre admission information is gathered. This includes details of medical, communication and personal care needs as well as a Social Services support plan. The individual charter (contract) provided with the Service User Guide, clearly details what the service will provide and the rights of the individual. This contract, although used for people recently admitted to the home, should be put in place for everyone. The charter still refers to an annual care plan review, when this should be taking place every six months. St Annes Road East (85) F57 F09 S9887 St Annes Rd East (85) V216202 090805 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9 Care plans and risk assessments are not regularly reviewed, which could lead to changing needs not being addressed. EVIDENCE: Files show that not everyone has a full six monthly review. During the past few months some people have left the home, to move into more independent accommodation, with the staff team focussing on the care plans for these people. The daily records show that the four people living at the home receive appropriate day to day support, but longer term goals and plans to meet these goals are not in place for everyone. Good work has been done with one individual who has made a great deal of progress in joining the group for meals and going out of the home, activities which were most difficult for her in the past. A consistent staff approach appears to have lead to these good outcomes. However, incident reports show an increase in challenging behaviour for one person, and although reference is made to reviewing the guidance and approaches for staff, this has not yet taken place. This individual has not had a full care plan review since April 2004. Staff have provided one person at the home with a communication bag, containing familiar objects and there are plans to further develop communication aids with the support of a language specialist. Each person has a named key worker and this role is St Annes Road East (85) F57 F09 S9887 St Annes Rd East (85) V216202 090805 Stage 4.doc Version 1.30 Page 10 currently being strengthened and further developed, which will help the review process. Risk assessments are in place, which cover individual activities and also general risks, such as fire. Risk management strategies are in place and staff sign these. Some of these are out of date and clearly in need of review. For one person the risk assessment stated that two staff support her when out, yet just one staff member went out with her on the day of the inspection. The staff member explained that two staff were no longer needed, but this should be formally reviewed and recorded. There was no risk assessment in place for one person who has a kettle in her bedroom. St Annes Road East (85) F57 F09 S9887 St Annes Rd East (85) V216202 090805 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 There are good opportunities for people to participate in local community activities. Relationships are given a high priority, with staff providing good support in this area. EVIDENCE: Daily records detail all activities. During the inspection two people were out at a craft/social group and one person went out for lunch. Two people at the home spoke of a variety of activities including, keep fit, listening to music, shopping, drama group, visiting friends and enjoying a holiday abroad. A weekly plan shows the regular activities for each person. Excellent progress has been made regarding supporting a person to go out of the home, which has proved very difficult in the past. Consistency in approach has lead to good outcomes for this person. One person used to have a work placement and staff stated that they are looking at the possibility of this starting again. Files show records of relatives/friends birthdays and staff support people to buy a card or gift. Relatives regularly visit people at the home, as seen during previous inspections. One person spoke of being supported to keep in touch with her friend after she moved to the home. One person had recently been St Annes Road East (85) F57 F09 S9887 St Annes Rd East (85) V216202 090805 Stage 4.doc Version 1.30 Page 12 helped to make and deliver a card to neighbours. During the inspection, staff supported people at the home to communicate and share information with the inspector. St Annes Road East (85) F57 F09 S9887 St Annes Rd East (85) V216202 090805 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 19 Personal and healthcare needs are met. EVIDENCE: Files contain good information about the personal and healthcare needs of people at the home. Individual protocols help staff to provide personal care in an individual manner and as preferred by each person. Records show that other professionals are involved where necessary. A speech and language assessment has taken place for one person with specific communication needs. A communication bag is used for this person, with objects such as a sponge being handed to him to indicate bath time. Good records are kept of all health care appointments. One person said that she gets the help needed and explained how staff had supported her to see her GP recently. This appointment and the outcome were recorded in her file. People are encouraged to take part in healthy activities such as keep fit classes and menus provide good nutrition. Some people at the home are being encouraged to reduce their weight, through keeping to a health diet. St Annes Road East (85) F57 F09 S9887 St Annes Rd East (85) V216202 090805 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of the above standards were assessed at this inspection. EVIDENCE: St Annes Road East (85) F57 F09 S9887 St Annes Rd East (85) V216202 090805 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The premises are safe, comfortable, clean and attractive and provide good access to local amenities. EVIDENCE: The dining room, main lounge, kitchen and several bedrooms have recently been redecorated. There is a large kitchen, dining room, main lounge and smaller lounge, which provide good opportunities for people to spend time alone if they wish. One person showed me his newly furbished bedroom and confirmed that he had chosen the colour scheme. This person also stated that everyone at the home had chosen the colours and carpet for the dining room. People at the home are supported to take a pride in their home and carry out a variety of domestic tasks, including doing their own laundry. There is a separate laundry room outside, at the back of the home. This is clean and well organised. Staff carry out regular health and safety checks within the home. St Annes Road East (85) F57 F09 S9887 St Annes Rd East (85) V216202 090805 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 People are supported by an experienced and competent staff team, who are working hard to gain their NVQ qualifications. EVIDENCE: The staff team has remained reasonably stable, with only two new staff since the last inspection, one of these being the team manager. During the inspection staff communicated effectively with the people living at the home and helped people to communicate with the inspector. One staff member has undergone specific communication training to better meet the needs of one person at the home and there are plans for other staff to follow suit. Staff appeared motivated and had a good understanding of the needs of people living there. There are always at least two staff on duty during the day. United Response provides a good programme of core training, which is attended by all staff. Progress is being made with NVQ training. Out of ten support staff, two have completed NVQ level 3, three are undertaking this award and two more are undertaking the level two award. St Annes Road East (85) F57 F09 S9887 St Annes Rd East (85) V216202 090805 Stage 4.doc Version 1.30 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The health and safety of people living at the home is promoted. EVIDENCE: United Response has good systems in place, which promote health and safety. There is a schedule of daily, weekly, monthly and quarterly, health and safety monitoring. Reminders for these checks are put in the diary and then a record of each check is kept. Checks include fridge/freezer temperatures, water temperatures, fire alarm system, medication checks, vehicle checks and checks of first aid supplies. Although there were some gaps in the records for recent checks, generally this system works well. There is a risk assessment in place relating to an individual who may in the case of a fire, refuse to evacuate the home. Water temperatures are thermostatically regulated to ensure that water is delivered at a safe temperature. The core training programme addresses health and safety issues, such as food hygiene. St Annes Road East (85) F57 F09 S9887 St Annes Rd East (85) V216202 090805 Stage 4.doc Version 1.30 Page 18 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 x x 3 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 x x Standard No 31 32 33 34 35 36 Score x 2 x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 St Annes Road East (85) Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x F57 F09 S9887 St Annes Rd East (85) V216202 090805 Stage 4.doc Version 1.30 Page 19 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 6 Regulation 15 Requirement The registered manager must ensure that all care plans are reviewed at least every six months. Timescale for action Immediate and ongoing. 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. Refer to Standard 5 9 32 Good Practice Recommendations The charter (contract) should be ammended to show that a six monthly review will take place. Risk assessments should be regularly updated. The registered manager should monitor the NVQ strategy to meet the target of 50 of care staff qualified to NVQ level 2. St Annes Road East (85) F57 F09 S9887 St Annes Rd East (85) V216202 090805 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Unit 1, Tustin Court Portway Preston PR2 2YQ 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 St Annes Road East (85) F57 F09 S9887 St Annes Rd East (85) V216202 090805 Stage 4.doc Version 1.30 Page 21 - 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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