Inspection on 08/10/07 for The Bungalow

This inspection was carried out on 8th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Bungalow 25/07/06

The Bungalow 06/03/06

The Bungalow 20/09/05

The Bungalow 09/03/05

The Bungalow 04/08/04

The Bungalow 20/02/04

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 The Bungalow Raby Hall Road Bromborough Wirral CH63 0NN Lead Inspector Beate Field Key Unannounced Inspection 8th October 2007 2:00 The Bungalow DS0000019000.V349963.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 The Bungalow DS0000019000.V349963.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. The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Bungalow Address Raby Hall Road Bromborough Wirral CH63 0NN 0151 334 7510 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) siobhan.wise@wirral.autistic.org Wirral Autistic Society Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th March 2007 Brief Description of the Service: The Bungalow is registered to provide personal care and accommodation to 3 adults who have autism. The Bungalow is set within the grounds of Raby Hall, which contains other services operated by Wirral Autistic Society. The home provides each resident with a single bedroom. There is a lounge, kitchen dining area, two separate toilets and a bathroom and a staff office/sleep in room. The home is close to local shops and to public transport services. Parking is available. The fees at the home are £1170 per week. A copy of the statement of purpose, which describes the services offered at The Bungalow, is made available to relatives and social workers. The service users guide to the home is made available before a prospective resident comes to live at the home and the content is discussed with them, where possible, to ensure their understanding. The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection is based on a visit to the home, information received about the service since the last inspection and by questionnaires completed by the manager, staff and health care professionals. During the visit to the home time was spent looking at a sample of records and policies and procedures and talking to the manager. A tour of the home was undertaken. The inspector spoke with staff and observed the care provided to residents. What the service does well: What has improved since the last inspection? Since the last inspection maintenance and decorative works have taken place to improve the appearance and safety of the home. Work has begun and is ongoing around ensuring that residents have access to communication aids, which will assist them in making choices. The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 6 What they could do better: 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. The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment process ensures that the service is only offered to individuals whose needs can be met at the home. The contracts/terms and conditions support the interests of residents. EVIDENCE: No new residents have come to live at the home since the last inspection. Records from previous visits to the home show that the assessment process is thorough and ensures that a service is only offered to an individual whose needs can be met at the home. Staff who undertake assessments are appropriately trained to do so. The initial assessments indicate the communication, religious and cultural needs of a prospective resident. Prospective residents can make a number of visits to the home to get to know the service, meet the staff and residents. Parents/carers and representatives from placing authorities are also able to make visits to the service. The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 9 The contracts/statement of terms and conditions between the home and the residents contain the required information. A representative of the residents has signed the contracts to agree this meets the residents’ best interests. The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 10 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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal goals and individual needs of residents are in general well documented, providing staff with the information they need to support the residents. EVIDENCE: Care plans were examined and contained clear information to enable staff to provide appropriate support around day-to-day living and personal goals. A review of the care plans seen had taken place within the last 6 months. The documentation available from reviews indicated that the resident, their relatives, social worker and other relevant individuals are invited to contribute to reviews. Care plans indicated that resident’s independence is promoted, in accordance with their abilities. Risk assessments are available in order to safeguard The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 11 residents and promote their independence. The action taken to minimise the risks to a resident of having an accident during the night had not been fully documented. Although the staff spoken with were aware of the action to be taken this needs to be fully recorded so that all staff have this information to refer to. Reactive plans, which detail behaviour management strategies, are available. Staff training records show that staff have received the training they need to support residents when they display any challenging behaviours. Work is taking place to improve the communication aids available to residents, which will support them to make choices about their daily lives at the home. The residents’ communication passports are being reviewed and pictorial aids are being developed. A service users guide and a complaint procedure that are more suited to the needs of the residents are in the process of being developed. The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 12 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 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to take part in appropriate activities that provide opportunities for their educational, social and personal development. Varied and well-balanced meals are provided in homely surroundings. EVIDENCE: Residents attend day services where they are provided with a range of opportunities to promote their personal development. Residents have a timetable of activities, which has been drawn up to meet their needs, skills and individual preferences. Records and a discussion with staff indicate that there are opportunities for residents to become involved in the local community in accordance with their The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 13 wishes. The home has access to private transport and there is easy access to bus services. Staff and records indicated that family links and friendships are promoted. Discussions with the staff and observations confirmed that the home’s routines are flexible as much as possible and fit in with the needs and wishes of the residents. Work is taking place to improve the communication aids at the home so that residents can be better assisted to make choices around meals and activities. Care plans indicate the dietary requirements of residents. Advice is obtained from a dietician if this is required. A record is kept of food provided to residents. The records showed that well-balanced and varied meals are provided which meet the cultural background of the residents. Residents go shopping and help with preparing meals with staff support. The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The personal care and health needs of the residents are well met. EVIDENCE: Records clearly detail the support resident’s need with their personal care. The routines of residents are documented and provide good guidance for staff on how to support them. Staff receive training on promoting privacy and dignity during their induction and were able to describe how they promote this when interviewed. Records of reviews show that residents have access to medical/health care professionals as needed. Residents are supported to attend health care appointments. Questionnaires returned by GP’s showed that the home appropriately seeks advice and acts upon it. A medication procedure is available which provides clear guidance. Medication is stored securely. The records of training indicate that staff have been trained The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 15 in the safe handling and administration of medication. A selection of medication administration record sheets and corresponding medication were inspected and were in general found to be well maintained. The records of the amount of one type of medication held at the home did not correspond to the actual amount of medication available. The manager addressed this following the visit and identified that the records had been correct. It is recommended that the systems for auditing medication be reviewed to ensure that there is clear evidence at the home as to the amount of medication available. The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 16 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff training and policies and procedures are in place to ensure that residents’ views are heard and they are protected from harm. EVIDENCE: Wirral Autistic Society has a complaints policy and procedure. A copy of the procedure is held in the home and is also detailed in the Statement of Purpose. No complaints have been received by the home or by CSCI since the last inspection of the service. A complaints procedure is available in pictorial form however this is being reviewed so that a procedure is available that each resident will be able to understand. Staff have access to appropriate adult protection procedures. The two staff spoken with were able to demonstrate a clear understanding of how to protect vulnerable adults from abuse. All staff that work at the home have been given training on recognising abuse and of the action to be taken in the event of abuse being suspected. Monies held at the home, on behalf of residents are checked daily by staff, audited by the manager on a monthly basis and by the representative of the registered provider at their monthly visits. Receipts are maintained and records are signed by staff. The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 17 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, 25, 26 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a safe, clean and pleasant environment for the residents. EVIDENCE: The premises provide a comfortable, homely environment for residents. The home is well maintained and there is evidence of ongoing improvements to maintain standards. Bedrooms are attractively decorated and it is evident that the staff have taken residents preferences into consideration when personalising the rooms. Steps have been taken to ensure the safety of residents at the home. Window restrictors, radiator covers and temperature-controlled water are provided. The grounds at the front of the home are not enclosed. The Bungalow DS0000019000.V349963.R01.S.doc It is recommended Version 5.2 Page 18 that consideration be given to enclosing this area. This would provide added privacy and security for the residents. Two doors are in use, which open in two sections. These doors are not domestic in appearance. A risk assessment around the use of these doors is available. Consideration should be given to replacing these doors with alternative doors that are not institutional in appearance. The home was found to be clean and hygienic throughout. The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 19 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 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by competent staff that have access to good training opportunities. EVIDENCE: The rota shows that there is generally one member of staff on duty at all times with a second member of staff being available some evenings to support the residents in individual activities. The two staff spoken with said that the staffing levels are sufficient. Permanent staff or Wirral Autistic Society’s bank staff cover absences at the home. The same staff are used to ensure continuity of care. One member of staff holds an NVQ at level 2 and one member of staff is currently working towards this qualification. A comprehensive induction and foundation training programme is provided to permanent and bank staff. The training covers health and safety matters, adult protection, equal opportunities, communications, deaf awareness, moving and handling, first aid, safe handling of medication, autism specific The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 20 training and promoting the rights of the service user. The induction and foundation training programmes have been developed in accordance with the National Training Organisation training targets. No new staff have been employed at the home since the last inspection. At the last inspection records showed that appropriate recruitment checks had been carried out before staff were employed. Staff questionnaires confirmed this. The staff interviewed reported that they are well supported by the manager. The questionnaires returned by staff showed that they receive regular management support. Records of supervision of staff were not consistently recorded. This needs to be addressed in order to demonstrate that staff are being provided with the appropriate support and guidance to carry out their roles. The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 21 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 and 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 in the best interests of the residents. EVIDENCE: The current manager has been managing the home for over 12 months. An application to register the manager has not been made to CSCI. An application needs to be made so that CSCI can assess the manager’s suitability for this position. The manager holds an appropriate qualification in care and has undertaken training to keep his knowledge and skills up to date. The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 22 The two staff interviewed and the questionnaires returned by staff showed that they are well supported by the manager. They reported that they consider their views regarding the running of the home are sought and listened to. Team meetings are held on a regular basis. There are a range of quality assurance systems in place. Wirral Autistic Society is accredited by the National Autistic Society which carries out an inspection of services provided. Wirral Autistic Society conducts an internal audit of the society as a whole on an annual basis. Questionnaires are sent to relatives regarding how the home operates. Visits to the home by the representative of the registered provider are made. These reports are made available to CSCI. The manager carries out a monthly house check of all reccords and the premises. The manager reported that questionnaires for health and social care professionals are in the process of being devised. Training around safe working practices such as manual handling, fire safety, infection control and first aid is made available to staff as part of their induction. There is a rolling programme of training opportunities provided and staff can access this when required. There are a range of policies and procedures available that promote safe working practices. Records show that the gas supply and electrical wiring have been checked and are safe. The records of fire equipment checks indicated that the fire alarm and emergency lighting are tested at appropriate intervals and that fire drills take place on a regular basis. The record of contractors checks of emergency lighting were seen, however the records of the contractors checks of the fire alarm could not be located. The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 23 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 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 2 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 2 X 2 X 3 X X 2 X The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 24 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. 1. Standard YA9 Regulation 13 Requirement The registered person must ensure that risk assessments clearly indicate the support staff are to give to residents to safeguard their well being. The registered person must ensure that records of staff supervision are maintained. The registered person must ensure that an application is made to CSCI to register the manager for the home. The registered persons must provide evidence that the fire alarm is regularly serviced. Timescale for action 08/10/07 2. 3. YA36 YA37 18 8 08/11/07 08/11/07 4. YA42 23 08/11/07 The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 25 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. Refer to Standard YA7 YA20 Good Practice Recommendations Further improvements are to be made to the communication aids available at the home to assist residents to make choices. It is recommended that the systems for auditing medication be reviewed to ensure that there is clear evidence at the home as to the amount of medication available. It is recommended that consideration be given to enclosing the grounds at the front of the home as this would provide added privacy and security for the residents. Consideration should be given to replacing the doors that open in two halves with alternative doors that are not institutional in appearance. 50 of care staff are to hold an NVQ in Care or equivalent. 3. 4. 5. YA24 YA24 YA32 The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Merseyside Area Office 2nd Floor, South Wing Burlington House Crosby Road North Waterloo, Liverpool L22 OLG 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. Extracts may not be used or reproduced without the express permission of CSCI The Bungalow DS0000019000.V349963.R01.S.doc Version 5.2 Page 27 - 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. 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