Inspection on 16/03/06 for The Grove

This inspection was carried out on 16th March 2006.

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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Grove 07/05/09

The Grove 09/05/07

The Grove 10/11/05

The Grove 21/12/04

The Grove 22/06/04

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 Grove 65/67 Belfield Digmoor Skelmersdale Lancashire WN8 9HQ Lead Inspector Lesley Plant Unannounced Inspection 16th March 2006 11:00 The Grove DS0000005996.V279329.R01.S.doc Version 5.1 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 Grove DS0000005996.V279329.R01.S.doc Version 5.1 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 Grove DS0000005996.V279329.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Grove Address 65/67 Belfield Digmoor Skelmersdale Lancashire WN8 9HQ 01695 725119 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) Dawaking Care Ltd Care Home 7 Category(ies) of Learning disability (7) registration, with number of places The Grove DS0000005996.V279329.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. This home is registered for a maximum of 7 service users to include: up to 7 service users in the category LD - (Learning Disability) needing personal care only. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. 10th November 2005 4. Date of last inspection Brief Description of the Service: The Grove is at the end of a terrace comprising of two properties in the Digmoor area of Skelmersdale. It provides long- term placements for seven adults with a learning disability. The home is well situated in relation to local shops and facilities. The home has been extended and provides single bedroom accommodation on three levels. There are two lounges, a dining room, kitchen, clinical room and a laundry room. There is a bathroom on each floor. The home can provide accommodation for one service user with a physical disability as it has a ground floor bedroom and a ground floor toilet and shower room. The grounds of the home are paved with planted areas and provide ramped access to both the front and rear of the house. The Grove DS0000005996.V279329.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced, started at 11am and took place over three and a half hours. There are currently five people living at the home. At the time of the inspection two individuals were at home, with three attending local day centres. The inspector spoke with the two members of staff on duty, including the acting manager of the home and spent time with the two service users. Feedback from those living at the home was limited as one individual has specific communication needs and the other chose not to communicate with the inspector. Care and administration records and some of the written policies were viewed. Comment cards providing feedback about the service were received from two relatives and two health/social care professionals in contact with the home. Staff had also supported four service users to complete comment cards. Further information was provided via a pre inspection questionnaire completed by the acting manager of the home. Key standards not assessed at this inspection will have been addressed at the previous inspection on the 10th November 2005. What the service does well: All elements of care plans are reviewed at least every six months, with the written monthly overview providing a good link into the review process. The good daily recordings and well-organised files mean that information is easy to find. The written monthly reviews give a good overview of events and activities for each person at the home. The staff team provide consistent support and the staff on duty clearly know service users well and were able to explain key elements of care required. Staff keep good records of all health care appointments, meaning that changing health needs can be monitored. The provider organisation arranges a good rolling programme of mandatory training. Each member of staff has a training file containing a training needs analysis, training plan and training record, along with copies of certificates gained. There is a well-organised system of health and safety checks, with good records being maintained. Recommendations made at the last inspection have been swiftly responded to. The Grove DS0000005996.V279329.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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 Grove DS0000005996.V279329.R01.S.doc Version 5.1 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 Grove DS0000005996.V279329.R01.S.doc Version 5.1 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 the following standard(s): None of the above standards were assessed at this inspection. EVIDENCE: The Grove DS0000005996.V279329.R01.S.doc Version 5.1 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 the following standard(s): 6 and 9 Although care plans address issues of risk, current arrangements for one person are not robust enough to offer protection from harm. EVIDENCE: The care plans for two individuals were viewed and showed that individual support needs are recognised and addressed. During the inspection staff were observed providing plenty of fluids for one person, as identified on his care plan. All elements of the care plan are reviewed at least every six months, with the written monthly overview providing a good link into the review process. Relatives are invited to the six monthly reviews. The good daily recordings and well-organised files mean that information is easy to find. Each person also has a person centred plan, produced in a pictorial format to aid the understanding of the individual. Following advice at the last inspection, the care plan for one individual has been developed to include how staff are to meet his specific understanding and communication needs. During discussion with the acting manager, it was advised that building up a more detailed communication profile for this individual would further strengthen work in this area. Risk assessments are in place and staff have developed strategies to minimise risks for individuals. Due to safety issues there are some restrictions in place The Grove DS0000005996.V279329.R01.S.doc Version 5.1 Page 10 regarding individuals accessing the kitchen. A staff member explained how one person, who goes out without support staff, uses his mobile phone to keep in touch with the home. Although issues of risk are in the main being addressed there are serious shortfalls in this area. The assessment for one person states that he requires constant supervision for his personal safety. At the start of the inspection this individual opened the door to the inspector and left the building, walking over the car park away from the home. The inspector guided this person back to the home and had to call loudly for staff attention. This situation was discussed with the acting manager and possible solutions such as increased staffing levels or a buzzer to alert staff if the door is opened, identified. This safety concern must be addressed. The Grove DS0000005996.V279329.R01.S.doc Version 5.1 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 the following standard(s): 13,15 and 16 Community activities and support from staff help individuals to make and maintain relationships. Daily routines promote independence. EVIDENCE: Staff keep good daily records, which detail activities and the use of local community facilities and services. The people living at the home regularly visit local shops, pubs, churches and leisure facilities. A staff member explained how close links have been forged with a nearby church and that individuals are made to feel very welcome there and also when visiting the local pub. Staff play a key role in maintaining these neighbourly relationships. Service users use various forms of transport including local buses. Staff rotas show that there are two staff on duty during the day and evening, including weekends. At the time of the inspection two staff were available to meet the needs of the two people who were not attending day services, meaning that if they chose to go out, both had individual support. The written monthly reviews give a good overview of events and activities for each person at the home. The people living at the home have different levels of contact with relatives, according to their wishes. One person, who has relatives living overseas, is The Grove DS0000005996.V279329.R01.S.doc Version 5.1 Page 12 supported to keep in regular phone contact and also to visit for holidays. This same individual has a girlfriend and although he is able to go out independently, staff provide a safety net of support, for example with the individual being encouraged to keep in touch using a mobile phone. The two relatives who completed feedback comment cards both responded that they are made welcome at the home and can visit their relative in private if they wish. Person centred plans recognise the importance of maintaining supportive relationships and contain relationship maps. A number of people have a key to their bedroom, this being agreed individually according to wishes and capabilities. Some people at the home like to join in with domestic tasks, with one person particularly enjoying helping in the kitchen and ironing. An individual recently requested a move to a different bedroom at the home and this has taken place. There are certain restrictions regarding access to the kitchen, which have been deemed necessary, for health and safety reasons. A specific agreement is in place for one person who smokes. The written policy regarding daily routines was viewed and contains guidance for staff regarding privacy and rights. The Grove DS0000005996.V279329.R01.S.doc Version 5.1 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 the following standard(s): 18 and 19 Personal support needs and healthcare needs are met. EVIDENCE: The people living at the home have different support needs regarding personal care. Information on files shows that personal care needs are identified within assessments and then addressed within care plans. Personal preferences are taken into account, as noted for one person who has specific likes and dislikes regarding hair washing. Care plans, daily records and observation during the inspection show that daily routines are flexible, with times for getting up, meals, showering etc dependent upon the plans for the day, such as attending day services. A member of staff explained that people are able to have a late breakfast at the weekend and although there are no set bedtimes, people are encouraged to go to bed at a reasonable time. The staff team provide consistent support and the staff on duty clearly know service users well and were able to explain key elements of care required. Staff keep good records of all health care appointments, which include dentist, chiropody and GP visits. Records clearly show the outcome of each appointment, with the staff communication book then directing the rest of the team to read the appropriate file entry. Written monthly reviews also include any health issues/developments. Care plans identify specific needs, such as for one person to drink plenty of fluids to avoid constipation and staff were The Grove DS0000005996.V279329.R01.S.doc Version 5.1 Page 14 observed providing drinks for this person during the inspection. Records also showed that staff monitor weights and bowel functions when required. Health action plans have also been introduced. One person is reluctant to undergo any regular health screening/tests and her care plan identifies this and also guides staff to continue to encourage compliance. As recommended at the last inspection the acting manager periodically supervises staff administering medication. Records of these supervisions show that an assessment is made of competence, looking how the member of staff followed procedures and their response to questions about medication. This monitoring will help to ensure that good practice is always carried out. The Grove DS0000005996.V279329.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the above standards were assessed at this inspection. EVIDENCE: The Grove DS0000005996.V279329.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the above standards were assessed at this inspection. EVIDENCE: Although not fully assessed it was noted that several improvements have been made to the building. A new entrance hall, doorway and ramp have been built, with the fire safety department confirming approval of the changes. The lounge has been redecorated and refurnished and the kitchen has been renewed. The Grove DS0000005996.V279329.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 35 Although a number of the team have no NVQ qualification, good training opportunities equip staff for their role. EVIDENCE: The staff on duty appeared motivated in their work and communicated well with the people at the home. Staff were able to explain some of the specific communication needs and preferences of one individual who has no verbal communication. The acting manager does not feel that any specialist training is required to meet the needs of the current service users. However, it was explained that previously staff had received specific training regarding the health care needs of someone who used to live at the Grove. Feedback comment cards received from two health/social care professionals indicate that staff have built up good professional relationships with other workers. At present the staff team consists of the acting manager and eight support staff, including one senior staff member and two night staff. Of these eight staff three have achieved NVQ level 2 or above. Progress with NVQ training should be monitored. An established induction process is in place, which includes attending mandatory health and safety courses such as food hygiene. Staff follow the Learning Disability Award Framework and are then encouraged to register for NVQ training. The provider organisation arranges a rolling programme of all mandatory training. A member of staff talked about the training opportunities The Grove DS0000005996.V279329.R01.S.doc Version 5.1 Page 18 made available and stated that refresher courses are also arranged. Wellmaintained training records were viewed. Each member of staff has a training file containing a training needs analysis, training plan and training record, along with copies of certificates gained. The Grove DS0000005996.V279329.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Feedback about the quality of the service is actively sought. Policies, staff training and good practice promote the health and safety of staff and service users. EVIDENCE: The acting manager has applied for registration with the CSCI and was on duty at the home at the time of the inspection. The acting manager has worked for the provider organisation for over five years, has completed NVQ level 4 in Care and is currently undertaking further NVQ units in order to gain the Registered Managers Award. The home has well organised systems in place and appears to be well managed, with the acting manager responding swiftly to recommendations made at the last inspection. Relatives are invited to the regular six monthly care plan review and this is seen as a good opportunity to gain feedback regarding the quality of the service provided. Service user satisfaction surveys are distributed annually, seeking information about all aspects of life at the home. Completed survey forms were viewed, with the acting manager being advised to improve the The Grove DS0000005996.V279329.R01.S.doc Version 5.1 Page 20 format of the questionnaire in order for it to be more meaningful and more easily understood by the people living at the home. Health and social care professionals are also periodically canvassed for their views of the home and the responses viewed gave much positive feedback. The Service User Guide and other key policies are regularly reviewed. Records show that staff undergo relevant health and safety training, which includes food hygiene, health and safety, first aid, moving and handling, infection control and fire safety. A staff member spoken to confirmed the relevance of these courses and stated that the fire safety training was of a high standard. Written policies guide staff in their work, with staff signing to confirm that they have been read and understood. The acting manager was advised to check for omissions in the staff signatures on the risk management and health and safety files as there appeared to be some gaps. Risk assessments are in place for certain working practices and the use of different cleaning materials. The inspector discussed infection control with a member of staff, who described how staff use protective clothing for certain tasks and how good hygiene practices are followed. There is a well-organised system of health and safety checks, with good records being maintained. Checks of water temperatures and fridge temperatures were viewed. The home has a fire emergency plan and risk assessment in place, which have recently been reviewed. Records show that fire equipment is regularly tested and fire drills are held. The Grove DS0000005996.V279329.R01.S.doc Version 5.1 Page 21 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 X 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 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 2 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 1 X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 2 X 3 X X 3 X The Grove DS0000005996.V279329.R01.S.doc Version 5.1 Page 22 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 unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. Timescale for action 16/03/06 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 YA32 YA37 Good Practice Recommendations 50 of care staff should achieve NVQ level 2 or above. The manager should achieve NVQ level 4 in care and management. 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