Inspection on 12/01/06 for The Maples

This inspection was carried out on 12th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 14 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Maples 18/10/07

The Maples 14/06/06

The Maples 27/04/05

The Maples 08/12/04

The Maples 27/04/04

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 Maples 327 Hoylake Road Moreton Wirral CH46 ORN Lead Inspector Helen Carton Unannounced Inspection 12th January 2006 11:00 The Maples DS0000018946.V280289.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 Maples DS0000018946.V280289.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 Maples DS0000018946.V280289.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Maples Address 327 Hoylake Road Moreton Wirral CH46 ORN 0151 678 6956 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) www.c-i-c.co.uk. Community Integrated Care Care Home 5 Category(ies) of Learning disability (5) registration, with number of places The Maples DS0000018946.V280289.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user over 65 years of age may be accommodated Date of last inspection 27th April 2005 Brief Description of the Service: The Maples is situated by Moreton Cross on the Wirral and is close to the main shopping area. The home is a dormer bungalow with single bedroom accommodation being provided on both the ground and first floor. A bathroom with toilet and a separate shower room is provided on the ground floor with a further toilet situated on the first floor. There is a separate dining room that is also used as a quiet seating area at the rear of the building and a lounge situated at the front of the home. The home has equipment and adaptations in place to meet the assessed needs of the service users accommodated. There is a limited amount of off road parking available to the front of the home and a large garden to the rear. The Maples DS0000018946.V280289.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. There are five people living at The Maples. This inspection was unannounced and took approximately four hours. The inspector spent time with three residents’ and spoke to three members of the staff team one of which was the manager. What the service does well: What has improved since the last inspection? What they could do better: There are a number of things the home needs to do to make sure the residents receive a consistent level of care and are living in a safe environment. The owner’s records, policies and procedures must show in an open and transparent way when the organisation is using residents’ monies to provide facilities for the home. In the home’s statement of purpose the owners’ detail how they will support residents’ to make informed decisions and choices. However they have signed consumer hire agreements for residents’ without The Maples DS0000018946.V280289.R01.S.doc Version 5.1 Page 6 discussing this with family members or independent advocates. To ensure these agreements are in the best interests of the residents’. The home’s records must provide detailed information particularly about safety checks made particularly fire logbooks and safety checks. Training carried out by members of the staff team must be fully recorded so the owners’ can demonstrate they have trained and skilled people supporting residents’. Individual risk assessments and management plans are limited and need to provide more detail. To make sure residents’ are supported in the best way in sometimes very difficult situations. Through the care planning processes in the home a number of specialist activities have been identified as being of benefit to individual people. These activities are not taking place regularly and the home needs to work on this. To make sure the home provides a wide range of social activity that gives residents choice. 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 Maples DS0000018946.V280289.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 Maples DS0000018946.V280289.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): 1,2 & 5 The owners are providing contradictory information with regard to who is financially responsible for the home’s transport. The financial arrangements for residents are unclear and do not provide enough safeguards to prevent possible financial abuse. EVIDENCE: Residents living at The Maples have complex needs resulting in all five adults having difficulty in communicating their needs to others. They have lived in the home for a number of years. Since the last inspection the manager and staff team are attempting to gain information about residents’ lives before they moved into the home including any pre admission assessments. At the last inspection examination of records in the home showed that information held in the home’s statement of purpose and the residents’ contracts is contradictory. With the owners of the home saying they will provide a minibus for use by the residents and yet the residents contracts showing that residents are to pay towards the purchasing and running cost of the minibus. Discussion with the manager also highlighted that residents are paying different amounts. This is not clear in any information provided by the owners to residents’ or their supporters. The owners do not appear to have involved independent advocates for those service users who have no family contact to make sure the monies spent on the home’s minibus is the best use The Maples DS0000018946.V280289.R01.S.doc Version 5.1 Page 9 of their money. During this visit the inspector looked at the same records and was concerned that no changes had been made to the statement of purpose or the service users guide. The Commission will discuss this issue with the responsible individual for the home. The Maples DS0000018946.V280289.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 The care planning system provides a good level of information and guidance to the staff team. The home’s risk assessments are limited and do not provide detailed information and guidance resulting in a possible risk of injury to both service users and members of the staff team. EVIDENCE: There is clear and detailed information in residents care plans providing the staff team with clear guidance as to the manner in which residents prefer to be supported in their daily lives. The home also completes documents called essential lifestyle plans that provide information about residents’ likes and dislikes including preferred routines and leisure activities. The inspector discussed with the manager the need to ensure activities detailed in the essential lifestyle plans are carried out regularly and documented in the residents’ activity plans. The risk assessments currently used in the home provide the staff team with limited information. Particularly those to direct the staff team as to the best way to support residents who may be presenting with aggressive or The Maples DS0000018946.V280289.R01.S.doc Version 5.1 Page 11 inappropriate behaviour. This could potentially put residents’, the staff team and members of the public at risk. Staff members spoken to during the visits to the home were able to tell the inspector how they would support a resident who was experiencing a difficult time and displaying aggressive behaviour. The manager told the inspector she was in the process of reviewing risk assessments to make sure detailed information is provided to enable the whole staff team to support residents’ in a safe and consistent manner. The Maples DS0000018946.V280289.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 13, 15 & 16. The home is not providing residents’ with a good range of appropriate activities. Limiting personal development and choice. Issues of diversity are not being managed effectively in the home. EVIDENCE: The inspector looked at a sample of residents’ activity sheets. The inspector noted in one week two residents’ had not left the home with activities taking place in the home such as listening to music and watching DVD’s. A number of activities where documented as being carried out such as bowling and use of a hydro pool however discussions with the registered manager indicated these had not been carried out. Access to specialist activities and past times are not being routinely provided by the home. The home has a new minibus with three members of the staff team having the necessary experience to use it. Residents’ are accessing local facilities such as cafes’ shops and pubs in the Moreton area. The Maples DS0000018946.V280289.R01.S.doc Version 5.1 Page 13 Meal planning and residents’ likes and dislikes are documented in the care plans and meals are discussed during team handovers and meetings. The manager and members of the staff team informed the inspector making observations during mealtimes, is the main way in which they find out if residents’ enjoy meals. The inspector looked at some of the residents’ files and noted that comments had been made in the male residents’ care plans that staff members ensure all clothing, toiletries, surroundings and films are masculine based. The inspector discussed with the manager the issue of diversity and the need for the staff team to be aware of different lifestyles. The Maples DS0000018946.V280289.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 Residents’ health care needs are well met by the home. EVIDENCE: Records show the home actively supports residents’ with all health care needs and will seek the advice and support of other health care professional. The home now completes health care passports so they can keep an accurate record of all health care input received by residents’. The Maples DS0000018946.V280289.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): 22 The home has a complaints procedure however it is not user friendly. There is detailed information with regard to the safety and protection of vulnerable adults. EVIDENCE: The home has a detailed complaints procedure with timescales for action and responses to concerns raised, however this documentation is lengthy and not user friendly. The Maples DS0000018946.V280289.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): 24,25,27, 29 & 30 The owner is providing a homely environment with a high standard of furnishings and cleanliness. The home is not providing residents with the specialist equipment they need to maximise their equipment. EVIDENCE: The owner is continuing to refurbish the home with new furniture being bought for the lounge. New bedroom furniture has been provided in all bedrooms and the dining room has been refurbished. The inspector found the home to be clean and tidy. The inspector viewed a sample of residents’ bedrooms and found them to be comfortable, homely and reflecting the likes and personalities of residents’. The home has a shower room and separate bathroom with a hoist being used to support residents to use the bath. The hoist has recently been serviced. The manager told the inspector two of the residents’ where buying their own specialist chairs following assessments by a registered physiotherapist. The The Maples DS0000018946.V280289.R01.S.doc Version 5.1 Page 17 inspector advised the manager it is the home responsibility to provide furniture and fittings including specialist equipment to maximise residents’ independence. The Maples DS0000018946.V280289.R01.S.doc Version 5.1 Page 18 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): 31, 32, 33, 34 & 35. The reduction in the use of agency staff has provided residents’ with continuity of care. The owner is beginning to provide training for the staff team to enable them to support residents in the most appropriate manner. EVIDENCE: The manager told the inspector since the last visit she has been reviewing the staff teams training records and is discussing their training needs with a training agency. The staff team have received basic food hygiene training and about ten have undertaken NVQ training. The home has reduced the number of times it has needed to use agency staff this has resulted in the home providing residents’ with continuity of care. A sample of staffing records were looked at the inspector found they were on the whole well maintained. However the owner must make sure the home has a record of all checks carried out by the human resources department. The Maples DS0000018946.V280289.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, 40, 41 & 42. The owner’s financial practices do not safeguard and promote residents’ rights and best interests. EVIDENCE: The manager has commenced the NVQ level 4 managers award and hopes to complete it by the end of the year. The home’s statement of purpose states the owner will provide the transport for the residents’ use. The inspector looked at residents files and found Consumer Hire Agreements, which state,” the vehicle referred to in Clause 4.1 will remain our (the owners) property at all times and can never become yours. You must not sell or dispose of the vehicle”. Two employees of the owner signed these documents and there is no documentary evidence that any attempt had been made to involve family members or independent advocates. This is contrary information being provided to residents’, prospective residents’ and their families. This issue is to be discussed with the owner separate from the inspection process. The Maples DS0000018946.V280289.R01.S.doc Version 5.1 Page 20 Since the last inspection visit the manager has produced questionnaires to seek information from people who visit or have contact with the home regularly. This is to help ensure the service they are providing meets residents’ needs and expectations. The inspector looked at maintenance records they were well maintained. The inspector looked at the fire safety logbook and discussed with the manager the need to carryout training and equipment checks in the required timescales. Over the past year residents’ have needed to make insurance claims against the owner’s policy. The inspector noted the claims were made in October 05 and residents’ have not been reimbursed. The Maples DS0000018946.V280289.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 1 2 3 3 X 4 X 5 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 X ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 2 33 2 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 1 X 2 X LIFESTYLES Standard No Score 11 2 12 X 13 2 14 X 15 2 16 1 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 X X 2 X X 1 1 2 X The Maples DS0000018946.V280289.R01.S.doc Version 5.1 Page 22 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 YA1 Regulation 4 Requirement The registered persons must ensure the statement of purpose accurately reflects the facilities to be provided by the home. With particular regard to the purchase and maintenance of the home’s minibus. Previous timescale of 20/6/05 not met. The registered persons must ensure the service user guide and terms and conditions accurately reflect the services to be provided by the home and those that are the responsibility of the residents. Previous timescale of 20/6/05 not met. The registered persons must ensure risk assessments and management plans are produced where challenging, inappropriate behaviour have been identified. Previous timescale of 20/6/05 not met. Timescale for action 30/03/06 2. YA5 5 30/03/06 3. YA9 13 30/03/06 The Maples DS0000018946.V280289.R01.S.doc Version 5.1 Page 23 4. YA11YA13 16 The registered persons must 30/03/06 ensure activities detailed in residents care plans and activity diaries are provided at regular intervals. Previous timescale of 30/08/05 not met. The registered persons must ensure the complaints procedure is appropriate to the needs of the service users. With particular regard to the language and layout. Previous timescale of 30/08/05 not met. Registered persons must ensure suitable seating is provided for residents’ use. That supports residents’ physical needs and promotes their independents. 30/04/06 5. YA22 22 6. YA29 23 30/05/06 7. YA32YA33YA35 18 The registered persons must 30/06/06 ensure training is provided to the staff team. To ensure they have the necessary skills and knowledge to support service users in the most appropriate manner. With particular regard to the provision of specialist training to enable the staff team to be confident in the support they offer residents’. The registered persons must 30/03/06 provide the Commission with detailed information about the processes undertaken. Regarding the Consumer Hire Agreements signed for by CIC on behalf of the residents living at the home. The registered persons must ensure detailed documents DS0000018946.V280289.R01.S.doc 8. YA40YA41 12 & 16 9. YA41 16 30/04/06 The Maples Version 5.1 Page 24 and records are kept with regard to how the organisation manages service users monies. This must include details of who has been involved in the decision making to ensure all financial arrangements are open and transparent. Previous timescale of 30/08/05 not met. 10. YA42 24 28/02/06 The registered persons must ensure the home makes adequate precautions against the risk of fire. Particularly with regard to providing training to the staff team. And carrying out the required fire equipment checks within the stated timescales. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Maples DS0000018946.V280289.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 The Maples DS0000018946.V280289.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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