Inspection on 27/02/07 for The Willows

This inspection was carried out on 27th February 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Willows 19/01/06

The Willows 21/06/05

The Willows 21/10/04

The Willows 24/05/04

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 The Willows 31-33 Sutton Drive Upton Chester Cheshire CH2 2HN Lead Inspector Mr Val Flannery Unannounced Inspection 27 February and 9 March 2007 04:20 The Willows DS0000006666.V320857.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 Willows DS0000006666.V320857.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 Willows DS0000006666.V320857.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Willows Address 31-33 Sutton Drive Upton Chester Cheshire CH2 2HN 01244 382701 F/P 01244 382701 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.macintyrecharity.org MacIntyre Care Ms Carol Jinks Care Home 5 Category(ies) of Learning disability (5) registration, with number of places The Willows DS0000006666.V320857.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than 5 Service Users may be Learning Disability (LD) Date of last inspection 19th January 2006 Brief Description of the Service: The Willows cares for five adults with a learning disability. The home is on a residential estate in Chester, close to local shops and on the bus route to Chester city centre. The two-storey building was originally two separate semidetached houses. Access between the ground floor and first floor is by the stairs. All the bedrooms are single and four of them are on the first floor. The fifth room is on the ground floor and has an en-suite shower and toilet. Sufficient communal toilet, bathing and shared space, including a dining area, are provided for the service users. The garden to the rear of the home provides a secure area for use by service users. Staff are on duty twenty-four hours a day to deliver care to service users. The fees for the home start from £329.47 per week. This information was provided by the manager on the 9 March 2007 The Willows DS0000006666.V320857.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on the 27 February and 9 March 2007and lasted 5 hours. The visit was carried out by Val Flannery, Regulatory Inspector This visit was just one part of the inspection. Before the visit the home manager was asked to complete a questionnaire to provide up to date information about services in the home. CSCI questionnaires were also made available for residents, families, health and social care professionals to find out their views. Other information received since the last key inspection was also reviewed. During the visit various records and the premises were looked at. Service users and staff were spoken with and they gave their views about the service. What the service does well: The home provides relevant information new residents can visit the home to find move in. Staff from the home carry out their relatives and the staff at the home met there. about the service it provides. Possible out more about it before deciding to an assessment so that the resident, know that the person’s needs can be Although a number of the service users have limited communication, they are actively involved in making decisions on how they live their lives so they have some choice in what they do each day. Individual service users have plans of care, including a weekly activity programme, to make sure they get the level of care and support they need. The staff team help them with the personal care they need to enable them to take part in their everyday lives. The residents receive the healthcare they need from doctors, nurses and others, such as dentists, so they stay well and healthy. The home is well looked after so that it’s comfortable and safe for the residents. The manager has a number of years experience in caring for service users with a learning disability. Staff are well trained and supervised so that they can give the best possible help and support to the residents. . The Willows DS0000006666.V320857.R01.S.doc Version 5.2 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 summary of this inspection report can be made available in other formats on request. The Willows DS0000006666.V320857.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 Willows DS0000006666.V320857.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): 1, 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is information available about the home and a process used when new residents move into the home so they know their needs can be met there. EVIDENCE: Essential Lifestyle Plans for residents included copies of the service user guide for the home. There is a copy of the updated statement of purpose available in the home. During the visit, detailed records were seen for the person who had moved into the home most recently. These contained a copy of McIntyre’s assessment pack that is used to carry out assessments of need before the new resident moves into the home. There was also a copy of the care programme that had been put together by the local authority that was paying for the resident’s care. The file included a copy of the agreement about living at the home between the resident and MacIntyre. Possible new residents are able to visit the home and spend time getting to know the staff and the other people who live at the home. This can include an overnight stay to give the person an idea of what it would be like to live there and help them decide if they want to move in. Service users are supported by families and social services (as appropriate) during the visits to the home. The Willows DS0000006666.V320857.R01.S.doc Version 5.2 Page 9 The service users spoken with said they ‘like living in the home’ and that ‘staff help them’. During the visit staff were seen talking with the service users and responding to their requests for help. It was evident that staff were aware of the different communication abilities of the service users and were meeting their needs. The Willows DS0000006666.V320857.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, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Records are in place that show that changes to service users’ needs are identified and acted upon. This ensures staff have the information to help service user make ‘safe’ choices about what they do each day. EVIDENCE: During the visit the records for one service user were seen. These included person centred plans, essential lifestyle plans and separate health/personal care records. The care plans included a care programme from the placing authority. Comprehensive plans of care and background information are available for each service users. These set out how service users preferred to be cared for, their likes and dislikes, family involvement and how their healthcare needs are to be met. Risk assessments are in place that show service users are encouraged and supported to take responsible risks, both in the home and in the local The Willows DS0000006666.V320857.R01.S.doc Version 5.2 Page 11 community. During the visit one service user was seen leaving the home to visit a local shop. Staff spoken with were aware of the needs and capabilities of service users. Service users were seen making decisions on, for example, whether they spent time in their bedrooms or in the communal lounges. Service users also were seen helping with the daily routines in the home by laying tables and helping staff prepare the evening meal. MacIntyre have provided policies and procedures on the confidentiality of information; this is included as part of the staff induction training. A copy of the policy is kept on individual service user records. The Willows DS0000006666.V320857.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): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff support service users to take part in a range of activities, both in the home and in the local community. This helps ensure service users maintain links with the local community. EVIDENCE: During the visit service users spoken with talked about their lifestyle and how the staff ‘helped them’ with the daily living tasks they found difficult. Two service users said they are supported by staff or relatives to attend church services on Sundays. They also spoke about their weekly activities, including attending a day centre and using local shops. A risk assessment is in place that ensures the safety and well being of a service user when he visits the local shops by himself. The plans of care and other records seen showed that each service user has an individual weekly The Willows DS0000006666.V320857.R01.S.doc Version 5.2 Page 13 schedule which involves them doing activities in the home and in the community. This included trips out to local shops and other local amenities. One service talked about holidays he had been on with staff and future holidays, including trips to Ireland and London. He also talked about his activities that included attending a swimming club and supporting the local football team. During the visit staff were seen supporting a service user to manage his finances. The daily routines for individual service users, particularly Monday to Friday, depend on their planned activities either with staff from the home or at community based events. Service users are given keys to their bedrooms and were seen using them to gain access as they wished. Staff were seen sitting down with the service users and planning the coming week’s menu. Staff spoken with said they also sit down with individual service users to ensure their choices are included in the menu. One service user said he could choose to have an alternative to the menu. Staff were seen helping service users with their evening meal. The appearance of the home is in keeping with the local community. Staff said there were good relationships with local community. The Willows DS0000006666.V320857.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 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides appropriate personal and healthcare support to service users. This ensures their assessed care needs are met and that they stay well and healthy. EVIDENCE: The records seen during the visit showed that the healthcare needs of service users are monitored and action is taken to resolve any problems. The healthcare records of one service user were seen during the visit. These showed that the service user receives visits from doctors and other healthcare professionals. Service users are helped to attend hospital appointments by staff or relatives. One service user talked about his doctor and why he went to see his GP at the medical centre. MacIntyre have provided policies and procedures on the administration of medication to service users by staff, a copy of which is kept in the home. The organisation also provides training for staff on the administration of medication so they can give residents their medication safely. A sample of the records of medication administered by staff was seen. These were completed The Willows DS0000006666.V320857.R01.S.doc Version 5.2 Page 15 satisfactorily. One service user is responsible for taking his own medication. A secure cupboard is provided in his bedroom where he can store his medication. Service users were seen receiving help from staff with personal care tasks; this was carried out in the service users’ bedrooms. It was done in a calm and sensitive manner. Both male and female staff are employed in the home so staff of the same gender can care for service users if they wish. Essential lifestyle plans showed how service users wished to be helped with personal tasks such as dressing/undressing and using the bathroom/toilet. The Willows DS0000006666.V320857.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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures are in place to deal with any complaints or adult protection issues that may arise. These ensure that the residents and/or their relatives are listened to and that residents are protected from possible harm. EVIDENCE: A copy of the organisation’s complaints procedure was on display in the home. A copy is also kept on individual service users’ files. The manager said the home has not received any complaints since the last inspection. The complaints/compliments book was seen during the visit. One service user spoken with said ‘it’s very nice living here’. A copy of the government’s guidelines on adult protection titled ‘No Secrets’ is kept in the home. Since the last inspection one referral has been made to Social Services under the adult protection procedure. To date this is still being processed by Social Services. Staff spoken with during the visit were aware of what action to take if they received a complaint or were concerned about an adult protection issue. They said they would normally refer their concerns to the senior member of staff on duty. The Willows DS0000006666.V320857.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, 27, 28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well looked after so that service users continue to live in comfortable and safe surroundings. They all have single rooms so their privacy and dignity is maintained. EVIDENCE: One of the resident’s bedrooms was seen during the inspection. This was individually furnished and decorated. The service user said he had chosen the décor and furniture for his bedroom. All the bedrooms are single. Four are on the first-floor and contain handwashing facilities. The fifth bedroom is on the ground floor and has an ensuite toilet and shower. The home has a dining room, large lounge with conservatory and one small lounge, all of which are on the ground floor. These areas are easily accessible to service users. There is a secure garden at the back of the home for service users to use. The Willows DS0000006666.V320857.R01.S.doc Version 5.2 Page 18 There are two bathrooms and two toilets on the first floor, with another toilet on the ground floor. These rooms have door locks to ensure the residents’ privacy is respected but the locks can be overridden by staff in an emergency. On the day of the inspection the home was clean and free from unpleasant smells. A tour of the building showed that it is well maintained and that a safe environment is provided for service users. Grab rails, bath hoists and a care call system are in place to help the residents stay safe. Service users were seen moving freely about the home and are able to go to their bedrooms as they wish. A number of the service users have keys to their bedroom; one service user said he ‘likes his room and likes to keep it locked’. The Willows DS0000006666.V320857.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): 31, 32, 33, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff receive training, support and supervision to ensure they are able to meet the needs of service users. Thorough recruitments processes are in place to make sure that residents are protected from possible harm. EVIDENCE: The manager and support staff spoken with during the visit were aware of their role and responsibilities in caring for service users. Staff were seen talking with service users, helping them move around the home and responding when they asked for help. It was evident that the staff on duty were aware of the service users’ capabilities. Service users were seen approaching staff and were comfortable in their company. Staff spoken with were able to talk in detail about the needs of service users and how these were to be met. They also said that they are able to discuss any concerns/worries with the manager and they would seek advice to ensure service users receive the help they need. The staffing rota showed that there are normally at least two staff on duty during the day and one staff sleeping in during the night. Additional staff are The Willows DS0000006666.V320857.R01.S.doc Version 5.2 Page 20 on duty during the week to support service users with community based activities, for example, swimming and attending a local disco. Information supplied by the manager showed that six of the eight support staff have achieved an NVQ Level 2. The manager said that three member of the support staff are currently doing NVQ Level 3 and one is doing an NVQ Assessor award. Staff have access to a range of training opportunities including: • Fire Awareness • Food Hygiene • Manual Handling • Risk assessment • Person Centred Planning • Medication • First Aid Individual staff have a Personal Development Portfolio that sets out the training they have attended and also includes their training needs. Records were seen that showed satisfactory recruitment procedures are in place including obtaining two references and Criminal Record Bureau disclosures before any new staff start working at the home. The Willows DS0000006666.V320857.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, 38, 39, 40, 42 & 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager is experienced at running services for people with learning disabilities; this ensures service users live in a home that is run well in their best interests. EVIDENCE: The registered manager has worked for the organisation in a senior capacity for a number of years. She is in the process of completing NVQ Level 4 in care. During the visit the manager said she has completed her Registered Managers Award. Service users spoken with said the manager talks to them and asks ‘if they are alright’. Staff said the manager listen to concerns and complaints raised by service users and staff and takes appropriate action to deal with the issues. The Willows DS0000006666.V320857.R01.S.doc Version 5.2 Page 22 MacIntyre Care have provided policies and procedures to assist staff in the day to day running of the home, copies of which are kept in the home. These included administration of medication, risk assessments and the care planning process. Staff spoken with during the inspection were able to discuss how the policies and procedures are designed to ensure the safety and well-being of services users. During the inspection a tour of the building showed that potential hazards are addressed. Records seen showed the organisation has procedures in place to deal with health and safety issues. These include service records for electrical installation, portable appliance tests and fire fighting equipment. The records also showed that fire drills and evacuation and weekly tests of the fire alarms are carried out. The area manager for the organisation visits the home each month. A copy of the report on the findings of her visit is available in the home. The manager said the annual quality assurance, that involves getting service users and relatives views on the quality of the service offered by the home, was not carried out for 2006. However, she confirmed that it will be carried out in 2007. The Willows DS0000006666.V320857.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 3 2 3 3 3 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 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 3 X 3 3 The Willows DS0000006666.V320857.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 Willows DS0000006666.V320857.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Willows DS0000006666.V320857.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!