Inspection on 25/08/05 for Upton Road (82)

This inspection was carried out on 25th August 2005.

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

The inspector 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

Upton Road (82) 19/02/07

Upton Road (82) 23/02/05

Upton Road (82) 31/08/04

Upton Road (82) 27/02/04

Upton Road (82) 23/02/03

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 82 Upton Road Moreton Wirral CH46 0SF Lead Inspector Leila Mavroupoulou Unannounced 25 August 2005 09:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 82 Upton Road Address Moreton Wirral CH46 0SF Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0151 604 1406 Alternative Futures Limited Linda Glover PC Care Home 5 Category(ies) of LD Learning Disability - 5 registration, with number of places 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 23 February 2005 Brief Description of the Service: 82 Upton Road is large detached house in the Moreton area on the Wirral. It provides accommodation, support and personal care to 5 younger people (1865 years) that have a learning disability. All accommodation is provided in single bedrooms, which the residents are able to personalise with their own belongings. The home has a large lounge, dining room and a bedroom on the ground floor with a walk in shower. On the first floor there are a further four bedrooms, there is also an assisted bath and staff room on the first floor. The home is staffed twenty four hours a day and many of the staff have completed their NVQ level 2 or 3 Care Award. The home has its own mini bus which is used regularly to enable the residents to access various community facilities without having to rely on public transport. There is a bus service outside of the home,which is sometimes used by the residents. The staff at the home monitor closely the physical and emotional health of the residents and access support and advice from various health professionals to promote the good health of the residents. 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which lasted for four and half hours. During the inspection four residents, five staff and the manager were spoken to. Also, some residents and staff files were inspected, the building and other records that the home is oblige to keep. What the service does well: What has improved since the last inspection? What they could do better: The hall stairs and landing and dining room should be redecorated to improve the physical environment of the home. The manager should review some of the residents’ protocols to ensure that they are still acceptable in meeting the needs of the residents. 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 The home’s Statement of Purpose provides initial information for the prospective resident family to make a decision as to whether the home would be able to meet the needs of the resident. EVIDENCE: The homes Statement of Purpose provides information about the facilities and services offered at the home. The information is presented in pictorial format to enable the prospective service user to understand the information more easily. The homes Statement of Purpose has recently been reviewed to reflect changes in the home. The home has not had an admission for many years. However, discussion with the staff and the home’s admission procedure show that the staff from the care home would assess the needs of the resident prior to admission to ensure that the home would be able to meet their needs. In addition the admission would be over a period of time to ensure that the move into the care home is least stressful as possible to the resident, by ensuring that they visit the home several times, to get to know the other residents, the staff and to become familiar with the environment. The staff at the home commented that it is important that the existing residents compatibility with the new resident is taken in consideration when offering a place at the home. 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9, The residents have a detailed care plans to ensure that their assessed needs are met. EVIDENCE: The staff at the care home is in the process of reviewing the residents care plans following a Personal Centred Approach. This approach looks at the long, medium and short-term needs of the resident. From this information a detailed care plan is devised and risk assessment showing what steps would be taken to achieve the resident’s goals. Each of the resident has a key worker that work more closely with the resident. The key worker review monthly the resident care plans and formal reviews are held six monthly with the family at the home. This was evidenced in one of the resident’s review summary. In addition formal reviews are held either six monthly or annually with the multidisciplinary team at Ashton House and the resident care plans and risk assessments are amended accordingly. The range of activities the residents participate in involves taking some responsible risks, for which ways to minimise the identified risks are implemented to promote the residents independence and to enable them to access community facilities. 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 Page 10 The staff supports the residents to make decisions over their daily lives such as choosing where to go on holiday, purchasing items for family members etc. The home has details of independent advocacy services, which the staff would access on behalf of the residents when necessary. Currently, the residents manage their monies with the support of the staff and a record is kept of all residents’ income and expenditure in the care home. The home’s finance is audited externally at regular intervals. 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16,17 The staff supports the residents to access a wide range of community facilities to enable the residents to be integrated into all aspect of community life. EVIDENCE: The staff supports the residents to make decisions over their daily life as far as possible within their capability. Observation and discussion with the residents and staff during the inspection clearly demonstrated this, as residents were able to choose to either to be on their own or with the other residents and staff. The residents have access to all parts of the home, one of the resident assists the staff in the kitchen with the washing up. The staff supports one of the resident to make hot drinks. Currently, none of the residents are responsible for particular household task. Observation of the way staff spoke to the residents show that their rights to choice and respect are promoted. The staff support the residents to access opportunities in further education. Currently, one of the resident attends college and the staff at the care home is looking to find employment for another resident. The residents are supported 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 Page 12 to maintain interests they had prior to coming into the care home. This is evidenced by one of the resident maintaining his interests in various types of transport. The residents have a holiday up to certain value included in their weekly fee and the resident chooses where to go. Two of the resident are going abroad for a week with staff at the care home and others are going for short breaks in the UK. The residents access a range of entertainment outside of the home such as: going to discos, pubs and other places of entertainment of their choice. The home maintains a record of all food provided to the residents. Even though there is a planned menu alternatives are always available to the planned menu. Currently, none of the residents require assistance at mealtimes or a special diet. However, both assistance and special diets would be provided once it is identified in the resident care plan. The resident are involved in the menu planning and would accompany staff to do the weekly shopping for the home. 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 The staff monitors closely the health needs of the residents to ensure that they access appropriate support from other health professionals to maintain their physical and metal health. EVIDENCE: Currently, all of the residents are mobile and do not require any assistance with transferring. The home has a walk in shower and an assisted bath to promote the safety of the residents. Discussion with the manager indicated that additional aids and equipment would be obtained as necessary to promote the residents’ health and safety, as identified in their care plan. The Community Nurse monitors the residents’ mental health through regular visits, which would be determined by the resident’s needs. In addition the residents receive regular health checks from their GP. Residents also have regular health checks from the continence adviser, dentist, optician and chiropodist. Each of the resident has a key worker that work more closely with the resident. The staff at the care home is currently developing their communication records of the residents verbal and non verbal communication. This is to consolidate all of the information that the staff group have to enable all staff to understand the needs of the resident more easily and quickly, especially for new staff. 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 Page 14 The home maintains an accurate record of the residents’ medication received into the care home, its administration to residents and any medication returned to the pharmacist. This has improved since the last inspection. Discussion with staff indicated that staff that have responsibility for administration of resident’s medication receives basic training. 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 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 standard(s) 22,23 The home has various policies and procedures relating to abuse to protect the residents. EVIDENCE: The home has various policies and procedures in place to protect the residents from all forms of abuse. These include Whistle Blowing Policy. These areas are covered with the staff during their induction as well the staff attending formal training courses on the Protection of Vulnerable Adults. All staff receives regular training on managing physical and verbal aggression to ensure that their knowledge and skills are current. Discussion with staff indicated that there are occasions when they have had to diffuse situations when the resident has been physically abusive. Following these incidents staff complete a full report of the events leading up to the situation and what action was taken. This allows staff to reflect on how the situation was managed and to enable them to learn from the situation and where necessary for the management team to review care practices. The home has a complaints procedure which families and others using the service are encouraged to use. The home has had no complaints since the last inspection. 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 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 standard(s) 24,30 The home has a very homely atmosphere to promote the emotional well being of the residents. EVIDENCE: The home is very in keeping with the local community and provides a homely environment for the residents. This was evidence by the staff commenting that they enjoy the atmosphere in the home, which makes working at the home very enjoyable. All parts of the home are accessible to the residents as they are all mobile. The home is furnished with domestic quality furnishings, which contributes towards the “homeliness” of the home, especially one of the resident’s bedroom and the sitting room. The home throughout was bright, clean and free from malodour at the time of the inspection. Both the sitting room and the dining room could be used for a variety of activities. Discussion with the manager indicated that measurements have been taken for the redecoration and new carpet to the hall stairs and landing. The residents’ bedrooms are furnished to reflect their needs and behaviour to promote their health and safety. Thus, in some bedrooms clothing are kept in locked cupboards. Many of the residents have personalised their bedroom with posters and have a television, video and music centre in their bedroom. All 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 Page 17 residents’ bedroom doors have a lock, which could be opened by staff in an emergency. The home laundry facility is sited away from the food preparation area and various policies and procedures in place to prevent the spread of infection. 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36 The staff receives appropriate training and support to ensure that they have the necessary skills to meet the needs of the residents. EVIDENCE: The home has a core staff group that have worked at the home for many years during which time they have got to know and develop a good relationship with the residents. Discussion with the staff indicated that they found working with the residents very rewarding and enjoyed working at the home because of the relaxed atmosphere and the range of tasks they had to carry out with the residents. The home has a low staff sickness and turnover record. Observation of staff and the residents activity programme show that staff have the time to do uninterrupted work with the residents, as the staffing rota is designed around the planned resident activities. The staff are aware of the limitation of their knowledge and skills and would seek advice from specialist health professionals or senior managers as required. The staffing level at the care home is reviewed regularly to reflect the needs of the residents and to promote their safety and that of the other residents, as evidenced in past situations. This is at the discretion of the manager. However, for a prolonged period this would need to be discussed with senior management because of the budgetary implication. 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 Page 19 The staff on duty were approachable and had a good rapport with the residents. The staff receives regular update on managing physical and verbal aggression to ensure that they are aware of current best practices in dealing with situations where the resident is aggressive. Many of the staff have already completed their NVQ level 2&3 care award and some are working towards achieving this qualification. The home now has a mentor who is able to provide ongoing support to the NVQ candidates. The staff said that this was excellent because they did not loose motivation in the NVQ, as they were able to complete the units quite quickly. Inspection of a sample of staff files show that the home obtains two written references for all staff and a Criminal Records Bureau check on staff before they could commence their employment at the home. The staff are given a written terms and conditions of employment and a job description. The staff files show that staff are inducted into their role and within six months of starting their employment they are expected to completed the mandatory training in moving and handling, food hygiene, first aid and fire awareness. The manager does not have a specific training budget. However, the company provide a range of courses in house at regular intervals, which the manager is able to access for staff. Each staff has a training and development plan showing what course they have attended and when they should be renewed. Discussion with staff and records seen by the inspector show that staff receive regular “one to one” supervision from the manager and a record is maintained of items discussed. In addition the manager has regular staff meetings and minutes of the meetings are kept. 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,40,41,42 The management of the home promotes the interests of the residents through ensuring that the home has the required resources to meet their assessed needs. EVIDENCE: The manager has been registered with the Commission as the registered manager and is nearing completion of her NVQ level 4 Registered Managers Award. Discussion with the staff indicated that she provides direction and strong leadership to the staff group, as the staff group commented on feeling more motivated and know what is expected of them. The manager showed the inspector the homes new policies, which are developed centrally for all of Alternative Futures homes. Staff are consulted about the draft policies and are given the opportunity to make their comments known at the staff meetings. The manager would then provide feedback at the managers meeting of the staff views. 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 Page 21 The home has a current Public Liability Insurance displayed and discussion with the manager indicated that records are kept of all expenditure in the care home for accounting purposes. The records are well maintained in the care home and residents are able to access their records in accordance with the home’s policy on access of information. It was observed that residents’ records were kept in a secure place. The health and safety of the residents is promoted through the staff receiving appropriate training in food hygiene, first aid, moving and handling and fire awareness, which are kept up to date by attending refreshers courses. In addition regular routine maintenance to the building and servicing of equipment is carried out in accordance with the manufacturer instructions or Health and Safety Executive such as: - maintaining records of all accidents/incidents to residents and staff. The home informs the Commission of any significant event in the care home. 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 82 Upton Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 3 3 x F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 Page 23 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 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. 1. Refer to Standard Good Practice Recommendations 82 Upton Road F52 F02 S000018950 82 Upton Rd V247187 250805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 3rd Floor 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. 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