Inspection on 08/02/06 for Wellington Road (51)

This inspection was carried out on 8th February 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Wellington Road (51) 24/09/08

Wellington Road (51) 22/06/06

Wellington Road (51) 20/09/05

Wellington Road (51) 10/03/05

Wellington Road (51) 24/09/04

Wellington Road (51) 27/02/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Wellington Road (51) 51 Wellington Road New Brighton Wallasey Wirral CH45 2ND Lead Inspector Leila Mavropoulou Unannounced Inspection 8th February 2006 04:00 Wellington Road (51) DS0000018954.V283272.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 Wellington Road (51) DS0000018954.V283272.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. Wellington Road (51) DS0000018954.V283272.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Wellington Road (51) Address 51 Wellington Road New Brighton Wallasey Wirral CH45 2ND 0151 639 5685 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) dmilligan@btinternet.com Mrs Patricia Pauline Milligan Darryl Lindsay Milligan Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Wellington Road (51) DS0000018954.V283272.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th September 2005 Brief Description of the Service: Wellington Road provides accommodation and personal care for 8 service users with learning disability in both single and shared bedrooms. The service is a large semi-detached house in the New Brighton area of Wallasey and is within a short walking distance from the promenade. The service has two large sitting rooms and a dining area on the ground floor. The service is a short walking distance from the local shops, train station and bus stop. Some staff have completed the NVQ level 2 Care Qualification. Wellington Road (51) DS0000018954.V283272.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which lasted three hours. During this time six service users and three staff were spoken to obtain their views about the quality of care provided at Wellington Road. Service users and staff records were inspected as well as other records that the service is required to maintain. What the service does well: What has improved since the last inspection? What they could do better: The registered manager should formalise staff supervision and ensure that issues discussed are recorded. The registered person must ensure that the documentation and record keeping of information, required to be kept at the care home, is improved. The registered person must forward a copy of their monthly visit report to the Commission. Wellington Road (51) DS0000018954.V283272.R01.S.doc Version 5.1 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. Wellington Road (51) DS0000018954.V283272.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 Wellington Road (51) DS0000018954.V283272.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, The registered manager would assess the needs of prospective service users to ensure that their assessed needs would be met at the care home. EVIDENCE: The service has a Statement of Purpose that gives prospective service users information about the service such as: category, number of service users, type of accommodation provided, qualification of staff etc. to enable service users to assess the suitability of the service. The registered manager should review the Statement of Purpose to ensure that it continues to reflect the current staffing qualifications. There has been no new admissions to the service for over ten years. However, the registered manager indicated that new service users needs would be assessed before they are offered a place at Wellington Road to ensure their compatibility with exiting service users. The assessment would be over several weeks and prospective service user would be encouraged to have overnight and weekend stays at the care home to get a “feel” of what it is like living at Wellington Road. The dependency level of service users at Wellington Road is low and the staff have the skills and experience to meet the service users needs. Discussion with the registered manager indicated that the needs of new service users would need to be similar to existing service users, to prevent significant change in the service provided at Wellington Road. Wellington Road (51) DS0000018954.V283272.R01.S.doc Version 5.1 Page 9 Service users are given a written terms and conditions of the care home. The registered manager should inform the service user in writing of changes in their weekly fees. Wellington Road (51) DS0000018954.V283272.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): 6,7,9,10 Each resident has a care plans and risk assessments to promote their physical and emotional well- being. EVIDENCE: Service users have care plans and risk assessments showing how their assessed needs would be met. These are reviewed at regular intervals with other health professionals. The service users at Wellington Road care needs have been stable for many years and they have established a programme of activities of daily living that promote their independence and meet their social and emotional needs. Observation and discussion with the staff demonstrate clearly that the service users make decision over their lives such as: choosing to gain employment, holidays, going home for the weekend, shopping, meals etc. The service users are supported by staff to manage their finance and records are kept of valuable/monies given to staff for safekeeping. Wellington Road (51) DS0000018954.V283272.R01.S.doc Version 5.1 Page 11 Discussion with the manager, staff and service uses show that the service users are consulted in all aspects of their life. This includes admission of a new service user to the care home. Staff support service users to take considered risks by taking appropriate action to minimise any identified risks. The service has a missing persons policy, which is implemented when there is an unexplained absence of a service user. Wellington Road (51) DS0000018954.V283272.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): 12,13,14,15,16,17 The staff supports service users to develop their social and daily living skills to maintain their independence and relationships with family and friends. EVIDENCE: The service users at Wellington Road attend various day centres Monday to Friday. Discussion with service users showed that they engage in number of activities to develop new skills/interests and are given the opportunity to meet other service users. Currently, some service users are following a course called “Passport to Cultures” where they learn about different cultures their food, religion and visit places of interests to the culture they are learning about. At the time of the inspection, service users were learning about the Chinese community and visits were made to China Town in Liverpool. Other service users are learning about Information Technology and one is learning how to cook. At Wellington Road service users participate in maintaining their bedroom and have responsibilities for specific tasks in the communal areas and at mealtimes. These tasks are rotated to enable all service users to carry out a different task each day. Wellington Road (51) DS0000018954.V283272.R01.S.doc Version 5.1 Page 13 The service is located close to shops, the promenade, pubs, restaurants, various churches, library etc. Service users are aware of community activities through the local newspapers and it was observed that staff discuss with service users what is happening to enable them to make a choice of what they would like to do such as: what film to go and see, or to go to the pub etc. The staffing level at the care home reflects the differing level of activity during the day and at weekends. A 5-day holiday away from Wellington Road is included in the weekly fee and service users choose where to go on holiday. Service users prefer to go out rather than entertainment being brought into the service, as they are all able to access community facilities easily. Some service users spend every weekend with their family, others see family and friends for the day and some service users are accompanied by staff to access community facilities such as: shopping, hairdresser etc. The service has an unrestricted visiting policy and service users choose where to see their visitors, either in the communal areas or in their bedroom. Service users bedroom doors have a lock and service users have a choice of locking their doors or not. Service users are involved in the menu planning and the purchasing of the weekly food shopping. The mealtimes at Wellington Road are flexible to meet the needs of service users. Usually, service users have their evening meal together at the dining table to promote group/family living. The service maintains a record of all food provided to service users. Wellington Road (51) DS0000018954.V283272.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): 18,19,20, Staff promote the health and emotional well being of service users by ensuring that other health professionals review their health care regularly. EVIDENCE: Service users at Wellington Road are mobile and do not require any assistance with transferring and minimal support and supervision with personal care. Discussion with staff and service users files showed that they receive regular health checks from the dentist, optician, chiropodist and that their medication and health are reviewed either by their GP or a multidisciplinary team at Ashton House. The staff would accompany service users to outpatient appointments. The service uses a monitored dosage system for the administration of service users medication. The service users medication records showed that medication received into the care were not checked to ensure that the correct amount of service users medication was received. Discussion with staff indicated that service users would be able to administer their own medication if they wish to do so, after the staff assesses the service user to identify risks; where necessary risk assessments are developed to minimise the risks identified. Wellington Road (51) DS0000018954.V283272.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): 22,23 Service users are protected from abuse through the service policies and procedures and training provided to staff. EVIDENCE: The service has a complaints procedure and no complaints have been received since the last inspection. Discussion with the registered manager indicated that any concerns that the service users or their family may have are dealt with promptly before they feel that the complaint should be dealt with formally through the service complaint procedure. The registered manager provides training for staff in managing physical and verbal aggression, through using a video training package. The registered manager should attend an external course on managing physical and verbal aggression to ensure that their knowledge and skills are current. Wellington Road (51) DS0000018954.V283272.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): 24,25,26,27,28,29,30 The service is generally well maintained and provide a homely and safe environment to service users. EVIDENCE: The service is generally well maintained and in keeping with the other properties in the street. The lounge dining room floor was not cleaned on the day of the inspection and the cloakroom on the ground floor had cleaning equipment and materials scattered on the floor. The furnishings in the care home are of a good quality and domestic in character. The service is not suitable for wheelchair users as the staircase is narrow and service users have to use the stairs to access their bedroom. The accommodation provided at Wellington Road is in both single and shared bedrooms. The shared bedrooms have a privacy screen to promote service users privacy. The furnishings in service users bedrooms show their taste and interests. Observation showed that service users bedrooms had adequate electrical plugs and storage for their electrical equipment and belongings. Some of the bedrooms have en-suites and bathrooms and toilets are located close to service users bedrooms on each floor. Wellington Road (51) DS0000018954.V283272.R01.S.doc Version 5.1 Page 17 The service has a lounge dining room and another lounge on the ground floor. On the first floor, there is a quiet lounge, which is used by service users for listening to music. A separate sleeping in bedroom is provided for staff working a sleeping in duty where there is adequate space for the storage of their personal belongings. Service users bedrooms have a call system, which could be used by service users in an emergency. Specialist aids are provided to service users as required e.g. a STROBE was obtained for a service user that has a hearing impairment, to enable them to respond to the fire alarm. The service laundry facility is sited away from the food preparation area. Policies and procedures are in place to minimise the spread of infection. Wellington Road (51) DS0000018954.V283272.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): 31,32,33,34,35,36 The staff at Wellington Road have the skills and knowledge to meet the assessed needs of service users. EVIDENCE: The staff at Wellington Road are friendly and approachable and are aware of the aims and objectives of the service. Observation of staff showed that they promote the philosophy of the service, which is Wellington Road is the service users home. The homely feeling is achieved through the management and staff attitude to service users that promote a warm, friendly and relaxed atmosphere where everyone rights are respected. The staff have the time to get to know and develop relationships with service users. Discussion with staff and entries in service users files showed that they are aware of their knowledge and skills limitations and would seek advice from other specialist health professional to promote the health and well being of service users. Some staff have completed their NVQ level 2 & 3 Care Qualification and one staff is working towards their NVQ level 2 Care Award. Discussion with the registered manager, staff and inspection of the staff rota confirm that that there is a low level of sickness and staff turnover at the care home. Thus, continuity of care is provided to service users. Discussion with the registered manager indicated that informal staff meetings are held Wellington Road (51) DS0000018954.V283272.R01.S.doc Version 5.1 Page 19 regularly often at shift handover. discussed. However, a record is not kept of issues The home has not had appointed any new employees since the last inspection. A sample of staff files seen showed that two written references and a Criminal Record Bureau check were obtained by the service prior to staff commencing their employment at the care home. Discussion with the registered manager and staff indicated that staff are supervised as part of their day-to-day work. However, formal supervision has not been implemented at the care home. Wellington Road (51) DS0000018954.V283272.R01.S.doc Version 5.1 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 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): 37,38,39,40,41,42,43 The health and safety of service users are promoted through regular checks of equipment used at the care home and staff training. EVIDENCE: The manager was registered with the Commission approximately eighteen months ago. The registered manager has not started their NVQ level 4 Care and Management award nor have they attended any training over the past twelve months to maintain their knowledge and skills. The service has developed a quality assurance system and service users and their representatives are consulted regularly to assess the quality of service provided at Wellington Road. This is achieved by using questionnaires, service users meetings and feedback from families/friends. The service policies and procedures are reviewed as and when required to ensure that the policies reflect changes in legislation and best practices. Wellington Road (51) DS0000018954.V283272.R01.S.doc Version 5.1 Page 21 Observation during the inspection indicated that the service’s filing system could be improved and that where tasks are delegated to members of staff the registered manager should have a system in place for checking that the tasks have been completed. The service promotes the health and safety of service users by ensuring the regular checks and servicing to fire equipment are carried out and that staff training in the following are up to date:- food hygiene, first aid, moving and handling and fire awareness. The registered person must ensure that a risk assessment of the building is carried out and reviewed at regular intervals to identify minor repairs and risks to service users. Discussion with the registered manager indicated that a member of staff was completing a risk assessment of the building. However, no records could be found at the inspection of this. The home maintains a record of all accidents to service users and staff and where necessary staff are aware that the Commission must be notified. The service has a current Public Liability Insurance displayed and discussion with the registered manager indicated that records are kept of expenditure at the care home. The registered person is required to visit the care home once a month to provide support and supervision to the registered manager. A copy of the registered person visit report must be forwarded to the Commission. Wellington Road (51) DS0000018954.V283272.R01.S.doc Version 5.1 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 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 2 25 3 26 3 27 2 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 2 33 2 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 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 2 X 2 3 3 3 2 2 2 Wellington Road (51) DS0000018954.V283272.R01.S.doc Version 5.1 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 YA20 Regulation 13 Requirement Timescale for action The registered person must 08/04/06 ensure that a record is kept of all service users medication received into the care home. The registered person must 08/04/06 ensure that all areas of the home are clean and that equipment is appropriately stored. The registered person must ensure that the en-suite bathroom on the first floor ceiling is repainted. The registered person must ensure that staff are provided with appropriate training for the work they are required to perform e.g. the registered manager NVQ level 4 care and management. The registered person must ensure that records required to be kept by the care home are well maintained and easily accessible. 08/04/06 2 YA24 12 & 23 3 YA27 23 4 YA37 18 08/04/06 5 YA41 17 08/04/06 Wellington Road (51) DS0000018954.V283272.R01.S.doc Version 5.1 Page 24 6 YA42 23 The registered person must ensure that the service has a current NIEC (Electrical Wiring) certificate. The registered person is required to forward a copy of this to the Commission by 8/04/06. The registered person must ensure that a risk assessment of the building is carried out, which is assessed at regular intervals. 08/04/06 7 YA43 26 The registered person must ensure that a copy of their monthly visit to care home report is forwarded to the Commission. 08/04/06 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. 3 Refer to Standard YA1 YA5 YA22 Good Practice Recommendations The registered person should review the Statement of Purpose to ensure that staff qualifications are correct. The registered person should inform the service user in writing changes in their weekly fees. The registered manager should attend an external training course on managing physical and verbal aggression to ensure their skills and knowledge is current. The registered person should ensure that 50 of the staff group have completed the NVQ level 2 Care Qualification. The registered person should ensure that minutes are kept of issues discussed at staff meetings. The registered person should ensure that there is a training and development for staff at the care home. 4 5 6 YA32 YA33 YA35 Wellington Road (51) DS0000018954.V283272.R01.S.doc Version 5.1 Page 25 7 YA36 The registered person should implement formal supervision training to staff and maintain a record of issues discussed. Wellington Road (51) DS0000018954.V283272.R01.S.doc Version 5.1 Page 26 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 Wellington Road (51) DS0000018954.V283272.R01.S.doc Version 5.1 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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