Inspection on 27/04/05 for West View (46)

This inspection was carried out on 27th April 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

West View (46) 18/10/06

West View (46) 19/10/05

West View (46) 27/10/04

West View (46) 16/06/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 West View (46) 46 West View Clitheroe Lancashire BB7 9RJ Lead Inspector Jane Craig Unannounced 27 April 2005 09:00 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. West View (46) F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service West View (46) Address 46 West View Clitheroe Lancashire BB7 1DG 01200 429376 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) Mrs Joanne Brown Care Home only Personal Care 3 Category(ies) of Learning disability (LD) 3 registration, with number of places West View (46) F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27 October 2004 Brief Description of the Service: West View provides care for up to three adults with a learning disability. The home is privately owned by Mrs Joanne Brown, who takes responsibility for the day to day management. West View is a terraced property situated in a residential area close to Clitheroe town centre. A bus stop is located near to the home and there are small shops, a church and library within walking distance. There is a small front garden and a yard to the rear. Parking is on the roadside. There are four single rooms, one on the ground floor and three upstairs. None of the bedrooms have en-suite facilities; the bathroom is on the upper floor. The communal areas on the ground floor comprise a large lounge and a kitchen/dining area. Furnishings are domestic and homely. West View (46) F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first unannounced inspection of 2005 and took place over one day. At the time there were 3 residents living in the home. West View is one of two homes in a scheme owned by the registered person. Staff are employed to work in both homes and residents spend time together on organised trips and holidays. Residents from West View may also join residents at Elms House for meetings and occasional meals. Day to day management support is provided from Elms House and the majority of records are stored there. During the course of the inspection, the inspector met with all of the residents, who were able to engage in discussions and make their views known. The inspector spoke with two members of staff and the owner (registered person). A tour of the premises took place and a number of documents and records were viewed. What the service does well: Residents were supported to take part in a wide range of activities outside the home. Staff made suggestions about new activities and helped residents to organise them if needed. Residents said they liked all the activities they did. Staff encouraged residents to be as independent as possible and respected their rights to choice and privacy. This was appreciated by residents who said that they were happy with their lifestyle. One resident said of staff, “they always respect me and I respect back.” Residents had a lot of opportunities to tell staff what they liked or disliked about the home and they felt that staff took notice of them. One resident said “I know Joanne (registered person) will always do anything if we ask her.” Residents had health check ups every year with their nurse. Any problems were acted upon. Staff helped residents to look after their own health problems if they were able. West View (46) F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 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. West View (46) F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 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 West View (46) F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 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) EVIDENCE: There had been no new residents admitted since the last inspection, therefore the key standard was not assessed and will be looked at during the next inspection. Other standards have been consistently met during previous inspections to the home. West View (46) F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 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 and 9 Improvements in the care planning process enabled residents to be involved in goal setting and care planning in accordance with their wishes. The risk assessment and management framework supported residents to take responsible risks. Lack of regular, formal reviews of individual risk assessments may result in changes to the level of risk not being recognised and appropriately managed. EVIDENCE: New person centred plans had been introduced. The plans included residents’ own thoughts on their strengths, needs and goals. Residents could be as involved in drawing up the plans as they wished. The residents kept their own plans and said the staff asked them what they should write in them. The plans provided staff with directions to assist residents to meet their daily living needs and work towards longer-term goals. Plans were reviewed six monthly and the inspector observed part of a review meeting. The resident was fully involved and was encouraged to lead the meeting by bringing up any areas for discussion. The plan was amended in accordance with his wishes and areas for re-assessment were highlighted by either the resident or staff. West View (46) F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 Page 10 Policies stated that the role of staff was to facilitate independence. Risk assessments and management strategies supported residents to lead the independent lifestyles they chose. Residents were aware of the potential risks due to the home being un-staffed for long periods and said they were not worried. One resident said “we like being by ourselves, we’re not scared.” They knew whom to contact in an emergency and one resident talked about his involvement in fire drills and said there were no problems. One resident talked about the routine for locking up at night, another said “I check out of the window if anyone comes to the door.” Risk assessments were in place for residents’ use of equipment and appliances in the home and the cooker had been changed to assist one resident. Staff said that residents’ abilities were continually monitored in this area but there were no regular written reviews. West View (46) F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 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) 12 and 16 Residents were supported to lead full and independent lifestyles. Residents were respected by staff and their rights were upheld. EVIDENCE: Residents were very independent and chose how they wished to spend their time. Person centred plans included a weekly programme and showed that residents were involved in various educational, recreational, domestic and voluntary work activities. One resident talked about his work on a gardening project, another talked about his art work and keep fit programme. Residents said that they were very happy with the amount of activities they did. Staff said they made suggestions or provided information about new activities and helped residents to organise them if needed. Two residents were involved in the service user network and one resident said that he was looking forward to working with the inspectors. Residents established their own routines according to their individual preferences and daily activities. One person said “I like being able to go to bed late.” Another person said he liked to come in and go out when he wanted but he always had to let staff know. When asked whether he felt respected by West View (46) F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 Page 12 staff, one resident said, “they always respect me and I respect back.” Residents said that staff gave them privacy and always rang the doorbell instead of using their keys. Staff talked about the importance of supporting and assisting residents to make sure they were safe, without compromising their independence and choice. West View (46) F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 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) 19, 20 and 21 Residents’ healthcare needs were identified and met, with evidence of multidisciplinary working. Residents were enabled to manage their own medicines and were protected by clear policies and risk assessments. Staff attitudes, knowledge and skills regarding care of the dying ensure that residents’ wishes will be carried out. EVIDENCE: Residents had access to annual health screening, which was carried out by a practice nurse, a specialist nurse and the registered person. A health action plan was developed following the screening. Any treatment or advice resulting from the action plan was transferred to the residents’ individual plan and referrals made to other specialists as necessary. Plans contained evidence of outpatient and clinic appointments. One resident said that he had to have his blood pressure checked since his health action plan. Staff spoken with were aware of the ongoing health needs of the residents and care or treatment to be provided, for example, for a diabetic resident. Residents said that staff helped them to make appointments. One said, “I told (keyworker) that I had a pain in my leg and she took me to the doctors for some pills.” Policies and procedures for medicines management had been revised and were complete. All staff had received accredited training in handling medication. West View (46) F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 Page 14 Residents were assessed as to their ability to manage their own medication. Two residents, who only had medicines occasionally, went to Elms House, where staff administered it. They were happy with this arrangement. One resident collected his own weekly prescription and administered his own medicines, via a monitored dose system. He had appropriate storage facilities. Staff checked in the medication and monitored his ability to manage, via a risk assessment. The policy on the care of dying residents made provision for them to stay at the home, or at Elms House, for as long as their needs could be met. Staff had experience of caring for a terminally ill resident and three had formal training in care of the dying and bereavement. Staff spoken with said they would like to be able to care for the residents until their death. Staff had discussed residents’ wishes for care during terminal illness and after death and these were recorded on their plans. One resident said, “staff will look after me and I want to stay here.” During the course of his review, one resident asked for his plan to be changed. West View (46) F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 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) 23 Staff had a thorough understanding of adult protection issues ensuring that any allegations would be dealt with appropriately. EVIDENCE: Staff received training in the protection of vulnerable adults. Those spoken to demonstrated a good understanding of their roles and responsibilities in detecting and reporting allegations, including any against senior staff. Written policies and procedures were available for reference. Following a previous recommendation, staff had received training in managing difficult behaviours, including physical interventions. Residents knew who to speak to if they encountered any problems with staff or another resident. They said staff treated them very well but if there were any problems they would go to Joanne (registered person). There had been some friction between two of the residents towards the third. Regular meetings had been set up to enable them to air and resolve differences and staff monitored the situation closely. All the residents said they were happy living at the home, especially the amount of independence they had. When asked whether they felt safe, one said “double yes.” West View (46) F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 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 and 30 The standard of décor needs further improvement to provide a comfortable and homely environment for residents. The standard of cleanliness and hygiene was satisfactory. EVIDENCE: Since the last inspection there had been some improvements to the décor. One of the bedrooms had been repainted, there was a new gate and the back yard had been painted. Two of the bedrooms needed redecorating to provide a more homely and comfortable environment for residents. These and other areas for redecoration and refurbishment were highlighted on the development plan. Furnishings were homely and the bedrooms reflected the individual tastes of the residents. They were happy with the home, one said, “I love it that much.” The home was clean and tidy at the time of the inspection. Residents’ had responsibilities for some domestic tasks, staff attended to others and a cleaner was employed once a week. Staff were aware of hygiene and infection control practices. They had written guidance and were awaiting update training. Two of the residents had previous health and hygiene training and staff said that they reminded them about hygiene when cooking, cleaning and handling laundry. West View (46) F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 The level of staff supervision provides safeguards for service users. EVIDENCE: Staff said that they received regular one to one supervision from the registered person. One member of staff said that she enjoyed the supervision meetings and found them useful. The sessions provided opportunities for keyworkers to discuss ‘their residents’, ensuring that care practices were monitored and reviewed by the registered person. Day to day monitoring of practice took place when staff worked with the registered person at Elms House. New staff would not be able to work alone at West View until the registered person deemed them competent. Staff received annual appraisals of their work. Residents’ comments showed that they had confidence in the staff. West View (46) F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 Page 18 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) 37,39,41 and 42 Policies and practices of the home revolve around the needs of the residents, who are confident that their views are listened to and acted upon. Health and safety training, practices and written procedures safeguard the health, safety and welfare of the residents and staff. EVIDENCE: The registered person took day to day responsibility for the home. Since the last inspection she had completed the Registered Managers Award and was awaiting formal assessment. It was evident that the registered person kept up to date with any new legislation and best practice guidance and ensured that this was put into practice. The staff and residents spoke highly of the registered person and valued her daily involvement. A resident said “I can always go to Joanne.” During reviews of their plans, residents’ were asked about their likes and dislikes, including any issues about the home. Residents attended meetings at Elms House where they were encouraged to air their views about all aspects of the service. Surveys were conducted annually and residents were encouraged West View (46) F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 Page 19 to ask anyone of their choice to help them to complete them. One resident had used the advocacy service for this purpose. Residents were confident that any suggestions would be well received. One resident said, “I know Joanne will always do anything if we ask her.” The development plan for West View included extending the property to install a downstairs bathroom, following a suggestion from a resident. From talking to residents and staff, and observation during the inspection, it was apparent that the routines and practices of the home centred on the needs of the residents. Following a previous requirement, each resident had a list of personal furniture and other equipment on their file. Other records required by legislation were in place. The residents held their own personal plans. Other records were held securely at Elms House. Staff had received training in safe working practice topics to the level necessary to ensure the safety of current residents. Fire drills were carried out regularly and residents were aware of fire safety procedures. Certificates were available to show that installations and equipment in the home were serviced and maintained. Environmental risk assessments had been carried out with particular reference to the current residents. Safety notices were in a format understood by residents and were displayed in the kitchen. Residents were aware of the need for safety measures in the home, and talked about designated smoking areas, not carrying laundry or equipment up and down stairs and turning off the cooker when they finished. West View (46) F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 Page 20 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 x x x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 4 x x x 4 x Standard No 31 32 33 34 35 36 Score x x x x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 West View (46) Score x 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 x 4 x 3 3 x F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 Page 21 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 None 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. 2. Refer to Standard 9 24 Good Practice Recommendations Formal reviews of risk assessments should take place regularly. Records should be kept. The registered person should ensure that all parts of the home are reasonably decorated. West View (46) F57 F07 S9616 West View V222349 270405 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 1st Floor, Unit 4 Petre Road, Clayton-Le-Moors Accrington Lancashire. 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