Inspection on 12/12/05 for Westover Close, 1c

This inspection was carried out on 12th December 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Westover Close, 1c 15/02/07

Westover Close, 1c 19/07/05

Westover Close, 1c 29/11/04

Westover Close, 1c 22/07/04

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Ruskin Lodge

Dystlegh Grange

The Good Companions

Springfield Cottage

Cuerden Grange Rest Home

Cornmill Nursing Home

Vitalise Sandpipers Centre

Sue Ryder Care Birchley Hall

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

CARE HOME ADULTS 18-65 Westover Close, 1c 1c Westover Close Maghull Liverpool Merseyside L31 7BU Lead Inspector Mrs Trish Thomas Unannounced Inspection 11:00 12 December 2005 th Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 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 Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 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. Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Westover Close, 1c Address 1c Westover Close Maghull Liverpool Merseyside L31 7BU 0151 526 4133 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) Parkhaven Trust Mrs Suzanne Bridgewater Care Home 4 Category(ies) of Physical disability (4) registration, with number of places Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 4 PD. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 19/07/05 Date of last inspection Brief Description of the Service: 1c Westover Close is a purpose built bungalow for four young adults who are assessed with profound physical disabilities. The home is owned by Parkhaven Trust and Mrs. M. Bridgewater is the registered manager. The home is well integrated with other domestic dwellings in the street and has a car park at the front of the building and a patio and gardens at the side and rear. This is a permanent home, providing twenty-four hour care and support, home cooked meals and laundry services. All those in residence are registered with a local G.P. and treatment is provided on the premises by visiting therapists. The home provides a range of moving equipment, and some recent improvements have been made through installation of ceiling tracking to assist in moving residents in comfort and safety. The four residents occupy single bedrooms with adjacent bathrooms. Communal space consists of a lounge/dining area and a conservatory. Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This un-announced inspection took place in late morning/early afternoon. Residents were observed in the company of staff and their care files were read. Discussion took place with Mrs. M. Bridgewater (manager) and Mrs. L. Cork (senior) regarding care practice, health & safety and staffing and relating records were read. A tour of the building and gardens was carried out What the service does well: What has improved since the last inspection? Requirements from the last inspection have been addressed. Care plan reviews and residents’ risk assessments were up to date and the use of language in more recently compiled records was satisfactory. The manager’s efforts to obtain O.T. assessments are ongoing and some mobility equipment has been replaced. Fire records were up to date with regards to testing and instruction. Improvements had been made to the emergency lighting system. Since the last inspection, Mrs. Bridgewater’s application for registration with CSCI has been approved. A patio has been built at the side of the building, with ramped access for residents. The lounge, kitchen dining room and a bedroom have been decorated. There is a new carpet, furniture and television in the lounge. Access to bathrooms is currently under review and consideration is being given to changing the positions of doorways. Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 Page 6 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. Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 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 Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 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): 2 The home was meeting standard 2. Westover Close is the permanent home of the four residents who were assessed with profound physical disabilities and who also have communication difficulties. New admissions are not usual, and all the residents have lived in Westover Close for a number of years. Assessment is on- going during residence, within the care planning and social work review systems. EVIDENCE: Reference was made to residents’ assessments and discussion took place with the manager, Mrs. Bridgewater and one member of staff. All residents had assessments undertaken by relevant professionals, on admission to the home. It was evident in care files that particular attention has been paid to residents’ mobility and the equipment needed to support them. All residents receive regular physiotherapy treatment and professional advice, is acted upon in providing their support. One resident had recently had an Occupational Therapy assessment and was awaiting a new piece of equipment. Following assessment, a sleep system has been installed for one resident and the manager was monitoring staff skills in ensuring the comfort and safety of the resident whilst using the system. Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 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 the following standard(s): 6,7, 9. The home was meeting standards 6 and 7. A care plan has been developed for each resident, in consultation with representatives. Residents’ views and feelings are ascertained as far as possible, and the family representatives’ input is ongoing in decision-making. The sample of care plans which were seen, had been reviewed and amended accordingly. Standard 9. A shortfall was noted regarding risk management in response to an incident in the home. EVIDENCE: Standard 6. Care plans have been changed to a new format in recent months. They contained social histories, interests, skills, gifts, communication (means of non-verbal communication documented), routines, preferences, risk assessment, moving and handling assessment. The care plan includes area of need, how it will be met, and who will meet it. There was evidence of aid to diet, continence, referrals to G.P.s. and paramedical services. There was evidence of ongoing assessment and review of care plans in response to a requirement from the last inspection. Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 Page 10 Standard 7. Residents have limited decision-making capacity and limited forms of expression. With regards to their right to choice, communication strategies have been developed with the residents over time. Residents’ reactions to situations or questions, are observed by staff and as far as is possible, their responses will influenced day to day decisions, such as meals, clothing and outings. Contact with families is maintained through mutual visits, phone calls, reviews and emails. Care plans are in place for all residents, based on social work assessments, at time of admission and supported by therapeutic programmes. Standard 9. In response to an incident in the home, a requirement is made that the manager undertake a risk assessment of radiators and pipe work in the building, which may pose a risk to residents. Remedial action must be taken to guard against high surface temperatures. Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 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 the following standard(s): 12,13, 15,16, 17. The home was meeting standards 12,13, 15, 16 and 17. Opportunities for residents are constantly under review, and their lifestyles arranged, as far as it is possible to ascertain, in accordance with individual capacity and preference. Residents have access to the local community, supported by staff. Residents’ links with their families are supported by the home. Daily routines have been developed, which support residents’ therapeutic programmes and leisure activities. Residents’ specialist dietary needs and preferences are catered for in the home. EVIDENCE: Standard 12. It is recorded on residents’ care plans that due to their profound disabilities, they require a high level of support in all aspects of their lives. The service provided in Westover Close, concentrates on leisure and therapeutic activities. Staff maintain a calm and homely atmosphere, where residents may listen to music, watch DVDs and television programmes, or enjoy each other’s company. Residents’ bedrooms are decorated and furnished to their liking and are highly personalised and comfortable. A secluded ramped patio has been built at the side of the home, for residents to enjoy in fine weather. Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 Page 12 Standard 13. The home is an adapted bungalow and is domestic in style and well integrated with surrounding dwellings. From reading care files it was evident that residents are registered with a local G.P. and staff escort and support them to go on shopping trips, meals out and day trips, and hydrotherapy. Staff spoken with considered supporting residents in this way to be an important aspect of their role. Standard 15. From discussion with the manager and reading care files it was established that residents’ families live out of the area. Mutual visits are ongoing and all residents have an email address. Holidays are arranged during the summer and there are regular outings and daily shopping trips. The home has a mini bus and residents have their own wheelchairs. At the time of inspection, further opportunities in accessing specialist day care activities were being explored by the manager. The daily routine accommodates physiotherapy sessions for residents and staffing is flexible to meet the leisure needs of the residents. Standard 16. One resident is ambulant and from reading his care file it is evident that he enjoys some freedom of movement in the home (subject to risk assessment). The remaining residents rely on staff to support them in all aspects of their life and mobility. During inspection visits, residents have been observed using all areas of the building, the lounge, conservatory, dining area, or their bedrooms. They are assisted to the garden in fine weather. During the inspection, staff were seen speaking respectfully with residents and their privacy was respected through keeping bathroom and bedroom doors closed when residents were using these areas. Staff were including residents in general conversations and were not speaking exclusively to one another. The reaction from residents appeared positive. Standard 17. The home does not carry large food stocks. The kitchen is domestic in style and shopping is carried out regularly, according to residents’ preferences. Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 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 the following standard(s): 18,19,20. The home was meeting standards 18 and 19 . Provision of personal and emotional support and the health care needs of residents are recorded in their care plans, monitored and reviewed. None of the residents has capacity to self-medicate and the home has a satisfactory system in place to manage their prescribed medication. A minor shortfall was noted in record keeping. EVIDENCE: Standards 18 and 19. Reference was made to a sample of care plans where there were records of consultation with residents/ their representatives, as to the care and support to be provided in the home. All residents are registered with a local G.P. and medical appointments had been recorded. Regular therapeutic programmes have been established with physiotherapists, as an element of residents’ ongoing care. Standard 20. The home has a medication procedure and prescribed drugs are stored securely. Medication is signed for, by staff, at the time it is administered and the keys to the storage cupboard are signed over at the end of shift. There is an audit trail of refused medication and unwanted drugs are returned to the pharmacy. Staff who administer medication receive an inhouse training course and instruction from an external provider is also available. Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 Page 14 Medication Administration Records were read and a recommendation is made that handwritten additions are signed by the writer and checked and signed by a colleague. The procedure for administration of Midazolam was described by staff. Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 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 The home was meeting standards 22 and 23. The home has a complaints procedure, which is accessible to residents’ representatives. Training and procedures are in place to protect residents’ from abuse and neglect. EVIDENCE: Standard 22. Reference was made to the home’s complaints procedure, which includes stages and timescales for the process and contact persons. The home maintains a record of complaints and any remedial action taken in response to complaints. Standard 23. The manager confirmed that the provider organisation has adult protection (currently under review) and “whistle blowing” procedures. Staff receive training in Protection of Vulnerable Adults in accordance with Liverpool and Sefton Social Services’ procedures. Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 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, 30 The home was meeting standards 24 and 30. Westover Close is purpose-built and is arranged and furnished in a homely and comfortable style. The home was clean and hygienic and well maintained at the time of inspection. EVIDENCE: The home is purpose built and is furnished and decorated to a very good standard, in a comfortable domestic style. There was a calm and friendly atmosphere. Residents’ bedrooms are highly personalised with décor appropriate to a young lifestyle. Building maintenance is ongoing and there are plans to change access position to one of the bathrooms. The lounge and kitchen diner have been recently decorated. The home was clean and hygienic at the time of inspection. The home is single-storey with wide doorways and two assisted bathrooms, accessed from bedrooms. All rooms are accessed from a broad corridor, which is suitable for wheelchairs and for the resident who has some independent mobility. There is level access to the front car park and rear garden. The home has the use of the mini-bus, also used by other services of Parkhaven Trust. Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 Page 17 Due to their high levels of disability, residents require a number of aids and adaptations to accommodate their mobility and support. Ceiling tracking has been fitted throughout the home, to assist with use of the hoist for the residents. A range of personalised equipment is in place for residents, such as a sleep system, individualised wheelchairs, moulded seating, support jackets and limb splints. Personal aids to disability are constantly under review. Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 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): 32,33,35. The home was meeting standard 32, staff have the competencies and qualities to meet the needs of the residents. The home was not meeting standard 33 as a shortfall was noted regarding a specialist training method. The home was meeting standard 35, staff are supported by management in fulfilling the aims of the home and the changing needs of residents. EVIDENCE: Standard 32. There is a good level of training available and undertaken by staff. NVQ training is at satisfactory levels for care staff, a number having achieved level 3. Standard 33. Peg feeds were discussed with the manager, who said that instruction in the use of peg feeds is passed on between staff. A requirement is made that the manager arranges for training in peg feeds from a relevant professional, to be updated for new staff. It is recommended that the manager arranges monitoring/reviewing visits by relevant professional staff, for residents who have peg feeds. Staffing levels were being maintained as recorded on the staff roster. A sample of staff files was read and these were satisfactorily maintained. Standard 35. Reference was made to a sample of staff files. Induction training is provided for newly appointed staff and all staff receive regular formal supervision and appraisals. Training is provided in accordance with identified needs and the home’s aims and objectives. Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. The home was meeting standard 37. The manager is qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives. Standard 39. There is consultation with residents’ representatives regarding their opinions on standards in the home. Standard 42. The home was meeting standard 42 regarding health and safety records. EVIDENCE: Mrs. Bridgewater is the registered manager and has the experience and training to manage the home. Mrs. Bridgewater confirmed procedures for financial management in the home, implementation of policies and procedures and provided the records requested, which were in order. In assessing the quality of service, outcomes to residents are obtained through the care planning and review processes. There is ongoing consultation with residents’ representatives as to their views on quality service and review meetings are arranged. Fire records and fire instruction periods were satisfactory. There had been recent improvements to the emergency lighting system. Maintenance certification was in order. Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 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 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 2 X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Westover Close, 1c Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000005436.V273279.R01.S.doc Version 5.0 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 YA9 Regulation 13(4) (a) Requirement The manager must carry out a risk assessment of radiators and pipe work in the home, and arrange for remedial work where necessary, to guard residents against high surface temperatures. The manager must arrange for training from a relevant professional, in the use of peg feeds. To be updated for new staff. Timescale for action 19/12/05 2. YA33 18(1) c (i) 19/01/06 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. Refer to Standard YA33 YA20 Good Practice Recommendations The manager should arrange monitoring/reviewing visits by relevant professional staff, for residents who have peg feeds The manager should ensure that where handwritten additions are made to MAR sheets, the writer signs the change and has a colleague check and countersign. Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Westover Close, 1c DS0000005436.V273279.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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