Inspection on 01/08/07 for Wide Cove

This inspection was carried out on 1st August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Wide Cove 09/08/06

Wide Cove 06/02/06

Wide Cove 09/09/05

Wide Cove 15/02/05

Wide Cove 13/09/04

Wide Cove 08/02/04

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 Wide Cove 20 Brook Street Runcorn Cheshire WA7 1JJ Lead Inspector Maureen Brown Unannounced Inspection 1 August 2007 09:50 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 Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wide Cove Address 20 Brook Street Runcorn Cheshire WA7 1JJ 01928 572635 F/P 01928 572635 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) Mr Denis Edward Price Mrs Lynn Julia Price Mrs Doreen Elizabeth White Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (1) of places Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This service is registered for a maximum of 8 service users to include:* * No more than 8 service users in the category LD (Learning disability) 1 named service user in the category LD(E) (Learning disability – over 65 years of age) 9th August 2006 Date of last inspection Brief Description of the Service: Wide Cove is a care home providing personal care and accommodation for eight service users with a learning disability. Privately owned, the home is located close to shops, pub and other local amenities. It is a detached three-storey building with access between the floors via the stairs. The service users are accommodated in six single and one shared bedroom. These are individually furnished and decorated. The area to the side of the home is used as a car park. The garden area to the rear of the home is secure, well-maintained and accessible to service users. Although the postal address for Wide Cove is Brook Street, the home is accessed via Edgerton Street. The staff team comprises of a manager who is supported by eight support workers. The fees at Wide Cove are £530.00 per week. Optional extras include newspapers, books, tapes, clothing, toiletries and hairdressing. Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector visited without an appointment on 1 August 2007. The visit took five hours. The information reviewed included the previous inspection report, service history and other information received about the service. The site visit included a tour of the communal areas and two bedrooms, inspection of records and discussions with residents, the manager and the support workers on duty. Twenty-four out of forty-three standards were assessed and all were met. All the key standards were assessed. Service users commented, “I always like the meals in the home”, “If I was not happy I would speak to the manager or staff member” and “The home is always fresh and clean.” Relatives commented that “I am very grateful for all the care my relative receives at Wide Cove”, “The staff are caring, conscientious and helpful”, and “The care staff always support service users to live the life they choose”. GP’s commented that “The staff have the right skill and experience to support the residents”, “I feel the home has a holistic care approach” and “The home always supports the service users to live the life they choose.” Staff members commented, “I like working here”, “the Manager is very good”, and “the training is excellent”. Feedback was given to the manager at the end of the site visit. What the service does well: The staff team were keen for high standards to be maintained. Residents’ plans of care and individual case notes were well documented and reflected each resident’s needs. The staff managed daily activities and entertainments well and provided a wide range of choice. Residents confirmed by discussion and through surveys that they were pleased with the choices on offer. The care plans were person centred and reflected the diverse needs of the individual residents. Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient information is provided for residents to make a decision about moving into the home. EVIDENCE: The home’s statement of purpose and function, service users guide and a copy of the most recent inspection report were available for residents and prospective residents. These were reviewed in July 2007 and were written in standard print and plain English. It was recommended that other formats are considered in line with service users needs, and the manager commented that they were already looking at alternative formats. These documents contained all information needed to make an informed choice on whether this home could meet the needs of the prospective resident. A brochure of the home included details of the home, the care provided, the staff team and the philosophy of Wide Cove. Some service users confirmed that they were involved in the care planning process. During discussions with staff it was evident they were aware of service users needs. Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 Page 9 Within each service user file a pre-assessment document was available which detailed their needs. During discussions with the manager she stated that when a new service user was due to be admitted the home would obtain information from social services and others and the client would visit the home and then if they liked it they would have a meal at the home and build up to a weekend visit, day visits and after moving in would have a trial for three months. Seven out of the eight residents have lived in the home from sixteen to twenty-two years. Wide Cove was opened in 1985 for younger adults with a learning disability to live independently. The owners have two children with a learning disability and they also work within the home. The home has a strong diversity policy in respect of service users and staff. No one is excluded on grounds of ethnicity, religion or culture. Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The residents’ health, personal and social care needs are met by the staff team who enable them to maintain their privacy and dignity. Residents and relatives were very satisfied with the support they received from the manager and staff. EVIDENCE: Two residents’ care records were seen during this site visit. These were comprehensive and well presented in individual folders. Each file contained a care plan, risk assessments, health action plans and reviews. These were drawn up in consultation with the residents and were based on their assessed needs and risks. The care plans were reviewed on an annual basis and in conjunction with the residents. These files contained all the information necessary to ensure that service users needs are met. The care plans were clearly written and gave a very clear picture of the support needed. Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 Page 11 Other records seen relating to the service users included the Essential Lifestyle Plans, social services reviews, terms and conditions of residence and risk assessments. All these documents were up to date with appropriate recordings. Risk assessments were in place for all the relevant activities that residents undertook. These included bathing, showering, staying alone at home and going out. These were seen on the care plans and were up to date. Daily record sheets showed that information was recorded in respect of each resident. These were detailed and covered all areas of daily living and were accurate, clearly written and signed by carers. The residents spoken with confirmed they had been involved in the choice of décor and furniture within their bedroom and this was seen to reflect each resident’s personality and preferred tastes. Service users said that staff helped and supported them when they needed it, such as with personal care tasks. Also residents said that “I like to take part in cooking, dancing, crafts and exercise classes”, “The staff are always available when I need them” and “There are always activities I can take part in.” Observations made during the site visit included seeing staff knock on the bedroom door before entering and staff interactions with service users during lunch and throughout the time on site. The staff were attentive to service users needs and helped them when required. Often guidance and support rather than help was given to service users, enabling them to achieve tasks for themselves within their own time and limitations. Empowerment was very evident throughout all dealings seen between the staff team and service users. The general atmosphere within the home was warm and friendly. Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents’ were able to take part in a range of activities of their choosing. Personal and family relationships were encouraged by the home and the staff team supported people with this. EVIDENCE: All the residents have access to the local community. On the day of this site visit two of the eight residents were out and about at local day centres and working in the community. Of the residents who were at home, one was having a day off from work and the other person preferred to stay at home. Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 Page 13 Activity sheets were seen for two service users. This was a weekly sheet that detailed activities undertaken during the week by the individual. Other activities which could be on a one to one basis with staff or in small groups included going out bowling, canal trips, shopping trips to Widnes, going shopping locally and to the bank and library, holiday in Wales, going to Norton Priory, Blue Planet Aquarium and Albert Docks. Service users said they liked being out in the garden in the nice weather. From the service users surveys it was noted that family and friends visited and were made welcome by the staff. Residents shared with the inspector the contact they had with family members and said they could choose to see visitors within their own room or in the shared areas of the home. The visits from families and friends were recorded in the daily record sheets. The documentation regarding daily routines showed that this was good. The residents were supported with daily living tasks as appropriate and a rota had been set up to assist with the completion of household chores. Residents confirmed that mealtimes were flexible. At the site visit lunch was seen served. The two service users had choices of lunch, one wanted a cheese sandwich and the other one requested a ham sandwich. They were both offered a selection of other items for this meal. The main meal was eaten in the evenings as most service users were out and about during the day. One service user said “the meals are good here, plenty of variety and we choose the menus for the week. Each person chooses different days meals. If you don’t like what is on then an alternative meal is offered”. The manager stated that the staff team give advice on some healthy options and use of fresh fruit and vegetables. The kitchen was seen clean and tidy and fridge, freezer and hot food temperatures were taken and recorded. Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The residents’ health, personal and social care needs are met by the staff team who enable them to maintain their privacy and dignity. EVIDENCE: The care plan records included Health Action Plans, which were extensive documents covering all areas of health care needs. The information was well documented and included visits to GP, chiropodist, opticians, dentist and medical appointments. The medication system is the Venalink monitored dosage system and the drugs are supplied on a weekly basis and signed by the person in charge. Staff are trained in medication awareness. The medication is kept in the medication cupboard within the main office. Also staff files examined showed medication training undertaken. Homely remedy procedures were in place. The home had a medication policy and access to the Royal Pharmaceutical Society guide to administration of medication. Medication Administration Record sheets (MAR) were seen and appropriately completed by staff. Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear policies and procedures were in place to ensure that residents were protected from abuse, neglect and self-harm and staff were trained in the Protection of Vulnerable Adults. EVIDENCE: The home’s policy on complaints was seen and this contained details of CSCI and the ombudsman and it was reviewed in July 2007. Residents spoken to said that they would speak to the staff if they had a complaint. Staff confirmed that they were aware of the procedure and would pass concerns to the manager. The home nor the Commission had not received any complaints since the last visit. The residents said that they “felt concerns they had would be dealt with appropriately”. This was confirmed in the service users surveys. On examination of two staff files it was evident that POVA training had taken place. On discussions with the staff team they were able to explain what abuse was and that they would let the manager know if they were concerned about any service users. The home had Halton’s “No Secrets” policy, whistle blowing, restraint, aggression towards staff and Abuse Policy. All these were available for the staff to read. Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a clean and comfortable environment for the people to live in. EVIDENCE: The home was furnished in a domestic style and the garden areas were well kept. Residents said “they liked living at the home” and that “they were happy with the environment”. They said that staff had a free and easy rapport with them and this was seen during the site visit. The atmosphere within the home was very good and staff chatted to residents in a friendly manner. Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 Page 17 A tour of the communal areas and two bedrooms were seen. The home was found to be fresh, clean and odour free. Bedrooms seen had been personalised by the service users with their own furniture, pictures and mementoes. One service user was in their bedroom during the tour. The home was light, airy and was warm. On discussions with service users it was confirmed that the home was warm enough for them, they agreed it was. Improvements currently being undertaken include: 1. New windows have been installed to three quarters of the home. The rest are due to be completed in September; 2. All the bedrooms are being decorated before December; and 3. Communal areas are currently being redecorated with new carpets where necessary; Service users stated that they help with the daily chores and this was noted during the site visit. Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager provided clear leadership. Records were maintained to a good standard and service users are protected by the homes recruitment policy and practices. EVIDENCE: The staff rotas showed the staff on duty over the week. It also recorded the Registered Manager and Owners hours. Service users confirmed that enough staff were around to help them and observations made during the site visit showed staff were attentive to service users needs. The home’s manager was on duty with two residents in the home. Another staff member was due in at lunchtime. According to the rota when the other residents are in there are two care staff on in the morning, one in the afternoon and one person sleeping in. Relatives commented, “I know the registered manager and staff team care very much for my relative and their care and wellbeing is uppermost in their minds. They do a fantastic job.” And “Wide Cove provides a loving and secure home for all the residents. They are valued and cared for as individuals.” Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 Page 19 The recruitment procedure followed ensured that all the staff employed were suitable to work with vulnerable people. Two staff files were examined and these showed that pre-employment checks were carried out. Amongst the documentation available were two references, Criminal Record Bureau checks and a medical questionnaire. Copies of certificates of courses undertaken were also available. The files were up to date and well presented. Observed day-to-day supervision of staff was good and the staff team confirmed they were supported by the manager in their delivery of care to residents. The staff said that formal supervision was conducted on a regular basis and records were kept. The last sessions had been completed during June 2007. Staff appraisals were also undertaken and records seen. These had been completed during October 2006. All eight support staff had either obtained NVQ level II or III in Care. Mandatory training included training on Person Centred Planning, Learning Disabilities and Dementia, NVQ level II & III, promoting independence, equal opportunities, medication, fire training, epilepsy and food hygiene. All staff had completed mandatory training. Staff meetings take place on a regular basis usually every two months. The last meeting was held in June 2007 and issues discussed included the nonsmoking legislation, results of service users surveys, resident’s holidays and decoration programme. Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health, safety and welfare of the service users are protected. The views of service users are obtained and used to influence the running of the home. Staff are fully supervised. EVIDENCE: Safe working practices included visits from the fire safety officer and the environmental health officer, which had been completed satisfactorily. The insurance certificate was in place and up to date. Fire alarm tests were being undertaken on a weekly basis and emergency lighting tests were also being carried out on a monthly basis also with records kept. The gas safety and electrical safety certificates were up to date. Policies were available on COSHH, manual handling, protective equipment and hand hygiene. Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 Page 21 The registered manager provides clear leadership to the staff team. She has obtained the Registered Managers award, NVQ level IV and has eighteen years experience, she periodically updates her training and knowledge base. A selection of policies and procedures were examined. These were up to date. A quality assurance process was in place. Service user surveys were completed in February 2007. There was a good response from all the service users. Also each service user had quarterly reviews of the care plans and annual social services reviews. Regular house meetings were held and the last one in 17 July 2007 with seven service users attending. Issues discussed included choosing of new colours of bedrooms, holidays, menus and the no smoking legislation. With regard to holidays the owners stated that service users should have two a year and they said they would pay for one of the holidays. Minutes were kept of all meetings. Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 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 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 3 X 3 X X 3 X Wide Cove DS0000005201.V342045.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA1 Good Practice Recommendations The registered person should continue to develop other formats for the service users guide so that people who use the service have better access to information. 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