Inspection on 09/09/05 for Wide Cove

This inspection was carried out on 9th September 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

Wide Cove 01/08/07

Wide Cove 09/08/06

Wide Cove 06/02/06

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 9 September 2005 9:30 th 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. Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Wide Cove Address 20 Brook Street Runcorn Cheshire WA7 1JJ 01928 572635 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) Mr Denis Edward Price Mrs Doreen Elizabeth White Care Home 8 Category(ies) of Learning disability (8) Both registration, with number Learning disability over 65 years of age (1) of places Both Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 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) Date of last inspection 15 February 2005 Brief Description of the Service: Wide Cove is a care home providing personal care and accommodation for eight service users with a learning disability, one of whom is over 65 years of age. 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. Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on 9th September 2005. The total time on site was four hours. The inspector spent an hour planning the inspection by reviewing previous inspection reports and the service history. The inspection included a tour of the home, inspection of records and discussions with one resident, the registered manager and the support worker on duty. Twenty-four out of forty-three standards were assessed and most were met. Feedback from this inspection was given to the registered manager and the responsible individual at the end of the inspection. What the service does well: What has improved since the last inspection? What they could do better: The statement of purpose and service users guide should be updated and reviewed on an annual basis, and a copy sent to the Commission. Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 6 Within the care plans a person centred plan for dying and death should be completed with all residents. The homes policies and procedures should be reviewed annually. 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. Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 & 5 Sufficient information is provided for residents to make a decision about moving into the home. Full assessments of needs are carried out to ensure that the home can meet the needs of the residents. EVIDENCE: The home’s statement of purpose and function, the service users guide and a copy of the most recent inspection report were available for the residents and prospective residents. The statement of purpose and service users guide were last reviewed in September 2004. (See recommendation No 1). They contained information on the home’s environment, how rights would be maintained, aims and objectives, key objectives, which covered privacy, dignity, independence, security, civil rights, choice and fulfilment. Also included was choice of home, personal and health care, daily life and social activities, complaints procedure and staffing managements and administration. Also available was a brochure of the home that included details of the home, the care provided, the staff team and the philosophy of Wide Cove. All residents were aware of the service users guide and a copy of the last inspection report was available on request. Care plans examined showed that assessments had been carried out with each person before moving into the home. Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 9 Residents had visited the home prior to admission and overnight trial visits were encouraged. Admissions were planned and ranged from a short visit to overnight stays, dependent on the needs and wishes of the person. The staff member spoken to said they had completed mandatory training such as moving and handling, food hygiene and health and safety courses. Many other courses were available such as dementia, person centred planning and equal opportunities. She also said that staff were encouraged by the manager to attend training courses. The policy on the terms and conditions of residence formed the contract and contained the resident’s room number, and information on personal possessions, health, medication, care, insurance and outings. It also explained the terms and condition of residence, termination of agreement, registration of the home and the complaints procedure. The resident and the homes manager signed this document. Copies were kept on each residents care plan. The referrals and admission policy covered information on people who may refer residents, basic information to be collected, and assistance in arrangements of fees and the offer of residency. Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 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 standard(s) 6, 9 & 10 The residents’ health, personal and social care needs are met by the staff team who enable them to maintain their privacy and dignity. EVIDENCE: Three residents’ care records were seen during this inspection. These were comprehensive and well presented in individual folders. Each was subdivided into care plan, risk assessments, medication, reviews, contract, service users surveys, property and weight. The care plans seen 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. Health Action Plan files were being completed for each resident. These were comprehensive files that covered all aspects of health care needs and formed part of the plan of care. Within one of the care plans a person centred plan for dying and death had been developed. This is a good way of obtaining this information. (See recommendation No 2). Risk assessments were in place for all the relevant activities that residents undertook. These included bathing, showering and going out alone. These were seen on the care plans and were up to date. The risk management policy included information on over protection, dignity of risk, development Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 11 continuum, and reasonable levels of risk. The manager confirmed that staff were aware of this policy. Daily record sheets showed that information was recorded in respect of each resident. This was detailed and covered all areas of daily living. These records were accurate, clearly written and signed by carers. The resident 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. House meetings were held regularly with records kept, which the inspector saw. The resident confirmed that residents were involved in these meetings. There was a policy on confidentiality, sharing information and access to records that was discussed with staff in the induction process. Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 14 & 16 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: The residents’ plans reflect the range of activities undertaken, including developing and using practical life skills, attending college and day centres and going to work locally. The resident spoken to enjoyed going out and about in the community, to local shops, out for lunch, meeting family or friends or going to the cinema. All the residents have access to the local community. On the day of this inspection seven of the eight residents were out at local day centres and working in the community. The resident who was at home went out with the support worker for lunch and to do some shopping. From the service users surveys it was noted that family and friends visited and were made welcome by the staff. One resident shared with the inspector the Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 13 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 documentation seen 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, which the inspector saw. All residents had keys to their bedroom doors and one resident confirmed that they could lock the door. They were aware that staff could override this in an emergency. Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 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 standard(s) 18, 19 & 20 Residents received support from the staff for personal care in accordance with their stated preference. Administration and control of medications were appropriate for the needs of the service users. EVIDENCE: The personal support and daily routine sheets seen described how the residents preferred to be supported in their daily routines. Times for rising and resting and personal care preferences were recorded, as was choice of clothing, hairstyle and makeup. Two residents seen were dressed differently according to their own choice. Storage of medication was appropriate and a monitored dosage system was used. The medication administration sheets were signed and up to date. No controlled drugs were used at this time, however appropriate facilities were available if required. The home had policies on medication and drugs and noncompliance with the medication, non self-administration and training. During the previous inspection requirements were made with regard to administration of medication, availability of keys to the medication cupboard and completion of medication records. Improvements in all these areas were seen at this inspection. Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 15 The care plans records included Health Action Plans, which were very detailed and covered all areas of health needs. Visits from and to the GP, hospital, optical and chiropody appointments were recorded. One resident spoken to said that these services were accessed in the local community with the support of staff if required. Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Residents were satisfied with the support they received from the manager and staff. Clear policies and procedures were in place to ensure that residents were protected from abuse and neglect. EVIDENCE: The home’s policy on complaints was seen and one resident 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 onto the manager. No complaints had been made to the home or the Commission since the previous inspection. All relevant paperwork was available in the event of a complaint being received. The resident said that they “felt concerns they had would be dealt with appropriately”. This was confirmed in the service users surveys. The home’s Protection of Vulnerable Adults Policy was seen and this was consistent with the “No Secrets” guidance from the Department of Health. A copy of the Local Authority Adult Protection policy was available within the home and accessible to staff. The home’s whistle blowing policy was seen. The manager said that staff had undertaken training on Adult Protection, which was covered by a video, talks and the staff reading the Protection of Vulnerable Adults policy and guidance. Staff confirmed that they had received this training, and were able to demonstrate what to do if there was a suspicion of abuse. This was also covered in the induction process. Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 & 30 The home provided a clean and comfortable environment for people to live in. EVIDENCE: The home was furnished in a domestic style. One resident said that the bedroom was decorated to their preferred style. During this inspection one bedroom and the shared areas were seen. These were clean, tidy and free from any unpleasant smells. The kitchen was clean and tidy. Dry foods were stored appropriately in a locked cupboard. Records of menus and checks on fridge, freezer and hot food temperatures were kept. The laundry room was located away from the kitchen area and had sufficient equipment to meet the needs of the residents. Cleaning materials were kept secure and a COSHH policy and basic information sheets on hazardous materials were available. The garden areas were well kept. Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 18 From discussions with the resident at home at the time of the inspection and from service users’ surveys it was noted that residents “liked living at the home” and that they “were happy with the environment”. Residents commented that staff had a free and easy rapport with them and this was seen during the inspection. The atmosphere within the home was very good and staff chatted to the resident in a friendly manner. Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 19 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) 33, 35 & 36 The manager provided clear leadership. Records were well maintained. Staff received support to enable them to meet residents’ needs. EVIDENCE: At the time of this inspection the agreed staffing levels were met. One carer was in charge as only one resident was at home at the time of the inspection. 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. During the previous inspection a recommendation was made with regard to staffing levels. The manager had reassessed residents’ needs and the providers are in the process of increasing the care hours to meet the ongoing needs of the residents. Observed day-to-day supervision of staff was good and the staff team confirmed that 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. Staff confirmed that supervision sessions were held on a regular basis. Staff appraisals were also undertaken and noted. Records of these were seen. During this inspection staff were seen providing support to a resident in a dignified manner. Whilst getting ready to go out assistance was given. Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 20 Three of the five staff have either obtained NVQ level II or III in Care. Mandatory training included moving and handling, fire awareness and food hygiene training. All staff had completed mandatory training. Health and Safety and Adult Protection were other courses most staff had undertaken. During this inspection staff induction was discussed with the manager. The induction consisted of spending time in the home, fire awareness, about the staff member’s role, Health and Safety and policies, procedures and guidelines. New employees worked alongside other members of staff until they were ready to work unsupervised. This process took up to the first three months of employment. Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 21 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) 39, 40, 41 & 42 Residents’ records were kept safe and secure. Residents’ views were used in the planning for the home. Decisions are influenced by the information obtained from the completed satisfaction surveys and from conversations with residents. EVIDENCE: Records seen were kept in good order. These were in line with the Data Protection requirements. Residents confirmed they were aware of information kept about them. Residents’ files were kept secure. Care plans were discussed with the residents and staff said that residents give full input into the plans, which a resident confirmed. The record keeping policy included data protection information. Every six months the manager gives satisfaction surveys to residents. These details were kept on each resident’s files. The manager said that the information would be used to improve the service provided. Surveys covered Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 22 information about the staff, running of the home, privacy, independence, visitors, complaints, activities, heath care needs and other comments. A policy on monitoring service quality was seen at this inspection. Within the policy and procedure file there were policies on accidents, emergencies, first aid, health and safety, fire safety and moving and handling. All these areas of training were covered in the induction process and by staff being encouraged to attend relevant courses. (See recommendation No 3). Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 23 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 2 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 x 3 x Standard No 31 32 33 34 35 36 Score x x 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Wide Cove Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 2 3 3 x F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 24 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. 3. Refer to Standard 1 6 40 Good Practice Recommendations The registered person should ensure that the statement of purpose and service users guide are updated and reviewed on an annual basis, and a copy sent to the Commission. The registered person should ensure that person centred plans for dying and death are completed for all residents. The registered person should ensure that all the policies and procedures are reveiwed annually. Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Wide Cove F51 F01 S5201 Wide Cove V247555 090905 Stage 4.doc Version 1.40 Page 26 - 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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