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Inspection on 13/01/06 for Wirral Christian Centre

Also see our care home review for Wirral Christian Centre for more information

This inspection was carried out on 13th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents enjoy living at the home and being cared for by the staff. The staff team work closely together and are well supported by higher management. Residents are encouraged to make choices on a daily basis about all aspects of their daily life. They are treated with respect by staff that make sure their dignity is always maintained.

What has improved since the last inspection?

Staff have worked hard to develop care plans and risk assessments to make sure residents are kept safe. Further work is planned on the organisation of the care files. The home has purchased a new chair lift to ensure residents can move about the home. Staff are now more aware of abuse policies and procedures following recent training. This will help to ensure residents are kept in a safe place at all times.

What the care home could do better:

The home must ensure the main passenger lift is kept working to help residents move about the home freely. All health and safety certificates must be kept in a place that the manager can access to ensure she is aware of those that may need updating or renewing.Handwritten entries must be double signed by staff to make sure mistakes are not made, however in general medication records had improved. The residents identified by staff during previous inspections as being out of category, still need urgent re assessment by social services

CARE HOMES FOR OLDER PEOPLE Wirral Christian Centre Woodchurch Road Birkenhead Wirral CH41 2UE Lead Inspector Natalie Charnley Unannounced Inspection 13th January 2006 11:00 X10015.doc Version 1.40 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 Wirral Christian Centre DS0000018956.V280385.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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. Wirral Christian Centre DS0000018956.V280385.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Wirral Christian Centre Address Woodchurch Road Birkenhead Wirral CH41 2UE 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) 0151 653 8307 Wirral Christian Centre Trust Limited Mrs Evelyn Jane Epton Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Wirral Christian Centre DS0000018956.V280385.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Two named adults with physical disablement and one named adult with a learning disability may be accommodated Thirty-six elderly persons (not falling within any other category) To accommodate one named person under 65 years old Date of last inspection 28th October 2005 Brief Description of the Service: The Wirral Christian Centre is a residential home located in Birkenhead, Wirral and was formally the local children’s hospital. It is located on a busy main road and is close to local shops, bus stops and transport links. The home is located in a large building that also houses a day nursery which is inspected by Ofsted. The home uses two floors of the building, bedrooms and lounge areas are located on both. The total maximum number of residents living at the home at one time is 39. The home has a small car park to the front and access is via the main reception. This area is accessible for wheelchairs. Wirral Christian Centre DS0000018956.V280385.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over the period of one day. The inspector arrived at the home at 11am and left at 3pm. The inspector spoke to the home manager, a visiting physiotherapist, five residents, one visitor and six staff. The inspector completed the inspection by looking at the home records, a tour of the building, formal and informal interviews and information from previous inspection reports. The inspector followed a plan written before the start of the inspection to ensure that all areas that need covering are done so. Feedback was given to the manager during and at the end of the inspection. The home has been assessed on all the core standards during the 2005/06 inspection year. What the service does well: What has improved since the last inspection? What they could do better: The home must ensure the main passenger lift is kept working to help residents move about the home freely. All health and safety certificates must be kept in a place that the manager can access to ensure she is aware of those that may need updating or renewing. Wirral Christian Centre DS0000018956.V280385.R01.S.doc Version 5.1 Page 6 Handwritten entries must be double signed by staff to make sure mistakes are not made, however in general medication records had improved. The residents identified by staff during previous inspections as being out of category, still need urgent re assessment by social services 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. Wirral Christian Centre DS0000018956.V280385.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wirral Christian Centre DS0000018956.V280385.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No judgement was made in this area at this inspection. EVIDENCE: None of the above standards were checked in full during this inspection, however pre admission assessments have now been re developed to ensure enough information is kept regarding the health and needs of residents. The manager reported that she is still awaiting re assessment of those residents identified at the last inspection as being out of category. Wirral Christian Centre DS0000018956.V280385.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,9 and 10 Care plans detail how staff are to care for residents but need to include details of social likes and dislikes to ensure residents are fulfilled. Medication recording has improved but still needs attention to maintain the safety of residents Residents have their dignity and privacy maintained at all times EVIDENCE: Five care plans were looked at. The home has made some changes to these documents since the last inspection and have put in place a dependency profile and tools for looking if a resident is at risk from pressure sores, lifting or falls. The home still needs to find a suitable tool for looking at nutritional risk. Care plans were now being reviewed on a more regular basis by staff. None of the care plans looked at showed details of what ‘social’ input a resident wants during their daily lives, this is an area that the home need to explore. The manager stated that she plans to re-organise the way care plans are stored in the near future to make accessing the information in them easier for staff. Wirral Christian Centre DS0000018956.V280385.R01.S.doc Version 5.1 Page 10 Medication administration records were checked along with the controlled drug book. Records had improved since the last inspection and medications are now signed in and out of the home. All medications that have variable doses are now recorded correctly, however handwritten entries remain only signed by one member of staff which leaves staff open to making drug errors as a second member of staff ensures all information written is accurate. Residents spoken to during the inspection stated that they are treated with dignity and respect. One lady commented, “staff here are so kind, they are polite and well mannered”. Staff were observed talking to residents in a clear and kind manner and knocking on bedroom doors before entering. Staff confirmed residents see health professionals in the privacy of their own rooms; this was also observed when a community physiotherapist visited the home. Wirral Christian Centre DS0000018956.V280385.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 Residents are assisted by staff to make choices on how to live their lives. EVIDENCE: Residents spoken to during the inspection stated that they are encouraged to make their own decisions on a daily basis and commented “ we can get up and go to bed when we want” and “ we come and go as we please”. Residents also commented that they were saddened that they couldn’t go down to the dining area for meals at present as the lift was out of order and had been for “ a few days” and were upset that they had been given conflicting views as to when it was going to be fixed. The manager must address these concerns as a matter of urgency. Staff were observed asking residents about meal and drink choices during the lunchtime period. Residents were seen being encouraged to manage small amounts of money independently and confirmed that they are supported by staff in doing this. Wirral Christian Centre DS0000018956.V280385.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 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 Staff have improved their knowledge of adult protection issues, which will help ensure that residents are kept safe. EVIDENCE: The home are still in the process of trying to get a copy of Wirral council adult protection procedures, despite this being a requirement of the last inspection report. Staff confirmed that they had been provided with abuse awareness training on a video and demonstrated that they now had a broader knowledge and understanding of abuse. Staff continue to be checked for criminal record checks and POVA (protection of vulnerable adult) checks before starting work at the home. Wirral Christian Centre DS0000018956.V280385.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No judgement was made in this area at this inspection. EVIDENCE: None of the above standards were checked in full, however the home was found to be clean and tidy in all areas. The main lift to the upper floors was found to be out of order and needs to be repaired as a matter of urgency. Wirral Christian Centre DS0000018956.V280385.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 29 Staffing levels are sufficient to allow staff to care for the residents. Recruitment practices at the home are good, ensuring residents are protected. EVIDENCE: The home rota showed that enough staff are on each shift to care for all the residents at the home. The manager stated that she is working on a proposal for changing the staffing levels and would but this in writing to the inspector. A handover was observed between morning and afternoon staff which gave good details about the residents and what had happened on the previous shift. Staff interviewed stated that staffing levels were “good” and “we all pull together if a shift needs covering”. Residents and visitors also commented “staff are so kind”, “staff are always about and very helpful” and “they are dedicated and fun to be with”. Five staff files were looked at, including the two most recently appointed staff. These showed that appropriate checks were being carried out on staff to make sure they are suitable to work with vulnerable adults. Details of staff inductions, contracts, terms and conditions of employment and supervision were also included. One member of staff had recently won ‘employee of the month’ which the manager stated had helped staff morale. Wirral Christian Centre DS0000018956.V280385.R01.S.doc Version 5.1 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 38 The manager leads by example and provides a good environment for staff to work in. Access to details on health and safety at the home is needed by the manager to ensure residents are within a safe environment EVIDENCE: The home has two managers who are registered with the Commission for Social Care Inspection. One of these managers works in the capacity of ‘general manager’ and the other works on the floor along side the other staff. Both managers work closely with each other to ensure staff have the same information given to them. The manager in daily charge of the home has worked there since 1988 and holds on management qualification and is looking into starting the registered managers NVQ 4 award. Staff and residents spoke highly of this manager stating the she is “supportive” and “fair”. Wirral Christian Centre DS0000018956.V280385.R01.S.doc Version 5.1 Page 16 Accident records at the home are now stored correctly and are well recorded. All health and safety certificates that the home require were not able to be accessed, which the manager must address and will be checked again during the next inspection. Staff had received a fire drill in November 2005 and the home are part way through a new fire risk assessment which is being done via the internet and ensure the safety of the home against fire. Wirral Christian Centre DS0000018956.V280385.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 2 Wirral Christian Centre DS0000018956.V280385.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? YES 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 OP4 Regulation 14(2) Requirement The registered manager must ensure that the seven identified residents who staff feel are out of category are re assessed by social services. Remains outstanding from the last inspection: previous timescale 15.12.05 The registered manager must ensure that care plans contain information regarding social likes and dislikes of residents The registered manager must ensure that risk assessments are completed for all residents in re a) Nutrition and that these are updated on a regular basis. Remains outstanding from previous report: previous timescale 01.01.06 The registered manager must ensure that all handwritten entries are signed and dated by two members of staff. The registered manager needs to ensure all staff can access local policies and procedures Remains outstanding from DS0000018956.V280385.R01.S.doc Timescale for action 01/01/06 2 OP7 15(1) 01/04/06 3 OP8 13(4)(a) 01/03/06 4. OP9 13(2) 01/03/06 5 OP18 18(1)(c) 01/03/06 Wirral Christian Centre Version 5.1 Page 19 6 7 OP19 OP38 23 12(1) the previous inspection: previous timescale 30.1.06 The registered manager must ensure that the lift is repaired The registered manager must be able to access all health and safety certificates 01/02/06 01/03/06 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 OP19 OP27 Good Practice Recommendations The home may wish to provide a formal staff room for staff to take their designated breaks other than the main office. Remains outstanding The home may wish to alter the way staff are allocated to shifts to ensure staff can be recruited at the home. This would be in negotiation with the inspector. Remains outstanding Wirral Christian Centre DS0000018956.V280385.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Wirral Christian Centre DS0000018956.V280385.R01.S.doc Version 5.1 Page 21 - 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. 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