Inspection on 21/06/06 for Wirral Christian Centre

This inspection was carried out on 21st June 2006.

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

Other inspections for this house

Wirral Christian Centre 13/01/06

Wirral Christian Centre 28/10/05

Wirral Christian Centre 14/03/05

Wirral Christian Centre 15/09/04

Wirral Christian Centre 18/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Wirral Christian Centre Woodchurch Road Birkenhead Wirral CH41 2UE Lead Inspector Natalie Charnley Unannounced Inspection 21st June 2006 09:30 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.V295490.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 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.V295490.R01.S.doc Version 5.2 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 Carol Frances Eichenauer Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Wirral Christian Centre DS0000018956.V295490.R01.S.doc Version 5.2 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 13/01/06 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. It costs £365.73 per week to live at the home Wirral Christian Centre DS0000018956.V295490.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over a period of one day. The inspector arrived at the home at 09:30 and left at 16:00. The inspector spoke with 6 staff and 4 residents and 2 visitors. The majority of residents were at ‘Wednesday Club’ during the inspection and were not available to comment. Comment cards were left at the home for residents, staff and visitors to complete. The person in charge was also given an ‘inspection feedback’ card to complete regarding the inspection process. The inspector completed the inspection by looking at the homes records, a tour of the building, formal and informal interviews and information from previous inspection reports. The inspector followed an inspection plan written before the start of the inspection using all information held on file at Commission for Social Care Inspection regarding the home, to ensure that all areas that needed covering were done so. Feedback was given to the person in charge during and at the end of the inspection. This report is based on pre inspection information provided by the home as well a site visit. The home has shown excellent improvements since the last inspection. Many new areas of development have been addressed and several examples of good practice have been identified. The manager continues lead by example and move the home in a positive direction. What the service does well: What has improved since the last inspection? Wirral Christian Centre DS0000018956.V295490.R01.S.doc Version 5.2 Page 6 Policies and procedures have been reviewed and developed. The manager is to discuss one policy per week with staff as part of their ongoing training. Two new chair lifts have been purchased. Substantial maintenance and decoration work has been carried out around the home to a good standard. Medication practices continue to develop; some small changes still need to be made to ensure the medications are given correctly. 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. Wirral Christian Centre DS0000018956.V295490.R01.S.doc Version 5.2 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.V295490.R01.S.doc Version 5.2 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): 3 Quality outcome in this area is good. This judgement has been made using available evidence including a visit to the service. Information gathered by the home before resident moves in, ensures that they can care for residents appropriately. EVIDENCE: The most recent resident moved to the home in May 2006. The home was able to produce evidence that the resident had been on an introductory visit on 19th May and that a full assessment had been carried out at the local hospital. The home had taken details of physical and mental health and how the resident would need to be supported on a daily basis. These were well recorded. The home are still awaiting social service assessments to be completed on a number of residents, however, evidence that these referrals had been made was available. Wirral Christian Centre DS0000018956.V295490.R01.S.doc Version 5.2 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): 7,8,9 and 10 Quality outcome in this area is good. This judgement has been made using available evidence including a visit to the service. 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 feel they have their dignity and privacy maintained at all times EVIDENCE: All residents living at the home have individual care plans that staff follow. Four plans were sampled as part of the case tacking methodology, which means that the residents care and experiences of living at the home was closely looked at. Plans were generally well written, but some could benefit from a little more detail, however, all had clear actions that staff needed to take to care for residents. Plans were reviewed monthly and showed that resident can access a range of health professionals. Wirral Christian Centre DS0000018956.V295490.R01.S.doc Version 5.2 Page 10 One resident had been referred by the home to a diabetic foot clinic for monitoring and another had received input from a speech and language therapist. One residents notes showed that over the last few weeks, he was not eating very much. The home have addressed this by commencing daily food charts as part of a nutritional assessment, this is an example of good practice. The home has worked hard at producing a good care file for each resident. Each file has a selection of risk assessments and a dependency profile to monitor any deterioration in health. Staff has worked hard to produce good social histories with the residents help, detailing there past achievements, likes and dislikes. Medication administration records (MAR charts) and medication storage areas were checked. MAR charts showed continuing improvements, however, some handwritten entries were very untidy, leaving instructions very hard to read, which could leave residents at risk. One resident who self-administers their own medication did have a risk assessment in place however this was from 2003. This document needs to be kept under review by staff. The manager explained that staff had received medication training from the local pharmacy in February and are currently looking at using accredited training for staff. Residents spoken to during the inspection stated that they are treated with dignity and respect. Staff were observed talking to residents in a clear and kind manner and knocking on bedroom doors before entering. One resident commented “ staff look after me well here, they are always well mannered”. Wirral Christian Centre DS0000018956.V295490.R01.S.doc Version 5.2 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): 12, 13, 14 and 15 Quality outcomes in this area are excellent. This judgement has been made using available evidence including a visit to the service. Residents are stimulated with a variety of daily activities. Residents are encouraged to make personal choices and meals provided are wholesome and nutritious. EVIDENCE: Evidence of activities are located everywhere around the home. Photographs show trips out and parties, involving staff residents and family members. The home have introduced an exercise class, knitting circle and are currently celebrating and joining in a ‘world cup theme’, having decorated various areas of the home to allow residents to watch matches. The inspector was shown excellent examples of some of the recent art and craft and flower arranging work that had been produced. The home follows a weekly activity plan, which is arranged by the designated activity co-ordinator. Residents spoke about joining in cooking classes, entertainers and trips out to local shops, stating things such as “ we do a lot here to keep busy” and “I join in everything if I feel like it”. Residents are able to join in new games such as ‘deal or no deal’, reminiscence bingo and quizzes. Residents are able to join in with ‘Wednesday club’ and attend a life group or prayer meeting if they wish. Wirral Christian Centre DS0000018956.V295490.R01.S.doc Version 5.2 Page 12 A number of residents attend churches outside of the home, and despite the home having a Christian ethos; there is no religious bias towards residents. Residents and comment cards confirmed that visitors are welcome at the home at any time and can see relatives in communal or private areas of the home. Staff were observed asking residents about meal and drink choices during the morning and afternoon. Residents were seen being encouraged to manage small amounts of money independently and confirmed that they are supported by staff in doing this. The home operates a 4-week menu that rotates around. Menus samples looked at and residents comments confirmed that there is always a choice of meal and that food is “tasty and fresh”. The home is able to offer a vegetarian alternative menu and currently cater for 6 diabetic residents, who may need slight variations of meals. Residents also confirmed that they could have meals either in their bedrooms or in the pleasantly decorated dining area on the ground floor. Wirral Christian Centre DS0000018956.V295490.R01.S.doc Version 5.2 Page 13 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): 16 and 18 Quality outcomes in this area are good. This judgement has been made using available evidence including a visit to the service. The home has a complaints procedure, which is easy for residents or families to use. Staff have a good knowledge of adult protection procedures, which protects residents from abuse. EVIDENCE: The home has an up to date complaint procedure in place, details of which are displayed around the home for residents to read. ne resident was asked if he knew how to make a complaint and told the inspector “ it’s on the notice board, if the home cant help me, then that’s when I ring you”. Policies are also in place to protect staff including a policy on equal opportunities, bullying and harassment, whistle blowing and sexual harassment. The home has recently sent 2 members of staff on a formal abuse awareness day. Staff stated that they found this “very useful” and “ informative”. Other staff at the home had watched a training video and been instructed by the manager regarding the contents of the local authority policy. Wirral Christian Centre DS0000018956.V295490.R01.S.doc Version 5.2 Page 14 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): 19 and 26 Quality outcomes in this area are good. This judgement has been made using available evidence including a visit to the service. The home is suitable for the residents who live there, creating a homely environment. All areas are clean and tidy. EVIDENCE: A full tour of the home was carried out. A representative of the home explained that the home have plans to expand in the future and detailed the large amounts of refurbishments that have been carried out at the home since the last inspection, these were evidenced whilst walking around the home. All areas of the home were well lit, clean, tidy and homely. Residents have a variety of communal areas, including an area in which they can smoke. Residents pictures are displayed around the home and it is planned that a formal display will be made of the art and crafts produced by residents. Two new chair lifts have been installed, one on the staircase on the top floor and one to create easier access to the gardens. Residents stated that they Wirral Christian Centre DS0000018956.V295490.R01.S.doc Version 5.2 Page 15 were happy with their accommodation stating, “my room always gets kept clean” and “the home is nice, I enjoy being in my bedroom, but everywhere is nice here”. The laundry area was tidy and well organised. Staff have access to a policy on infection control and have good knowledge in this area, which ensures the residents are kept safe. The home is currently working towards an agreed timescale with the Commission for Social Care Inspection to change the layout of some areas of the home that interact with the nursery school. The work in this area is progressing well and was discussed with the registered manager. Wirral Christian Centre DS0000018956.V295490.R01.S.doc Version 5.2 Page 16 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): 27,28, 29 and 30 Quality outcomes in this area are good. This judgement has been made using available evidence including a visit to the service. Staff are competent to provide care to residents and have been trained on a variety of subjects. Staffing levels are sufficient to operate a safe home. EVIDENCE: The home employ three care staff on the morning shift and three care staff on the afternoon shift. Another staff member works on a ‘middle’ shift between 10am and 4pm. Since the last inspection, the home has changed the way the night shift is staffed and have now introduced an ‘on call rota’, which the manager feels in working well. Night staff are continually consulted as to how they are managing by the manager. A group of supporting staff are also employed at the home including two cooks, one kitchen assistant, four cleaners, one handyman and a laundry assistant. Residents spoke highly of the staff at the home stating they were “friendly” and “always there for us”. A selection of staff files were sampled and showed that all appropriate character checks were being carried out. Staff were also receiving job descriptions and terms and conditions of employment when they stared work. Staff were spoken to throughout the day and during the changeover of shifts. All stated that they were happy in their work and had received training both inside and out of the home. Training records showed that all mandatory training had either been completed or was organised in the near future. Wirral Christian Centre DS0000018956.V295490.R01.S.doc Version 5.2 Page 17 Staff are now completing evaluation forms following all training in order for the manager to see if it has been useful or not. This is an example of good practice. Out of a total of 15 care staff, 8 hold a specialist NVQ in care. This meets the required target of 50 . Other staff have also started these courses, which will increase the homes percentage. Wirral Christian Centre DS0000018956.V295490.R01.S.doc Version 5.2 Page 18 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): 31,33,35 and 38 Quality outcomes in this area are good. This judgement has been made using available evidence including a visit to the service. Management of the home is clear and effective, quality monitoring is developing well. Financial arrangements safeguard residents. 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. Wirral Christian Centre DS0000018956.V295490.R01.S.doc Version 5.2 Page 19 The manager has a place to start the ‘Registered Managers Award’, which is a specialist qualification in September this year. Staff commented that the manager was supportive and always listened. The home is looking into starting the Investors in People award, which is a quality assurance scheme. Early work is now being undertaken and is developing well, showing some good practice examples. Questionnaires are sent to residents on a regular basis to ask for their opinions on key areas at the home, recent surveys completed looked at activities and catering. The home is developing these for other areas and discussion took place with the inspector. It is recommended that the home formulate a ‘quality policy’, which will help them follow a clear route for quality assurance and try and develop a residents forum to obtain further views about the home. Financial records were sampled, which were well recorded. Records showed all monies that are held on a residents behalf and all monies given to individual residents. Large amounts of money are returned to families or put in residents bank accounts in order to ensure money is kept safely. Accidents are well recorded by the home and are monitored by the manager for signs that patterns in accidents are occurring. All necessary certificates are in place to show that the home is safe. The manager has yet to complete the on line fire risk assessment since the last inspection, which must be completed. Fire alarm and emergency lighting checks are carried out on a regular basis and are recorded by the maintenance man. Staff also have access to regular fire drills, the last of which was in April 2006. The manager now discusses and records a resident fire check on a monthly basis. This is to ensure that each resident is aware of where their nearest fire exit is located and what to do in the event of an emergency. Wirral Christian Centre DS0000018956.V295490.R01.S.doc Version 5.2 Page 20 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Wirral Christian Centre DS0000018956.V295490.R01.S.doc Version 5.2 Page 21 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 The registered manager must ensure that all handwritten entries are clear and legible. The registered manager must ensure that an fire risk assessment is carried out on the home Timescale for action 01/09/06 2 3 OP9 OP38 13(2) 23(4) 01/07/06 01/08/06 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 Refer to Standard OP33 Good Practice Recommendations It is recommended that the home formulate a ‘quality assurance policy’ and arrange for a residents forum to meet on a regular basis. Wirral Christian Centre DS0000018956.V295490.R01.S.doc Version 5.2 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 Wirral Christian Centre DS0000018956.V295490.R01.S.doc Version 5.2 Page 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!