CARE HOME ADULTS 18-65
York Road, 73 73 York Road Southport Merseyside PR8 2DU Lead Inspector
Mr Paul Kenyon Unannounced Inspection 12:00 31st October and 10 November 2005
th York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service York Road, 73 Address 73 York Road Southport Merseyside PR8 2DU 01704 567592 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) Speciality Care (Rest Homes) Limited Mr James Michael Delaney Care Home 5 Category(ies) of Learning disability (5) registration, with number of places York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users to include up to 5 LD Date of last inspection 31st March 2005 Brief Description of the Service: 73 York Road is a registered care home offering support for five younger adults with a Learning Disability. The home is managed and operated by a subsidiary of Craigmoor Care known as Speciality Care Limited. The home is designated as a ‘Home for Life’ and former students using the educational facility at Arden College in Southport live there The home is a semi-detached property within the Birkdale area of Southport. It is close to local shopping facilities and other amenities. The home has not been purpose built yet has been adapted to become registered by the previous Registration Authority. Jim Delaney who has worked there for a number of years manages the home. Facilities are spread over four levels. The basement contains the office; staff sleep- in facility and laundry. The ground floor includes two lounges, a dining room combined with a kitchen. On the remaining two floors are bathrooms with toilets as well as all service user bedrooms. The address does not cater at resent for those with additional physical disabilities and as a result contains no specialist adaptations or passenger lift. York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the first inspection to be held this inspection year (April 2005 to March 2006) and took place during the early afternoon. A second inspection was held on the 10th November 2005 to examine personnel and training records that are held in the main office of Arden College. In total the inspection lasted 3 and a half hours. The standards measured during this inspection related to key standards that are applicable to care homes providing support to younger adults. The inspection involved a tour of the premises and discussions with three residents. The inspection also included discussions with the parents of one resident who were visiting the home. The nature of the disability of residents is such that it is not always possible to elicit direct views about their experiences, however, discussions were held as well as general observations and compliance with standards in order for a conclusion about the service to be made. What the service does well:
The Service is good at providing individual terms of residency for resident in a format that is appropriate to their needs. Care plans are clear, reviewed on a regular basis and have been summarised to enable staff to access them more easily. All residents have signed their care plans. The service is good at striving to enable greater decision making for residents and this is apparent through the steps being made to enable greater financial independence for two residents. The service is prepared to consult with residents on issues that affect their lives through the use of regular staff/resident meetings. The service has enabled residents to either access local college facilities or to ensure that they have regular and meaningful access to the local community with staff support on a one to one basis. The service is good at explaining the complaints procedure to residents in an appropriate format and explaining their right to complain through resident meetings. The home uses the same forum to explain issues about allegations of abuse as well as providing staff with the policies and procedures to enable residents to be protected. The Manager provides supervision to staff and ensures that all records are secure and confidential. The service is good at ensuring the health and safety of residents and staff through checks to fire detection systems, the control of
York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 Page 6 substances hazardous to health, the checking of water temperatures, the testing of portable appliances and the use of general risk assessments. The Inspector spoke with three residents during the inspection as well as parents of another resident. Comments included: ‘I am fine’ ‘I am happy with staff sorting out any problems I have’ I go to college to work on computers and do drama and I get the chance to use the home’s computer’ ‘I am managing with my medication alright’ ‘When I open a bank account it will honestly be better’ ‘I feel safe here’ ‘We feel that our relation is safe and have no hesitation in saying that’ ‘The staff communicate with us and we know that our relation is very happy here and cannot wait to return’ ‘The keyworker is brilliant, staff are informal, have a good relationship with us and they are good at meeting health needs’ What has improved since the last inspection? What they could do better:
A requirement in this report relates to a carpet in a bedroom area. This is starting to become loose from a gripper rod and while it does not present a trip hazard at the moment, this will become on if no action is taken and as a result the securing of this carpet is raised as a requirement. The organisation needs to ensure that all information is available on personnel files. One file did not contain information confirming the eligibility for that member of staff to work. The organisation needs to ensure that training in health and safety matters is provided consistently to all staff.
York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 Page 7 Several good practice recommendations are raised all to do with the premises. These are outlined in the main body of this report under Standard 24. 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. York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 Page 8 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 York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 5 Each resident has a contract in relation to his or her residency within the home. EVIDENCE: Contracts of residency are available. These are in a standard pictorial format outlining details of what the service can offer. In addition to this, residents and representatives of the organisation have signed all. York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 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 the following standard(s): 6,7 and 8 Residents benefit from clear individual plans of care that are reviewed regularly. Residents are aware of the content of these plans. Residents are being supported to achieve greater independence in financial affairs and all are consulted on issues that affect their daily life in York Road. EVIDENCE: Five care plans were examined. It is understood that these are being presented into an individual format appropriate to the needs of residents. Each care plan highlights the needs that residents have and include reference to any risks present or issues with respect to behavioural needs. All care plans are reviewed at least every six months although there was evidence in some plans that reviews had been more frequent. Residents have signed all care plans. All care plans have now been made more accessible to the staff team with evidence that these have become working documents. When not in use these documents are secure but are available for staff to refer to. Detailed daily records, which outline the progress of each resident, reinforce care plans and these records are linked to specific goals within the plan of care. York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 Page 11 One resident confirmed that he was looking towards opening a bank account. Documentary evidence was examined to confirm this. The resident stated ‘it will honestly be better’. The service continues to hold joint staff and resident meetings. An agenda was on display confirming the next meeting for the 10th of November. This had been added to and included awareness on bullying. A resident confirmed that matters such as this were discussed at such meetings. Minutes of previous meetings were examined. Topics included activities planned, holidays and the complaints process. York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 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 the following standard(s): 12 and 13 Residents are supported to pursue education and to access the community. EVIDENCE: Since the last inspection, four residents now attend a local college on a part time basis. Three residents confirmed that ‘they liked it’ and stated that they worked with computers, did drama and cookery. One resident who worked on computers at college stated that he had access to the computer in the home. Another returned from college during the inspection and showed the Inspector the food that he had made. Some residents are supported by staff in college with another able to remain in college independently. One resident accesses the community on a daily basis and has one to one staff support. This is in line with his risk assessment and his needs. The individual follows a daily programme of community-based activities with consistent staff support for this. All residents have lived within the Southport area for a number of years and are past discussions with them have noted that they are very familiar with facilities in the local community. York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 Residents who are prescribed medication are protected by the home’s medication procedure. EVIDENCE: Only two residents are prescribed medication these are kept ion a secure medication cabinet that is locked at all times. A medication refrigerator is also available containing injection medication. One resident partially self medicates and use these injections on a daily basis. This individual has been using this injection medication for most of his life and is considered safe to do this. Medication records were examined and found to be completed appropriately with codes used for when medication is not given, for example, when the individual is on social leave. All medication is ordered by the home and a receipt and disposal book is maintained. York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Residents have access to a clear complaints procedure that it presented to them in an appropriate format. Residents are protected from abuse by the home’s policies and procedures. EVIDENCE: A complaints procedure is available containing all the relevant information needed for a complaint to be made. The complaints procedure is verbally reinforced to residents through regular meetings and the minutes of these meetings confirm this. One resident stated that he had had concerns but ‘staff deal with it and I am happy for them to do that’. The Inspector had the opportunity to speak with the parents of one resident. They confirmed that they did not have any complaints but would ‘know what to do if there was a complaint’. The Commission for Social Care Inspection has not received any complaints about the service. A file relating to the protection of vulnerable adults is available. This includes a summary of the organisations’ policy and the Local Authority procedure for dealing with abuse. No allegations of abuse have been raised. Information suggested that staff have received abuse awareness training. Again abuse awareness is reinforced to residents through residents meetings and this was confirmed through the minutes of the meeting as well as the inclusion of bullying as an agenda topic at the next meeting. A whistle blowing policy is available ad includes the Commission for Social Care Inspection as a point of reference for staff. One resident stated that they felt ‘safe’ in the home and the parents of another resident also stated that she was felt she was safe in the home as well as safe in accessing the local community. RECRUITMENT? York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 Page 15 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 Residents do not live in a completely safe environment. EVIDENCE: A tour of the building found that it was clean and hygienic. The house blends in with the local community with no indication externally that it is a residential care home. Since the last inspection the front driveway has been re-surfaced and is tidier in appearance. The home is generally in a good state of decoration although there is some minor wear and tear evident. One resident is to have his room decorated and confirmed that he had picked the colour scheme. The room has generously sized lounge areas as well as a dining area. The kitchen units are now looking worn and jaded in appearance and it is recommended that these be replaced. In general, the Manager does not have clear information about which parts of the home will receive refurbishment. As a result of this it is recommended at present that a written refurbishment plan is produced outlining planned action for the next twelve months. There are two bathroom areas, one on the top floor of the home and one on the first floor. The bath on the top floor is not easily accessible to one resident
York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 Page 16 who confirmed that he preferred a bath as opposed to using the shower. Given that another bath is available, it is recommended that the bath on the upper floor is adapted so that it is easier for individuals to access it. It was noted that a carpet had become detached from a gripper rod at the doorway of one bedroom. This does not present a trip hazard at present but will do if left. It is required that this is addressed. York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 Page 17 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 and 36. Residents benefit from a staff team who are fully supervised and supported. In the main recruitment processes protect residents but evidence needs to be produced to confirm the work status of one staff member. EVIDENCE: All supervision records were examined as part of this inspection. All are kept in a secure cupboard, which in turn is located in the main office, which is locked when not in use. These records confirmed that all staff had received recent supervision covering a consistent format. A total of three personnel files were examined. All contained evidence of Criminal Records checks, two references, medical declarations and information to confirm the member of staff’s identity. One file did not contain a member of staff’s work permit. It is required that a copy of this is made available for inspection. York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 The health and safety of staff and residents is not fully protected by the home’s health and safety systems. EVIDENCE: Fire records indicated that fire detection systems are checked on a regular basis. Checks on fire extinguishers have not occurred for over twelve months yet the Manager was able to provide evidence that he had contacted contractors to arrange this. The same applied to wiring checks to the electric system of the home. Staff have received fire awareness training. Accidents are recorded as well as incidents. Incidents have decreased and there have been no recorded accidents for some time. Hand washbasins are fitted with temperature control valves yet temperatures are still checked on a monthly basis. Information is available for staff on cleaning products and substances that are potentially hazardous to health. Radiators in the home minimise scalding and there are restrictors are fitted to windows on the first and second floors. York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 Page 19 Health and safety training is provided but not all staff have completed this. Not all staff have obtained a certificate in Food Hygiene, First Aid and Manual Handling. The completion of these courses is raised as a requirement in this report. York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 X X Standard No 24 25 26 27 28 29 30
STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 2 X 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
York Road, 73 Score X X 3 x Standard No 37 38 39 40 41 42 43 Score X X X X X 2 X DS0000005271.V261319.R01.S.doc Version 5.0 Page 21 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement The bedroom carpet identified during the inspection must be made secure around the doorway. Information confirming one member of staff’s status to work must be provided on file. Mandatory training must be consistently provided to staff. Timescale for action 31/10/05 1 YA24 23 2 3 YA34 YA42 19 18 30/11/05 31/12/05 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 YA24 YA24 YA24 Good Practice Recommendations The kitchen wall and base units should be replaced The bath on the second floor should be made more accessible to residents A refurbishment plan relating to the home for intended work over the next twelve months should be produced York Road, 73 DS0000005271.V261319.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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