Inspection on 13/07/05 for York Street (32)

This inspection was carried out on 13th July 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

York Street (32) 09/11/07

York Street (32) 17/10/06

York Street (32) 23/01/06

York Street (32) 07/12/04

York Street (32) 06/05/04

York Street (32) 05/02/04

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 32 York Street Bromborough Pool Wirral Merseyside CH62 4TY Lead Inspector Beate Roth Unannounced 13 July 2005 09:30 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. 32 York Street v238576 f52_f02_s19016_yorkst_v238576_130705_stage_4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 32 York Street Address 32 York Street Bromborough Pool Wirral Merseyside CH62 4TY 0151 643 9196 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) Wirral Autistic Society Mrs Helen Rudd CRH PC 2 Category(ies) of LD - 2 registration, with number of places 32 York Street v238576 f52_f02_s19016_yorkst_v238576_130705_stage_4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 7th and 9th December 2004 Brief Description of the Service: 32 York Street is registered to provide personal care for two adults with a learning disability. The home is a two storey terraced property located in a residential area. On the ground floor there is a lounge, dining room and a kitchen. On the first floor there are two single bedrooms, an office/staff sleep in room and a bathroom. There is a patio and a garden to the rear of the home. Parking is available on the main road. York Street is close to local shops and to public transport services. The home is run by Wirral Autistic Society who have several care homes for adults with a learning disability in the area. Wirral Autistic Society provides a range of services and facilities, which are fully utilised by the service users, accommodated at 32 York Street. 32 York Street v238576 f52_f02_s19016_yorkst_v238576_130705_stage_4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over two and a half hours. During the inspection time was spent in the office examining records and policies and procedures and talking to the manager. A tour of the home was undertaken. A member of staff was observed delivering care to a service user. A service user and a member of staff were spoken with. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 32 York Street v238576 f52_f02_s19016_yorkst_v238576_130705_stage_4.doc Version 1.30 Page 6 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 32 York Street v238576 f52_f02_s19016_yorkst_v238576_130705_stage_4.doc Version 1.30 Page 7 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) 2 and 5 A full assessment would take place to ensure that a service user’s needs could be met and a contract would be provided. EVIDENCE: There have been no new service users admitted to the home since the last inspection. New service users would be assessed by the manager for the home and by a representative from day services. The manager would visit a prospective service user where they are living. Information would be gathered from the service users’ carers, social worker and any other relevant agencies. An examination of an initial assessment pro forma at a previous inspection indicated that all the information recommended in this standard is available. An assessment would be made if a service user moved to the home from another home within the Society. This information would be recorded. The contracts/terms and conditions between the home and the service user were available for inspection. These contain the required information. However, the current fee charged was not entered on the contract. A record of this information was available. 32 York Street v238576 f52_f02_s19016_yorkst_v238576_130705_stage_4.doc Version 1.30 Page 8 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 and 7 Care planning reflects the assessed and changing needs of service users and service users’ need for independence is balanced with any risks to their wellbeing. EVIDENCE: There is currently one service user living at the home. The service user plan was examined and contained detailed and clear information to enable staff to provide appropriate support around day-to-day living and personal goals. These plans are formulated at a service users review and cover the information required by the National Minimum Standards. A review had taken place within the last 6 months. The documentation available from reviews indicated that the service user, their relatives, social worker and other relevant individuals are invited to contribute to reviews. There was evidence that the needs of service users are re-assessed to ensure the home is appropriate for their needs. The service user interviewed was aware of their care plan and they commented positively on the support they receive from staff. An examination of the service user plan indicated that service users’ rights to live as independently as possible, in accordance with their abilities, is promoted by the home. Risk assessments are available which indicate why service users’ rights need to be limited in order to safeguard their well being. 32 York Street v238576 f52_f02_s19016_yorkst_v238576_130705_stage_4.doc Version 1.30 Page 9 Reactive plans which detail behaviour management strategies are also available. Staff are trained in behaviour management strategies such as supportive holds and breakaway techniques as part of their induction. The manager reported that this training is not accredited. Any training that provides guidance on physical intervention must be accredited. A re-assessment of the physical intervention technique that is sometimes used with the service user identified with the manager needs to be undertaken. It appears that this intervention is more suited to two members of staff being available, rather than one. Only one member of staff is on duty at any one time. A further member of staff can be called on from another home run by the Wirral Autistic Society that is close by, however to rely on this assistance does not appear appropriate. 32 York Street v238576 f52_f02_s19016_yorkst_v238576_130705_stage_4.doc Version 1.30 Page 10 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) 11, 12 and 13 Service users are able to take part in appropriate activities that provide opportunities for their educational, social and personal development. Links with the local community are good. EVIDENCE: Service users attend day services five days a week where they are provided with a range of opportunities to promote their personal development. Service users have a timetable of activities, which has been drawn up to meet their needs, skills and individual preferences. Some of the opportunities available are horticulture, craftwork, community work experience, drama and physical education. Activities are provided by either Wirral Autistic Society’s day services or by outside organisations such as local colleges. Service users are provided with work experience opportunities in accordance with their abilities. There are opportunities for service users to become involved in the local community. For example, the service users visit local shops, go to the gym, cinema, bowling and participate in community life through attendance at college courses. The home has access to private transport and there is easy access to train and bus services. 32 York Street v238576 f52_f02_s19016_yorkst_v238576_130705_stage_4.doc Version 1.30 Page 11 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) 19 and 20 The physical and emotional health needs of service users are met. Service users are in the main protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Visits to service users from medical/health care professionals take place in private. Records of reviews indicate that service users have access to medical/health care professionals as needed. Service users are supported to attend health care appointments. Service users are supported and facilitated to take control of and manage their own healthcare in accordance with their abilities. Medication is stored securely. The manager reported that both permanent and bank staff are trained in the administration of medication during the induction period. This was confirmed by a member of staff interviewed. A selection of medication administration record sheets and corresponding medication were inspected. Clearer information on the dosage not to be exceeded for one type of medication needs to be entered on to the medication container in accordance with guidelines from the GP and pharmacist. The manager reported that this information was available but has not been included on the current medication supplied by the pharmacist. 32 York Street v238576 f52_f02_s19016_yorkst_v238576_130705_stage_4.doc Version 1.30 Page 12 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) 23 The practices at the home provide protection for service users. EVIDENCE: A copy of Wirral Borough Council’s adult protection procedure was available at the home. A shorter and more accessible version of the adult protection procedure has been made available by Wirral Borough Council and was at the home for staff to refer to. Staff have received training in the adult protection procedures. From discussion with the manager and from an examination of the financial records, the home’s policies and practices with regards to service users’ money and financial affairs safeguard service users. 32 York Street v238576 f52_f02_s19016_yorkst_v238576_130705_stage_4.doc Version 1.30 Page 13 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, 25 and 26 The home provides a comfortable and pleasant environment for service users. EVIDENCE: The premises provide a comfortable environment for service users and are in general well maintained. Decorative work has taken place to improve the appearance of the home since the last inspection. Radiator covers have also been fitted. Furniture and fittings are of a satisfactory quality. The settee in the living room is showing signs of wear and there is some discoloured wood around the window in the bathroom. The manager is in the process of attending to this. The bedroom space requirements detailed in the National Minimum Standards are met. The bedroom seen was satisfactorily decorated and personalised in accordance with the service user’s taste. 32 York Street v238576 f52_f02_s19016_yorkst_v238576_130705_stage_4.doc Version 1.30 Page 14 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) 32, 33 and 34 Service users are supported and protected by the number of staff available, the training they have received and the manner in which they are recruited. However, service users would benefit further if 50 of staff had completed formal training. EVIDENCE: An examination of the rota indicates that the home is providing sufficient staffing levels. There is one member of staff on duty at all times. There is a network of support provided by Wirral Autistic Society for lone workers. Lone worker risk assessments are available. There are currently two permanent staff working at the home with absences being covered by bank staff. Bank staff have been recruited to work for Wirral Autistic Society to cover absences in the homes if needed or to provide support within the day care service. The manager reported that the same bank staff are employed at York Street in order to promote continuity of care. The manager reported some staffing difficulties that are currently being addressed by the reorganisation of the service provided. A comprehensive induction and foundation training programme is provided to permanent staff. This training is also provided to bank staff so as to ensure that they are appropriately trained should they need to be deployed. The manager is taking steps to ensure that 50 of staff hold an NVQ Level 2 by 32 York Street v238576 f52_f02_s19016_yorkst_v238576_130705_stage_4.doc Version 1.30 Page 15 2005. At present no staff member holds this qualification. The manager has responsibility for a further 2 care homes run by Wirral Autistic Society. The service user spoken with at the time of the inspection considered that they are happy with the support they receive from staff and the manager. The records of staff recruitment were examined and found to be well managed and contained all the required information. 32 York Street v238576 f52_f02_s19016_yorkst_v238576_130705_stage_4.doc Version 1.30 Page 16 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 and 42 The quality assurance systems promote the wellbeing of service users. The safety of service users is in the main well promoted. EVIDENCE: There are a range of quality assurance systems in place. Wirral Autistic Society is accredited by the National Autistic Society which carries out an inspection of services provided. Wirral Autistic Society conducts an internal audit of the society as a whole on an annual basis. The views of service users are obtained by key workers and the manager. The day service also provides a forum for service users to give their views on the services provided there. The views of GP’s are obtained regarding the provision of health care at the Wirral Autistic Society’s homes. Visits to the home by the representative of the registered provider have been made since April 2005. A sample of safety check records and certificates were examined. In general these were appropriately maintained. The records of the weekly checks of the smoke detectors and fire blanket indicated that these checks had not been 32 York Street v238576 f52_f02_s19016_yorkst_v238576_130705_stage_4.doc Version 1.30 Page 17 carried out consistently. Staff receive training in all health and safety matters. 32 York Street v238576 f52_f02_s19016_yorkst_v238576_130705_stage_4.doc Version 1.30 Page 18 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 3 x x 2 Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 2 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x x x x Standard No 11 12 13 14 15 16 17 3 3 3 x x x x Standard No 31 32 33 34 35 36 Score x 2 3 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 32 York Street Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 2 x v238576 f52_f02_s19016_yorkst_v238576_130705_stage_4.doc Version 1.30 Page 19 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. 2. Standard 7 7 Regulation 12, 18 13 Requirement Training provided to staff around any physical interventions must be accredited. A re-assessment of the physical intervention technique used with the service user identified with the manager must take place, to ensure that the wellbeing of the service user is promoted at all times. Clearer information on the dosage not to be exceeded for one type of medication identified with the manager must be entered on to the medication container in accordance with guidelines from the GP and pharmacist. The weekly checks of the fire blanket and smoke detectors are to be undertaken and recorded in accordance with the fire risk assessment. Timescale for action 12/01/06 19/07/05 3. 20 13 19/07/05 4. 42 23 12/07/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. 32 York Street v238576 f52_f02_s19016_yorkst_v238576_130705_stage_4.doc Version 1.30 Page 20 No. 1. 2. Refer to Standard 5 32 Good Practice Recommendations The fee payable is to be included in the service user contracts/terms and conditions. A minimum of 50 of staff are to have an NVQ level 2. 32 York Street v238576 f52_f02_s19016_yorkst_v238576_130705_stage_4.doc Version 1.30 Page 21 Commission for Social Care Inspection Liverpool Area Office 3rd Floor 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. 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