Inspection on 17/10/06 for York Street (32)

This inspection was carried out on 17th October 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 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) 23/01/06

York Street (32) 13/07/05

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 York Street (32) 32 York Street Bromborough Pool Wirral CH62 4TY Lead Inspector Les Hill Key Unannounced Inspection 17th October 2006 13:30 York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 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 Street (32) DS0000019016.V306937.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 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 Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service York Street (32) Address 32 York Street Bromborough Pool Wirral CH62 4TY 0151 643 9196 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) Wirral Autistic Society Mrs Helen Louise Rudd Care Home 2 Category(ies) of Learning disability (2) registration, with number of places York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd January 2006 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 road at the front and side of the home. 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. Fees are negotiated at the time of placement and are dependent upon a number of factors including the amount of staff cover required. York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of 32 York Street was undertaken on Tuesday 17th October2006 over a period of 2 hours. It involved the examination of some records, meeting with two staff and one resident and a tour of the building. The manager had completed a pre-inspection questionnaire that gave essential information about the day-to-day running of the home. The inspection was carried out as part of the Commission’s responsibility to visit and report on all registered care homes. What the service does well: What has improved since the last inspection? Risk assessments around one of the residents have been updated. Medication records are complete. Repairs have been carried out to the window and to a radiator cover. Lone worker risk assessments have been updated. Regular fire awareness training is in place. York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 6 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. York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence and discussions with staff during a site visit to the home. The home’s statement of purpose/service user guide is almost complete and should ensure residents have the information they need to make a choice about the home. Well-prepared assessments are in place that contain the aspirations of residents and give a strong base for the development of care plans. EVIDENCE: The home’s statement of purpose is well presented and contains most of the information required in Schedule 1 of the National Minimum Standards, Care Homes for Adults. The member of staff on duty told the inspector that the manager was aware that she needed to include up to date information about staff. The document contains information for residents on the terms and conditions of their stay in the home and in this respect doubles as the service user guide. The home does have a single, folded leaflet that is identified as the service user guide and this contains some simply presented information about moving into the home. Both documents should be amended to recognise the change in regulator from NCSC to the Commission for Social Care Inspection. Full and detailed assessments are in place that provide a strong base for staff to build their arrangements for care and support. The home’s manager will arrange to carry out assessments on any person referred for placement to York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 9 ensure that the home is able to provide the levels of care required. No new placements have been made at York Street since the CSCI inspection in January 2006. However, Wirral Autistic Society expect that a programme of introductions will be made before someone moves in to live at the home, to ensure that the person is comfortable with the environment and with the existing resident group. A written contract was in place on each of the two resident’s care files seen and this is updated with an annual fee amendment notice. York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 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, 8, 9 and 10 Quality in this outcome area is excellent. This judgement has been made using available evidence and discussions with staff during a site visit to the home. Care plans are clear and contain the views of residents. Guidance for staff is presented well and includes appropriate responses to inappropriate behaviours. Residents are consulted about the arrangements for their care and support and this is evidenced in records. Full and detailed risk assessments are in place. EVIDENCE: Care plans are constructed from an assessment document that breaks down individual skills into a number of stages. Once the stages have been achieved the resident is considered to be competent in that skill. Care plans also identify social, psychological and health needs. Care plans are detailed and contain clear guidance for staff on how individual residents should be supported. One of the residents had requested greater levels of independence and this was reflected in the care plans that had been created. Individual risk assessments are in place and are again quite detailed. Evidence contained on the files shows that annual reviews of care plans and York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 11 risk assessments are carried out. Residents and their relatives (where appropriate) are invited to contribute to, and to attend, the reviews. Care plans that detail specific behaviour management strategies are in place on both the residents own care file and in records directly accessible by staff. From the examination of care plans and from other records in the home it is evident that residents are consulted about their everyday lives and are supported to take identified risks. The needs of the two residents in the home are very different and a staff team has been created around each of them to ensure they can be supported to follow their individual interests and to receive support at the levels specified in their plan of care. Weekly activity sheets are in place to give some structure to daily routines and guidance for staff. Residents are encouraged to assist staff in tidying their rooms, preparing meals and in sharing responsibility for the general upkeep of the home. Staff are expected to maintain the confidentiality of information about residents at the home and residents know that information about them will not be shared with anyone who doesn’t have the right to know. York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 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): 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence and discussions with staff during a site visit to the home. Activity in, and out of, the home is organised around the expressed wishes and preferences of individual residents. Appropriate occupation is identified and resourced. Residents are recognised as people with individual needs and their lifestyle is supported and protected in line with agreed principles and their assessed ability. EVIDENCE: Care plans and care and support practices in the home recognise the individuality of residents and staffing arrangements ensure that their individual preferences can be supported. Staff on duty were fully aware of the likes and dislikes and of the needs and behaviours of both residents and the ways in which they should respond. There was clear evidence to show that staff have worked with one resident to ensure requests for greater independence are managed appropriately and that direct supervision is only provided when there are identified risks to safety. York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 13 One of the residents attends Wirral Autistic Society’s day care services on four days each week and also attends a one-day per week college course. The other resident attends day services on three days each week and has a supported work placement on one day each week. Day care opportunities are provided in horticulture, craftwork, drama, games and sport and supported work placements. Local colleges offer appropriate training and provide a range of courses that are designed for people with learning difficulties. Residents are supported to take part in ordinary leisure activities according to their individual preferences. There was evidence of visits to the cinema, to social clubs, to local pubs and restaurants and to places of interest in the area. One of the residents has a “Motability” car that is used to take them to places of interest and on home visits. Staff are clear about when and how the car is to be used and the resident is encouraged to help staff to keep it clean. Appropriate contact with family is identified in the care plans and is monitored by staff. It is also recorded that staff support one parent when the resident is visiting through telephone availability and a willingness to bring them back. Staff are aware that residents have rights. Residents are fully involved in the development of their own care plans and staff spend time explaining and reminding them of the reasons why support is provided in particular ways. Residents are involved in choosing the home’s menus. They will also assist staff when they go shopping for food. A record is kept of the meals prepared and staff said the residents are prepared to try new foods. The home’s manager reported in the questionnaire, that she would like to assess the nutritional value of the foods served in the home and as Wirral Autistic Society has its own food adviser, she will use their services in the future. York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence and discussions with staff during a site visit to the home. Residents care plans include the support required for their physical, emotional and health needs. Personal care is provided with dignity. Medicines are managed appropriately. EVIDENCE: Only one of the residents needs regular assistance with personal care and the care plan identifies the ways in which this should be provided. During the course of the inspection staff were observed to be sensitive to the residents changing moods and to provide both occupation and personal care in a calm and sensitive manner. Residents know which members of the staff team are working with them and they receive both consistency and continuity in support. One member of staff is shortly to leave the home and one of the residents has become quite upset. Staff were observed to be explaining the time factor and giving assurances about future care and support. Health passports were located on each of the resident’s care plans together with full and detailed information about past and current medical needs. York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 15 Records are made of appointments with GP’s Consultants. CPN’s, Dentists and other health care professionals and of any treatments required. A procedure for managing medication is in place and staff are trained in the administration of medicines. Medicines are stored securely and an examination of the records confirmed that they are being managed appropriately. The cream that is prescribed for one service user and to be used only when necessary is now included on the MAR sheet and times when it is used are being recorded. York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence and discussions with staff during a site visit to the home. Policies and procedures, supported by training encourage the resolution of concerns and complaints, and protect residents from abuse EVIDENCE: The home has a complaints policy and procedure that is explained to residents and is available to them in a variety of formats. However staff say that they respond to any concern raised and deal with it immediately so that it doesn’t become a source for complaint. A simplified version of the complaints procedure has also been sent to the families of residents. No formal complaints have been received at the home or by CSCI in the past twelve months. Policies and procedures on adult protection are in place and staff have been provided with appropriate, internal training. The manager reports that she would like all staff to attend adult protection training provided by the local authority, to support their own arrangements. No adult protection incidents or concerns have been reported on behalf of residents at the home. One of the residents can manage their own personal allowances with advice and guidance from staff. However, staff manage the personal money of the other resident and maintain detailed records of income and expenditure. York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30 Quality in this outcome area is good. This judgement as been made using available evidence and discussions with staff during a site visit to the home. Standards of accommodation are generally good although some remedial work to the kitchen would improve the standard of the units and create better working space. EVIDENCE: The home provides a comfortable environment for residents and is generally well maintained. Furnishings and fittings are domestic in style and are appropriate for the size and layout of the home. Some minor repairs, identified in the CSCI report of January 2006 have been attended to. The kitchen in the home is quite small. Kitchen units are old and some are broken. Worktop space is limited. The homes washing machine is in the kitchen and an electric clothes dryer is located in a brick outbuilding. The kitchen units should be replaced and this would provide the opportunity to use the small space in the best possible way. Outside garden areas are well laid out to provide pleasant recreational space and are well maintained. York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 18 Resident’s bedrooms are of a good size and fitted with appropriate furniture. Residents have personalised their own rooms and are encouraged to keep them clean and tidy through programmes of activity. The home’s bathroom affords appropriate privacy but its location can also ensure that supervised bathing is carried out to maintain the dignity of the individual resident. The lounge and dining area was originally one space but stud walls with an archway were created some time ago to enable them to be used separately when required. Neither of the residents currently living at the home requires specialist equipment to support their day-to-day needs. At the time of this inspection the home was clean and well cared for, though the manager says she is to introduce a new cleaning rota and work out a system for keeping the carpets cleaner. York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 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): 31, 32, 33, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence and discussions with staff during a site visit to the home. Staffing levels are appropriate for the needs of residents. Residents are supported by, and benefit from, well-trained and well-supported staff. EVIDENCE: Good staffing levels are provided. Each of the residents has a member of staff allocated to work with them at all times when they are at home, on holidays or on trips into the community. Staff work in two teams to maintain continuity of support for each of the residents in the home. Staff usually work until 11:00 or 12:00pm and one will “sleep in”. Lone worker policies are in place and staff have direct access to senior managers at all times. Bank staff are used to cover absences through sickness and holidays. Staff told the inspector that they have job descriptions and contracts of employment and are supported with regular one-to-one supervision. The manager carries out an annual appraisal and quarterly supervision. Five of the current six staff employed to work at 32 York Street have an award at NVQ level 2 or above. All new staff have a 2-day induction and a 3/-4 month programme of approved induction and foundation training through the LDAF system. Staff told the inspector that they are provided with regular training in York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 20 every area of need and were complimentary about the organisation’s commitment to training its staff. They were also complimentary about the system for one-to-one supervision and said they found it to be very helpful. As the home’s manager was not available for the inspection the records of recruitment and selection were not seen. They will be examined during the next CSCI inspection. York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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): 37, 38, 39, 40, 41, 42 and 43. Quality in this outcome area is good. This judgement has been made using available evidence and discussions with staff during a site visit to the home. Residents benefit from the ethos, leadership and management of the home that is supported by strong polices and procedures and good standards of record keeping. EVIDENCE: The manager of the home has a number of years experience in this role and has NVQ level 4 in the management of care and the Registered Managers Award. She regularly updates her training through attendance on courses and through routine supervision and consultation. Staff were complimentary about the manager and the support they receive. The inspector was impressed with the ethos and management of the home and the ways in which care practices are set around the needs of the residents. It was clear that staff know what is expected of them and that within the York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 22 boundaries set by care planning can make decisions about their day-to-day involvements with residents. When not on annual leave, the manager is in the house most days talking with residents and staff to ensure she is up to date on all matters affecting the dayto-day operation of the home and the needs of the two residents. Regular staff and resident meetings are held and minutes are kept. The manager routinely asks residents and their relatives for feedback and comments about the running of the home. Wirral Autistic Society has an annual accreditation from the National Autistic Society to confirm the positive nature of its work. Policies and procedures are in place for all appropriate matters and are kept under constant review by Wirral Autistic Society. Staff are encouraged to familiarise themselves with all of the regulations and procedures that govern the provision of residential care for vulnerable adults. Records seen during the inspection were well kept and written in an appropriate style. Staff told the inspector that they have received training in report writing. Records are kept securely in the home’s “sleep in”/office. Wirral Autistic Society has its own health and safety advisers as well as its own maintenance engineers. Staff are aware of the need for vigilance around the safety of residents and full risk assessments about the home are in place. The homes smoke alarms are routinely tested. York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 4 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 3 3 3 3 York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA24 Good Practice Recommendations The registered person should consider the replacement of the home’s kitchen and create a more workable space. York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 25 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 York Street (32) DS0000019016.V306937.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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