Inspection on 23/01/06 for York Street (32)

This inspection was carried out on 23rd January 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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

York Street (32) 09/11/07

York Street (32) 17/10/06

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 Beate Roth Unannounced Inspection 23rd January 2006 17:00 York Street (32) DS0000019016.V278550.R01.S.doc Version 5.1 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.V278550.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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.V278550.R01.S.doc Version 5.1 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.V278550.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th July 2005 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. York Street (32) DS0000019016.V278550.R01.S.doc Version 5.1 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. A tour of the home was undertaken. Staff were observed delivering support to the service users. Service users and staff were spoken with. Following the inspection the manager was spoken with. What the service does well: What has improved since the last inspection? What they could do better: The risk assessments and the behaviour management plan for a service user identified at this inspection need to be reviewed in the light of the change of placement, change in the needs of the service user and the different staffing levels available. Improvements need to be made to the recording around administering medication. The lone worker risk assessments need to be reviewed in accordance with the needs of the new service users living at the home. Some minor repairs are needed to two of the windows at the home and to secure a radiator cover. Steps also need to be taken to ensure that fire safety training is provided to day staff on a 6 monthly basis and night staff on a 3 monthly basis. York Street (32) DS0000019016.V278550.R01.S.doc Version 5.1 Page 6 The content of the contracts/terms and conditions and the way they are drawn up could better support the interests of service users. 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.V278550.R01.S.doc Version 5.1 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.V278550.R01.S.doc Version 5.1 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): 2, 4 and 5 A full assessment would take place to ensure that a service user’s needs could be met. The contracts/terms and conditions could better support the interests of service users. EVIDENCE: The records of initial assessments for new service users admitted to the home, since the last inspection were seen. These assessments cover the information recommended in the National Minimum Standards for Care Homes for Younger Adults and provide a good basis for care planning. New service users are assessed by the manager of the home. Both service users moved from existing services within Wirral Autistic Society and continue to have the staff they are familiar with, working with them, in order to promote continuity. There was evidence of consultation between the service users, relatives and relevant professionals to inform the assessment. The service users made visits to the home before moving in. The contracts/terms and conditions between the home and the service user were available for inspection. A record of the current fee was not recorded in the contracts but was available. Contracts have been signed by the service user and a representative from Wirral Autistic Society. It is recommended that where appropriate, service users be supported by family, friends and/or advocate, when drawing up the contract. York Street (32) DS0000019016.V278550.R01.S.doc Version 5.1 Page 9 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 and 9 In general, care planning reflects the assessed and changing needs of service users. Service users are consulted with and take part in life at the home. EVIDENCE: The service user plans were 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. A 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 wellbeing. Reactive plans, which detail behaviour management strategies are also York Street (32) DS0000019016.V278550.R01.S.doc Version 5.1 Page 10 available. Some risk assessments and the behaviour management plan for a service user need to be reviewed in the light of the change of placement, the change in the needs of the service user and the different staffing levels available. This was discussed with the manager following the inspection. Staff are trained in behaviour management strategies such as supportive holds and breakaway techniques as part of their induction. An accredited trainer is now providing instruction to staff. Service users are encouraged to contribute towards the running of the household. Service users go shopping and help with meal preparation in accordance with their abilities. Service users’ views are obtained through their individual key workers. York Street (32) DS0000019016.V278550.R01.S.doc Version 5.1 Page 11 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, 15, 16 and 17 Service users are able to take part in appropriate activities that provide opportunities for their educational, social and personal development. The daily routines and arrangements for promoting relationships with family and friends, support service users. 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. Staff and records indicated that family links and friendships are promoted. The arrangements for contact with family are written into the service users’ care plans. Service users have the opportunity to meet people and make friends York Street (32) DS0000019016.V278550.R01.S.doc Version 5.1 Page 12 with people who do not have their disability, through attendance at social clubs and through community activities. Discussions with the staff and observations confirmed that the home’s routines are flexible as much as possible. The weekday routines fit in with day services and work placements. It is understood that the service users benefit from a structured lifestyle. Choices are offered, although some of these may be limited and service user specific. Weekends are more flexible and fewer routines are in place at this time. The records inspected indicated the support service users need in their daily lives in order to make decisions and encourage independence. Care plans indicate the dietary requirements of service users. Advice is obtained from a dietician if this is required. A record is kept of food provided to service users. The records showed that well-balanced and varied meals are provided. A service user spoken with said that they choose the meals and do the shopping and cooking with staff support. Another service user said they had enjoyed their evening meal. York Street (32) DS0000019016.V278550.R01.S.doc Version 5.1 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): 18, 19 and 20 The personal care needs of service users are well met. Improvements need to be made to the recording around administering medication. EVIDENCE: Records detail the support service users need with their personal care. Observations indicated that staff, promote the privacy and dignity of service users. Consistency and continuity of support for service users is provided through the key worker system. Staff receive training on promoting privacy and dignity during their induction. 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. A medication procedure is available which provides clear guidance. Observations of staff administering medication indicated that they are following this procedure. Medication is stored securely. Members of staff interviewed reported that they have been trained in the administration of medication. A selection of medication administration record sheets and corresponding medication were inspected and in general found to be in order. A cream that is York Street (32) DS0000019016.V278550.R01.S.doc Version 5.1 Page 14 prescribed and available for a service user as and when needed, was not recorded on the medication administration records. This was brought to the attention of the manager to address. York Street (32) DS0000019016.V278550.R01.S.doc Version 5.1 Page 15 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 Staff training and policies and procedures are in place to ensure that service users views are heard and appropriate action taken. EVIDENCE: Staff reported that they elicit the views of service users in accordance with their abilities. Information is available to enable a complaint to be made by a service user or on their behalf, of by an advocate. The complaint procedure includes the timescales for dealing with each stage of a complaint. The complaint procedure is displayed on the service users’ notice boards. The procedure is available in different formats to reflect the abilities of service users. A record is kept of any complaints made. The records indicated that a complaint had not been made since the last inspection. During this time no complaints have been made to CSCI. A service user who spoke to the inspector said that if they wanted to complain or comment about any aspect of the service they receive at the home they would know who to approach. Staff were aware of how to respond to a complaint. York Street (32) DS0000019016.V278550.R01.S.doc Version 5.1 Page 16 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 and 30 In general, 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 and the home has been recarpeted throughout. The settee in the lounge has been replaced. There is some discoloured wood around the window in the bathroom. This window has a loose handle, which makes it difficult to close tightly. The radiator cover in one service users bedroom was loose. The window in this bedroom is not closing fully as the handles do not fit into the handle rests adequately. The manager is in the process of attending to this. Staff reported that there has been a delay in these repairs being carried out. The bedroom space requirements detailed in the National Minimum Standards are met. The bedrooms seen were satisfactorily decorated and personalised in accordance with the service user’s taste. York Street (32) DS0000019016.V278550.R01.S.doc Version 5.1 Page 17 A tour of the home showed that the home was clean. There are procedures for staff to refer to about hygiene and infection control. York Street (32) DS0000019016.V278550.R01.S.doc Version 5.1 Page 18 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, 33, 34 and 35 Service users are supported by the number of staff available, the training they have received and the manner in which they are recruited. EVIDENCE: An examination of the rota and a discussion with the staff and manager indicates that the home is providing sufficient staffing levels. There are two members of staff on duty at all times during the day until 11pm/12pm. At night, there is one sleeping in member of staff. There is a network of support provided by Wirral Autistic Society for lone workers. Lone worker risk assessments are available. The manager was asked to revise these in the light of the needs of the new service users living at the home. The manager reported that the needs of service users are regularly reviewed and that a change to the staffing arrangements at night would be made if appropriate. There is a core staff team employed at the home. Bank staff are used to cover absences. 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. 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. This York Street (32) DS0000019016.V278550.R01.S.doc Version 5.1 Page 19 includes training around meeting the needs of individuals who have autism. Staff are encouraged to undertake an NVQ in caring for adults with a learning disability. Over 50 of staff hold an NVQ Level 2. Specialist training is provided to staff to assist them to support service users. Observations indicated that staff are respectful and supportive of the service users. The records of staff recruitment were examined and found to be well managed and contained all the required information. Clear job descriptions were available for staff. The staff spoken with, were aware of their roles and responsibilities and the lines of accountability at the home. York Street (32) DS0000019016.V278550.R01.S.doc Version 5.1 Page 20 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 and 42 Improvements need to be made to the fire safety systems at the home. EVIDENCE: The manager of the home has had several years experience of management in a care setting. The manager has an NVQ Level 4 in care and management and other relevant qualifications. The manager has undertaken periodic training to maintain and update her knowledge skills and competence. The manager has responsibility for another care home run by Wirral Autistic Society. A 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. A sample of safety check records and certificates were examined. In general these were appropriately maintained. The records of the fire safety training provided to one team of staff at the home did not indicate that this has occurred at the frequencies recommended by the fire service, of 6 monthly for day staff and 3 monthly for night staff. York Street (32) DS0000019016.V278550.R01.S.doc Version 5.1 Page 21 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 X 2 3 3 X 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 X 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 X LIFESTYLES Standard No Score 11 3 12 X 13 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X X X X 2 X York Street (32) DS0000019016.V278550.R01.S.doc Version 5.1 Page 22 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. Standard YA9 Regulation 15 Requirement Timescale for action The registered person must 23/01/06 ensure that the risk assessments and the behaviour management plan for a service user identified at this inspection are reviewed in the light of the change of placement, change in the needs of the service user and the different staffing levels available. The registered person must ensure that a record of prescribed medication is entered on to the medication administration record sheet. The registered person must ensure that the windows identified at this inspection close securely and that the radiator cover identified at this inspection is secure. The registered person must ensure that the lone worker risk assessments are kept under review in accordance with the needs of the new service users living at the home. DS0000019016.V278550.R01.S.doc 2. YA20 13 23/01/06 3. YA24 23 23/02/06 4. YA33 13 23/01/06 York Street (32) Version 5.1 Page 23 5. YA42 23 The registered person must ensure that fire safety training is provided to day staff on a 6 monthly basis and night staff on a 3 monthly basis. 23/01/06 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 YA5 Good Practice Recommendations It is recommended that service users be supported by family, friends and/or advocate, as appropriate when drawing up the contract. 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