Care Home: Cherryvale

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What the care home does well Staff who work at Cherryvale know the people living there well and are able to understand and respond to the different ways they communicate, so people can be confident that their needs can be met. What has improved since the last inspection? The kitchen is currently being refurbished but has not been adapted so that people who use a wheelchair can easily access it. This means that people currently living there may not be able to access the kitchen to observe their meals being prepared and able to take an active part in everyday household tasks. What the care home could do better: Records showed that some staff had not had training for several years on various topics e.g. moving and handling and fire safety. The lack of training and forward planning of training for staff means that they may not be up to date with current good practice in how to support the people living there safely and well. Key inspection report Care homes for adults (18-65 years) Name: Address: Cherryvale Acrefield Road Cherryvale Liverpool Merseyside L25 5JN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Lorraine Farrar     Date: 0 9 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 23 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 23 Information about the care home Name of care home: Address: Cherryvale Acrefield Road Cherryvale Liverpool Merseyside L25 5JN 01514284458 01514284458 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.c-i-c.co.uk Community Integrated Care care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 3 Date of last inspection Brief description of the care home Cherryvale is a detached dormer bungalow providing accommodation and support for three adults who have a learning disability. It is based in a residential area of Woolton, with local shops and public transport near by.All of the rooms used by the people living there are on the ground floor. The first floor is used for office and laundry facilities only. Outside there is a well maintained, private garden and patio area, with some off street parking at the front of the bungalow. Various aids and adaptations are provided to support people with their personal care and mobility.There are staff available in the home twenty four hours to support the people living there.The service is operated by Community Integrated Care CIC who provide staff, budgets and support. CIC are a Care Homes for Adults (18-65 years) Page 4 of 23 Over 65 0 3 Brief description of the care home national organisation who provide support services to people across the country. It currently costs between GBP1178.50 and GBP1268.50 each week to live at Cherryvale. Care Homes for Adults (18-65 years) Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Before we visited Cherryvale we sent a self assesment form to the manager. This provided her with the opportunity to explain the areas the home are doing well in, how they have improved in the past year and the plans they have for future improvements. We also asked for information on where the manager feels the home could do better. In addition the form requests information about staff, safety checks and polices and procedures. We looked at any other information we have received about Cherryvale since our last big inspection in December 2008. This includes any reports they have made to us as well as any contact regarding the home that other people may have made. This gave us an overview of how the home has operated within the past twelve months and helped us to plan our visit. We visited the home on 10th December 2009 for five hours. During that time we met Care Homes for Adults (18-65 years) Page 6 of 23 with all of the people living there and with two members of staff including the manager. We looked at the support people get with their personal and health care, their money and their environment. We also looked at the support people get with their everyday lifestyles and how experienced and qualified staff are to provide that support. Care Homes for Adults (18-65 years) Page 7 of 23 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient information is given to and obtained about people considering moving into Cherryvale. This helps everyone to decide if it is the right place for them to live. Evidence: Nobody new has moved into Cherryvale for several years. Therefore it is not possible for us to practically assess the support offered to people who may be thinking about living there. There is however, a policy in place from the organisation for supporting people thinking about moving into the home. This explains that a full assessment of the persons needs and choices will be carried out with the person and other people who support them, such as their family. People will be offered the opportunity to visit the house, meet with staff and the people living there and stay overnight if they wanted to. In discussions with the manager she confirmed that this policy would be followed. An information brochure about Cherryvale is available to inform people about the services and support they can expect. The manager has identified that this needs to Care Homes for Adults (18-65 years) Page 10 of 23 Evidence: be up dated and explained that plans are in place to do this. She gave a clear explanation of how information would be given to people in a way they could more easily understand, for example by using photographs of the house and local area. This all helps everyone to decide if Cherryvale is the right place for the person to live and helps staff to plan how they will meet the persons needs and choices Care Homes for Adults (18-65 years) Page 11 of 23 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples individual needs and choices are recognised and supported by staff so they can be confident that appropriate support is being delivered. Evidence: We looked at two peoples plans of care that contained all the information about their needs and personal goals in order for staff to be able to support them. In discussion with staff they were able to explain how the people they looked after lived their lives and what was important to them. Staff spoke about respecting the persons right to make decisions and provided people with information, assistance and communication support they needed to make decisions about their own lives. Care Homes for Adults (18-65 years) Page 12 of 23 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported so they can live a lifestyle of their choice. Evidence: During our visit we saw staff enable people to engage in different activities to maintain and develop their social, emotional and communications skills. People were seen talking to staff, being enabled to make a drink and to go out shopping for food. The kitchen was being refurbished but alternative arrangements had been made for catering. Staff told us about the meals and how they support people with their dietary and any cultural needs they may have. Care Homes for Adults (18-65 years) Page 13 of 23 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal needs are identified and supported by staff in a way that they prefer and require. Evidence: Peoples care plans contain clear information about the support they need with their personal and health care. In discussion with staff they demonstrated a good knowledge and understanding of the people they support. People are supported to take their medication and are protected by the homes policies and procedures for dealing with medication. Care Homes for Adults (18-65 years) Page 14 of 23 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place at Cherryvale to protect the people living there from harm. Evidence: No concerns or complaints have been raised about Cherryvale since our last big inspection there in 2008. There are policies in place from the organisation to guide staff in how to deal with any issues that may arise. In discussions with staff they had a good understanding of how to deal with concerns. They also displayed a good understanding of safeguarding adults issues and the indicators to look for that may show people are unhappy. As the people living at Cherryvale do not use verbal forms of communication the knowledge staff have in this area helps to ensure they are safe and secure whilst living at there. Information about how to raise a concern or complaint is made available to the people living there and to their relatives and friends via the brochure about Cherryvale. During our visit we looked at a sample of how staff and the organisation support people to manage their money. We found that receipts and money held in the home tallied and systems are in place to make sure this is checked regularly. In addition a decision making finance plan is used to examine the various options open to people for transport and recorded why the decision to share a vehicle was in the persons best interests. This clear planning, recording and evidence of best interest decisions, helps to ensure that peoples money is managed safely and well and in their best interests. Care Homes for Adults (18-65 years) Page 15 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Cherryvale provides a safe, comfortable home for people to live in that is generally adapted and decorated to meet their needs and choices Evidence: Cherryvale is a detached dormer bungalow located in a residential area of Woolton, it fits in well with other family style houses in the local area. It is near to local facilities and public transport, with some parking provided in the front driveway. At the back of the bungalow there is a large, garden with seating areas, which are used in warmer months by the people who live there. Everyone living at Cherryvale has their own downstairs bedroom, which is decorated and furnished to suit their needs and choices. It was clear in meeting the people living there and observing how they spend their time, that they like their bedrooms and are able to make full use of both their private rooms and shared rooms as they choose. People share a large lounge and dining room, which is comfortable, nicely decorated and provides sufficient space for people to move around comfortably. A smaller room is used as a second lounge and sensory room for the people living there. We identified at our last inspection that the kitchen was shabby and would benefit from refurbishment. During this visit workmen were in the process of replacing the old kitchen with one that was more up to date and would be easier to keep clean. Care Homes for Adults (18-65 years) Page 16 of 23 Evidence: However the new kitchen has not been adapted so that it can be easily accessed by people who use a wheelchair. This means that the people currently living there may not be able to access the kitchen to observe their meals being prepared and take as active a part in everyday household activities as possible. The bungalow has a downstairs bathroom, which has been adapted with a shower that is fully accessible. In addition there are ramps to the front and back of the house, hoists and a shower chair and trolley available. These aids and adaptations help people to get around their home and receive support with their personal care, more easily. Upstairs there is laundry room that provides the equipment people need to ensure their clothes are well looked after and any risk of cross infection is minimised. Staff have access to disposable gloves, hand gel, water soluble bags and aprons that again help to minimise the risk of infection. In discussions with staff they had a good understanding of infection control and the measures to follow to prevent or quickly deal with a possible infection outbreak. Care Homes for Adults (18-65 years) Page 17 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. An experienced staff team who know them well supports the people living at Cherryvale. However a lack of up to date training for staff may impact on the overall quality of support people receive. Evidence: It was evident throughout our visit to Cherryvale that the staff team have built good relationships with the people living there. We observed that staff took time to chat and socialise with people as well as meet their support needs. Reactions from the people living there also showed that they feel comfortable with staff and enjoy spending time with them. In discussions with some of the staff team they had a good knowledge of the different support needs and choices of the people who live there and were able to explain how they meet these. Most of the staff team have worked at Cherryvale for some time and know the people living there well. We looked at recruitment records for a sample of staff, including a newer member of staff. These showed that before a member of staff starts work a series of checks are carried out on them. This includes obtaining written references and a Criminal Records Bureau (CRB) check. These checks help to ensure that staff are suitable to work with people who may be vulnerable. Care Homes for Adults (18-65 years) Page 18 of 23 Evidence: Over half of the staff team hold a national qualification in care (NVQ). However as identified at previous inspections staff have not had up to date training in both basic and more specialist areas of care. For example records showed that some staff had not had training for several years on areas such as moving and handling people and fire. In addition no training had been provided for staff in more specialist areas such as the Mental Capacity Act and new deprivation of Liberty Laws. The lack of training and forward planning of training for staff means that they may not be up to date with current good practice in how to support the people living there safely and well. Following our visit the manager contacted us to confirm that training in basic area of care had been arranged for staff. This included training in fire and moving and handling. Care Homes for Adults (18-65 years) Page 19 of 23 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems at Cherryvale to ensure the home is managed and people who live their benefit from a well run home. Evidence: There are systems in place to check the quality of the service provided. Senior management from the organisation visit the home regularly and audit the service. Records and certificates were available to demonstrate that health and safety checks had been carried out. Care Homes for Adults (18-65 years) Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 9 13(4) Care plans must contain up to date risk assessments for all areas of the persons life that may present a risk to them. This will help to ensure people can live a lifestyle of their choice whilst remaining as safe as possible. 31/08/2009 2 35 18(1)(c) A training plan must be 31/08/2009 compiled and implemented. This should cover all health and safety and basic training as well as more specialist training based upon peoples individual needs. This will help to ensure staff have the knowledge to support people safely. This requirement is outstanding from the last inspection. 3 42 13(4) A system must be put into 31/08/2009 place for ensuring all health and safety checks are carried out within the correct timescales. Care Homes for Adults (18-65 years) Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 35 18 A training plan must be 28/02/2010 compiled and implemented. This should cover all health and safety and basic training as well as more specialist training based upon peoples individual needs. This will help to ensure staff have the knowledge to support people safely. This requirement is outstanding from the last inspection. To ensure staff are competent to undertake their role. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 22 of 23 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 23 of 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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