Care Home: Elm Road, 13

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What the care home does well The house provides a comfortable, clean, safe and homely environment for residents to live. Care plans are detailed and other records are well written, easy to follow and up to date to ensure that staff have the information they need to provide residents with the correct level of care and support. Residents are given opportunities to live their lives in accordance to their wishes and the staff ensure that residents are assisted to make choices and decisions. Regular contact with family members is encouraged and visitors are Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 6made welcome. Daily routines are flexible to meet the needs of the three residents accommodated who are supported to be involved in the daily routines of the home. The staff have worked with the residents for many years thus providing continuity of care and support in the way the residents prefer. The staff interact at all times with the residents and a pleasant, relaxed and comfortable atmosphere was present throughout the visit. The residents are supported by staff that are qualified and competent to do their jobs. An ongoing training programme is in place. Residents` benefit from a service that is well managed. The service ensures the protection of residents by following a robust recruitment procedure and the staff are trained in adult protection procedures. The AQAA completed by the manager was very detailed and gave a clear account of the service provision, aims and objectives. What has improved since the last inspection? What the care home could do better: The kitchen units, which are still showing evidence of wear and tear, should be replaced and this was noted at the last few inspections. A new `medication cabinet` should be purchased to provide secure medication storage. The medication is presently securely stored in a locked cupboard. Water temperatures should be recorded when the residents use the bath. This was discussed with the manager during the visit and immediate action taken to maintain future records. CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Elm Road, 13 13 Elm Road Seaforth Liverpool Merseyside L21 1BJ Lead Inspector Elaine Stoddart Unannounced Inspection 4th December 2007 11:30 Elm Road, 13 DS0000005242.V348684.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 Elm Road, 13 DS0000005242.V348684.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 Older People and 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. Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elm Road, 13 Address 13 Elm Road Seaforth Liverpool Merseyside L21 1BJ 0151 476 1967 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) Expect Limited Mrs Maria McCarthy Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 3 MD. Date of last inspection Brief Description of the Service: 13 Elm Road is a mid-terraced house situated in a residential area of Seaforth. Parking is available on the road at the front of the house. The home is registered to provide care and support for three adults who have mental health difficulties. The home is generally well maintained and provides a comfortable place for the residents to live. The three residents have their own rooms and share the two lounges, kitchen and bathrooms. The home is of a domestic setting in all aspects and is indistinguishable as a care home. The home is operated by Expect, formerly Sefton Support Services. Crosby Housing Association owns the house. Staff are on duty 24 hours a day to provide care and support for the residents who live there, the overall philosophy being to maximise ordinary living and to promote independence of the residents in all aspects of their daily life. The cost for the service is £280.00 per week. Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one visit. It was an unannounced (site visit) and was conducted as part of the regulatory requirement for care homes to be inspected. A tour of the building and garden was conducted and a selection of care staff and home records were viewed. Case tracking was undertaken for the new resident who had moved in since the last visit. This was conducted to assess the care provided by the service. This involved discussion with the manager, a staff member, residents and observation during the visit. It was not possible to obtain the direct views of one resident due to the nature of her disability however her experiences were obtained through discussion with the manager, staff, general observations and compliance with standards. Satisfaction survey forms “Have Your Say About …” were distributed to the residents prior to the inspection. Comments included in the report are taken from the survey forms and also during the site visit. An AQAA (Annual Quality Assurance Assessment) was completed by the manager prior to the site visit. The AQAA comprises of two self-assessment questionnaires that focus on the outcomes for people. The self-assessment provides information as to how the manager and staff are meeting the needs of the current residents and a data set that gives basic facts and figures about the service including staff numbers and training. What the service does well: The house provides a comfortable, clean, safe and homely environment for residents to live. Care plans are detailed and other records are well written, easy to follow and up to date to ensure that staff have the information they need to provide residents with the correct level of care and support. Residents are given opportunities to live their lives in accordance to their wishes and the staff ensure that residents are assisted to make choices and decisions. Regular contact with family members is encouraged and visitors are Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 6 made welcome. Daily routines are flexible to meet the needs of the three residents accommodated who are supported to be involved in the daily routines of the home. The staff have worked with the residents for many years thus providing continuity of care and support in the way the residents prefer. The staff interact at all times with the residents and a pleasant, relaxed and comfortable atmosphere was present throughout the visit. The residents are supported by staff that are qualified and competent to do their jobs. An ongoing training programme is in place. Residents’ benefit from a service that is well managed. The service ensures the protection of residents by following a robust recruitment procedure and the staff are trained in adult protection procedures. The AQAA completed by the manager was very detailed and gave a clear account of the service provision, aims and objectives. What has improved since the last inspection? There were no requirements made at the last inspection. Improvements to the accommodation have taken place and include – the rear lounge has been redecorated and new furniture purchased. A new shower and flooring has been fitted in the ground floor bathroom. The bathroom and kitchen have been painted. The manager has obtained a National Vocational Qualification in Equality and Diversity Level 2. The manager has used this qualification, and the information provided by the Commission, when supervising her staff group to ensure they are familiar with the issues of equality and diversity. The in depth training programme has continued for the staff to ensure they are equipped with skills in all areas appropriate to meet the residents’ needs. Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1,2,4 (Adults 18 –65) Standards 3,6 (Older People) were assessed. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents’ needs are fully assessed prior to admission to ensure their needs can be met. Standard 6 (Older People is not provided as the service does not provide intermediate care). EVIDENCE: The assessment of need was viewed for the new resident who has moved into the service since the last visit. This contained detailed information relating to Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 10 the care needs of the residents and included information on medication, religious beliefs, personal profiles, risk assessments, family contacts, likes and dislikes and preferred daily routines. This information enables the staff to obtain an understanding of the resident’s background and assists them in providing the care and support required. The new resident is diabetic and staff have received training to enable them to meet her needs. The new resident was provided with a brochure on the details of the service containing the statement of purpose, service user guide, contract of terms and conditions, philosophy of care and complaints policy and procedures. The prospective resident was invited to view the service and meet the other residents and staff with the support of the referrer and family if possible. The prospective resident was invited to stay for lunch or dinner. The prospective resident then following the assessment and visit to the service made a decision to move into the home. The new resident was observed to be very comfortable and expressed that she has settled into the home very well. “I love it here. The staff are great. I came to have a look around with my son before I decided to move in”. Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7,9 (Adults) 7,14,33 (Older People) were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to make decisions and are supported to participate in daily living activities. Their changing needs and personal goals are reflected in their care plans. EVIDENCE: Discussion with the new resident and staff confirmed that she has settled in very well and gets on with the other residents and staff. She was observed to be relaxed and comfortable in her environment and interacted well with both the residents and staff on duty. Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 12 All residents have individual plans of care. The care plan for the new resident was viewed and was found to contain detailed information on her assessed needs, identifies how these needs are to be met and the goals they aim to achieve. These are drawn up in consultation with all involved in her care. The information covers what they can do independently i.e. daily routines, personal care. The plan identifies areas in which they need assistance i.e. finances, medication and shopping. The resident has signed and agreed the plan. All care plans are reviewed monthly by the support staff and every six months by all others involved in their care. The staff complete monthly summaries to record changing needs and adjust the care plans accordingly. This enables the service to closely monitor change and developments that occur. Care plans demonstrate daily routines in place and how the residents are encouraged to make their own decisions in what they wish to do. Records showed the residents’ likes and dislikes and relationships i.e. seeing their families. These wishes are respected and encouraged by the staff. The residents are encouraged to take part in the daily routines of the home and are encouraged to lead independent lifestyles within the risks identified. Risk assessments for the residents are in place and are reviewed regularly by the home’s manager to assess changing need. The manager is to update all care records in line with personal centred planning format and the forms are in place for them to complete in the near future. These will provide more detailed information on how the person wishes to be supported from the moment they awake until they rest for the night. The key worker and the resident will draw these up. Daily records are recorded by the staff to record activities, well-being, contacts and daily routines. Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. Service users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 14 Standards 12,13,15,16 (Adults) 10,12,13,15 (Older People) were assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are given opportunities to live fulfilling lives in accordance to their wishes. Meals are offered at flexible times to meet their needs, choice and wishes. EVIDENCE: Detailed care records are in place, which reflect the wishes and care needs of the residents. Guidelines are in place for staff to ensure they are aware of how the residents wish to be supported and how to deal with any problems, which may arise due to their mental health needs. Staff spoken with confirmed their understanding of the residents’ needs and as they have worked with them for many years they are confident in how to provide the support required. No new staff have been appointed since the last visit and consistent agency staff are only used if required. The staff showed their awareness and understanding of the residents’ individual needs throughout the visit. The staff are fully trained in all areas required to ensure they can meet the individual needs of the residents accommodated. As well as all the statutory training being kept up to date the staff are also trained in areas such as diabetes, mental health, protection of vulnerable adults (POVA), stress and crisis intervention. All the residents are given the opportunity to have privacy in their own rooms if they wish. Locked cabinets are available in their rooms for valuables and they have a key to the front door. One resident was observed to spend a short time in her room after her lunch and confirmed, “I like to have a rest and do some crocheting”. The staff on duty respected her wishes and were observed to knock on all private rooms before entering. One of the three residents chooses not to go outside the home. One takes a taxi occasionally to attend appointments. The new resident is more active and is supported by staff to go shopping. This she recently did with staff and said, “ They helped me to buy some new clothes. I had a great time”. The resident is hoping to join a nearby day club were she can mix with others and take part in activities. The new resident is looking forward to attending a Christmas party run by Expect. The resident is also planning a holiday for the coming year, with staff support. The manager and staff respect their decisions if they do not wish to go out. The staff are aware that it is particularly important that they are given opportunities for stimulation at home and provide 24 hour support at all times. Records examined and the residents spoken to confirmed this. The Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 15 residents were observed to be relaxed in their environment watching TV in the lounge and chatted with staff on duty. A pleasant, relaxed atmosphere was in place during the visit. The residents commented that they are looking forward to the Christmas period and the front room was decorated with a Christmas tree. Details of activities, interests and hobbies that residents are offered and take part in at home were recorded in detail. One resident enjoys spending time in her room listening to her radio, reading and watching television in the company of others in the main lounge. Another resident enjoys pampering sessions, which include having her nails manicured, and her hair washed and styled. Residents choose their own clothes, what they wish to wear and how they have their hair done. The residents are encouraged to maintain contact with their families and this is available to them by daily phone calls and weekly visits by family members. The residents are encouraged to take part in the daily living tasks of the home by helping to choose the food, set the tables and tidy their own rooms. The daily routines are flexible and meals are served for them when they wish. The new resident is diabetic and all the staff have received training in this area to ensure they meet her needs. Residents are able to make drinks and snacks with support. The residents use the small-enclosed garden during the summer months and as a designated smoking area. Additional hours are allocated to the home to enable them to go out supported should they wish. The manager and staff to review the resident’s activities, family contacts, and personal hygiene. They complete monthly summaries to ensure any changes that occur are addressed and recorded. The residents require staff support with finances and any correspondence and the staff are available to support them and are fully aware of their needs. Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19,20 (Adults) 8,9,10 (Older People) were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive personal support according to their wishes. EVIDENCE: Care files showed detailed information on the health care needs and personal support required for the residents and how they wish to be assisted in these areas. Each resident has a health action plan to enable the staff to provide support in areas of need. The residents require some physical support with personal care but require mostly advice, guidance & support. Care plans have detailed and agreed routines, which showed the need for staff guidance and Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 17 the importance of the routines for the residents. Regular care plan reviews and monthly summaries by staff allow staff to address any issues or changes to care that may be necessary. The death wishes of the residents are recorded and have been discussed in a sensitive manner using picture formats to discuss their wishes. Residents require assistance with medication, which is securely stored and administered by trained staff using the correct procedures. All stock is recorded on receipt and is administered from blister packs delivered from the chemist. Information is available to staff on the medication and their side effects to enable them to monitor progress. A medication cabinet would be beneficial. Medication is presently stored in a secure locked cupboard. Residents are encouraged to have regular health checks, which often require home visits, as two of the three do not wish to go out. One resident attends her own health care visits and is encouraged to take a taxi to do this. Access is available to health care services and records confirmed this. Chiropody visits; eye tests and dentists are visited when needed. The service undertakes a medication review annually for the residents. Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22.23 (Adults) 16,18 (Older people) were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies and procedures are in place to safeguard the residents who are aware of how to make a complaint. EVIDENCE: There have been no complaints made about the service since the last visit. The residents spoken confirmed that they would tell the manager if they had any concerns. “I would tell Maria if I had a complaint”. Staff are in daily 24-hour contact with the residents and deal with any comments on a daily basis should they arise. A complaints book is available should any complaints arise. The residents have families who are in regular contact and access is available to Sefton Advocacy service for support. All staff have received training in abuse awareness and physical intervention and confirmed they are aware of the procedures and commented, “I would not hesitate to report anything”. The staff procedures ‘Safeguarding Adults’ is available to staff for reference. A copy is available at the home. Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 19 The staff manage resident’s personal allowances. Daily expenditures are recorded, receipts obtained and all transactions and signed for. All monies are securely stored. The residents have access to their own bank accounts and information on these are securely stored and risk assessments are in place. Copies of resident’s bank statements are available on file. A policy and procedure for handling residents’ finances is in place and strict guidance for staff to follow. Contact has to be made to the head office to notify them of all dealings by staff with residents’ finances. One resident’s son deals with all her finances. The resident commented, “The staff have to help me as I can’t manage my own money”. Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24,25,26,27,28,29,30 (Adults) 19,20,21,22,23,24,25,26 (Older People) were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and provides a safe and comfortable environment for residents. EVIDENCE: Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 21 All communal areas and private rooms were viewed in addition to the outside front and rear of the property. All areas were clean and tidy and maintained to a good standard. The residents’ bedrooms were viewed, they were found to be comfortable and personalised to a good standard meeting the needs and lifestyles of individual residents. The residents have been involved in choosing colour schemes and furnishings for their rooms. The residents commented that they are satisfied with the accommodation. “We have a lovely clean house”. “ I love my room”. A stair lift is in place for one resident to use to assist her disability needs and the service maintenance for this is up to date. Smoke alarms, radiator covers and window restrictors are fitted throughout to ensure safety. Since the last visit the kitchen has been painted, a new shower and flooring fitted and the back room has new furniture and decoration. Refurbishment of the kitchen units is yet to take place and this would compliment the accommodation provided. This has been recommended within the findings of the main inspection report. Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32,34,35,36 (Adults) 27,28,29,30 (Older People) were assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff are trained to meet residents needs. The recruitment and selection procedures are robust. EVIDENCE: Three staff files were examined and all contained the required identification evidence, two references, Criminal Record Bureau (CRB) checks and proof of qualifications. The recruitment policy is robust and meets the National Minimum Standards. No new staff have been appointed since the last visit. Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 23 The staff group are consistent to provide continuing care and support to the residents Staff files showed evidence that staff have undertaken a full training programme to equip them with the skills to meet the needs of the residents. The training programme is kept up to date and includes statutory training i.e. moving and handling and food hygiene. Additional training i.e. crisis intervention, medication and abuse are provided. Staff are encouraged to obtain National Vocational Qualifications (NVQ) and all the staff based at the home are qualified in at least NVQ Level 2 (100 ). One member of staff is on duty per shift daytime and one for sleep in duty. The manager is available ‘on call’ at all times and there are emergency contacts if needed. Records viewed and staff spoken to confirm that regular meetings take place to keep staff up to date. Handovers take place at the beginning and end of each shift to ensure staff are aware of residents progress and to balance finances. This was observed to take place during the visit. Additional staff hours are provided should the residents choose to go out with support or to assist the staff on duty. Regular bank staff are only employed during staff sickness and holidays. Regular supervision is in place and records viewed and discussion with staff confirmed this. Annual appraisals are conducted for all staff. The staff spoken with are very positive about their work to meet the needs of the residents. “I love working here”. “We have a brilliant staff team”. Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. Service users live in a home which is run and managed by a person who is fit to be in charge of good character and able to discharge his or her responsibilities fully. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37,39,42 (Adults) 31,33,35,38 (Older People) were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed in the best interest of the residents. Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 25 EVIDENCE: The manager has worked with the residents for the past nine years and is experience and qualified in NVQ Level 4. The manager has recently completed NVQ level 2 in equality and diversity and uses this to promote staff and residents needs during her staff supervision. During the visit a positive, open and inclusive atmosphere was in place. The residents were observed relaxed and chatted freely with the staff on duty. The manager gives a clear sense of direction and leadership and the staff spoken confirmed this with positive comments. “Maria is brilliant” “We have regular supervision and staff meetings and have a great staff team” Administration and recording systems in the home are organised, detailed, relevant, easy to follow and up to date. Policies and procedures are in place and are in the process of being reviewed by the head office. Staff through the day-to-day running of the home value resident’s choices and opinions as they involve them in the day-to-day running of the service. The manager and staff were observed to be respectful towards the residents placing them at the centre of their work. Records showed that quality monitoring systems are in place. This involves residents and/or their relatives/representatives being consulted on their views about the service. A recent survey of relatives was conducted in October 2007. Also as part of a quality assurance process a representative for the home visits the premises monthly. They interview residents and staff and inspect the environment and records. An ongoing staff-training programme ensures that staff are trained to carry out their roles effectively. All staff are trained in health and safety and have access to a health and safety file for reference. Risk assessments are in place and reviewed regularly. Up to date certificates are in place and were viewed for all services i.e. gas, fire equipment and stair lift. Crosby Housing is responsible for the electricity contract and a letter to confirm is available. Fire records viewed are up to date to ensure the safety of the residents. All fire drills, smoke alarm checks and emergency lighting. Bath water temperatures are to be recorded following discussion with the manager. All accidents and injuries are recorded. Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 26 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 X 4 3 5 X 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 X 32 4 33 X 34 3 35 4 36 4 CONDUCT AND MANAGEMENT Standard No Score 37 3 38 X 39 3 40 X 41 X 42 3 43 X 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 4 16 4 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Elm Road, 13 Score 3 3 3 X DS0000005242.V348684.R01.S.doc Version 5.2 Page 27 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. 2. 3. Refer to Standard YA24 YA42 YA20 Good Practice Recommendations To raise the standard of accommodation the kitchen should be refurbished. Bath water temperatures should be recorded to safeguard residents. A medication cabinet should be provided to provide safe storage. Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Merseyside Area Office 2nd Floor South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. Elm Road, 13 DS0000005242.V348684.R01.S.doc Version 5.2 Page 29 - 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. 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