Care Home: Foxwood (2)

What the care home does well 2 Foxwood provides a comfortable, friendly and relaxed home for the people who live there. With all areas being personalised to reflect the residents` personalities and interests. Residents` enjoy going out to different places and going away for short holidays with the manager and staff team. The staff team are aware of residents` individual needs and are enthusiastic about supporting them to enjoy their daily lives and to promote their independence as much as possible. The staff team feel very supported and valued by the service manager and senior managers from the organisation enabling them to offer residents the most appropriate and safe care and support. The service manager and staff team keep good records about the support needs of residents and make sure health care professionals such as GPs are contacted if needed. Since the last site visit there have been few changes to the staff team, which gives residents the opportunity to get to know the people who will be supporting them with their personal care and emotional and mental health needs. The manager and the staff team are enthusiastic about the work they do and were observed supporting residents in a sensitive, affectionate and respectful way. What has improved since the last inspection? Overall the way in which the service records information has improved resulting in more detailed care plans and risk assessments. These records then support the manager and staff team to make sure the care and support they are providing is meeting residents changing needs and expectations. The environment has improved meaning residents are living in an attractive, homely and safe place. There have been changes in the organisation resulting in new senior managers being appointed. They are supporting the service manager to look at ways to improve the service and visit regularly to speak to residents and staff. What the care home could do better: Overall the records kept by the home are good however some records would benefit from greater detail to enable the staff team to offer appropriate and safe support to residents. The service must record financial decisions and information in greater detail to ensure residents are protected from possible financial abuse. CARE HOME ADULTS 18-65 Foxwood (2) 2 Foxwood Parklands Estate Liverpool Merseyside L12 0HZ Lead Inspector Helen Carton Key Unannounced Inspection 21st November 2007 10:30 Foxwood (2) DS0000025266.V355135.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 Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Foxwood (2) Address 2 Foxwood Parklands Estate Liverpool Merseyside L12 0HZ 0151 220 2578 0151 524 3602 Head Office phone number is 0151 524 3606 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) North West Community Services (Merseyside) Limited Patricia Raynard Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2006 Brief Description of the Service: Number two Foxwood is a large modern bungalow that provides accommodation and care for three adults with learning disabilities. The home is owned and managed by an independent company, North West Community Services. The home is located in a residential area of Liverpool, which is situated on the edge of Croxteth Country Park. The home is spacious, comfortable and well maintained. Accommodation comprises of a lounge/dining area, kitchen, bathroom and four bedrooms. Each service user has their own bedroom and the fourth bedroom is used as a staff office/sleep in room. Service users also have access to a garden area at the rear of the premises. The fees for the home are £1091.50 per week. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of the inspection process we sent the service an Annual Quality Assurance Assessment (AQAA) document, which was to be completed prior to the site visit. This document was to provide information about the service at 2 Foxwood and to tell us where they felt they had made improvements to the way they support residents and the staff team. The manager completed and returned the document before the site visit took place. A visit was made to enable us to examine documentation and to discuss how the service supports residents’ in all aspects of their lives. Part of this process involved speaking with the manager, members of the staff team and spending time with residents’ to find out their views on living at 2 Foxwood. We spent approximately five hours at the service. What the service does well: 2 Foxwood provides a comfortable, friendly and relaxed home for the people who live there. With all areas being personalised to reflect the residents’ personalities and interests. Residents’ enjoy going out to different places and going away for short holidays with the manager and staff team. The staff team are aware of residents’ individual needs and are enthusiastic about supporting them to enjoy their daily lives and to promote their independence as much as possible. The staff team feel very supported and valued by the service manager and senior managers from the organisation enabling them to offer residents the most appropriate and safe care and support. The service manager and staff team keep good records about the support needs of residents and make sure health care professionals such as GPs are contacted if needed. Since the last site visit there have been few changes to the staff team, which gives residents the opportunity to get to know the people who will be supporting them with their personal care and emotional and mental health needs. The manager and the staff team are enthusiastic about the work they do and were observed supporting residents in a sensitive, affectionate and respectful way. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2&5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall the information provided by the service is good allowing prospective residents the opportunity to make informed decisions about whether the service can meet their needs. EVIDENCE: The statement of purpose provides detailed information about the services the home can provide. Allowing people who may wish to live in the home to make an informed decision as to whether Foxwood can meet their care and social needs. As part of the statement of purpose information is provided about the organisation that owns Foxwood and other services they can offer. The people who live at Foxwood have lived there for a number of years we looked at assessment records which showed the service had gained information from residents, relatives and health care professionals about their care and social needs. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 9 Examination of records indicates each resident has a statement of terms and conditions detailing the care and support to be provided by foxwood however current charges were not documented. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9&10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall care planning and risk management strategies and care practices adopted by the service support residents’ holistic needs. EVIDENCE: Care plans have been developed for residents and provide the staff team with good information and guidance about their care needs. Information is also provided about daily routines and the type and level of support residents need with daily tasks. Care plans provide detailed information about the health care needs of residents and clearly show when health care professionals are supporting them. At the time of the site visit the care plans and accompanying documentation had been reviewed. With clear information about significant changes to residents physical and mental health needs. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 11 Risk assessments have been carried out with clear guidance for the staff team to follow this is to ensure residents are supported in the safest and most appropriate way. Supporting this information were professional guides and information sheets about the conditions and illnesses effecting residents. Enabling the staff team to offer the most appropriate, sensitive and safe support to them. We advised the manager to make sure sensitive information about personal care needs are recorded in detail to enable the staff team offer sensitive and positive support during these difficult times. Examination of daily records indicate staff are supporting residents in a consistent way in line with the information held in care plans with reports being written in a non- judgemental, factual and sensitive manner. Members of the staff team were observed supporting residents in a sensitive supportive and affectionate manner. During the site visit residents went out together and were supported by members of the staff team. We observed residents appearing comfortable and relaxed in their home and with the support being offered by the staff team and the manager. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16&17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service supports residents to live their lives as they choose and to participate in age appropriate activities and maintain positive relationships. EVIDENCE: Records show residents are involved as much as possible in decisions about their daily lives. The manager and the staff team work hard to support residents to be involved in age appropriate activities. Residents care plans provide good information about the activities residents enjoy and those that can cause anxiety and the actions to be taken to minimise it. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 13 During the site visit we observed residents being supported to attend a community activity looking back at the Liverpool of their youth. Records show the service supports residents to maintain positive relationships in their lives. Information provided in the AQAA indicated special dietary needs are catered for and residents are supported and encouraged to eat healthily this information was confirmed through observation made during meal times discussions with the manager and members of the staff team. Discussions with the manager and members of the staff team indicated they are committed to supporting residents to be involved in the local community and to spend their time engaging in activities they enjoy. This includes supporting them to go on short breaks in the UK and abroad. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19&20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service proactively supports residents to make informed decisions about their care and support resulting in individualised support and care being provided. EVIDENCE: Care plans provide detailed information about the health care needs of residents and clearly shows when health care professionals’ such district nurses’ are supporting them. We discussed with the manager the need to provide greater detail in plans where a specific health care needs cause emotional distress to residents This is to ensure the staff team support residents in the most sensitive and safe way. A record is kept of all visits made to or by medical and social professionals to ensure the service and others involved in supporting residents are acting in their best interest. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 15 A sample of residents’ medication and the corresponding Medication Administration Record (MAR) sheets were examined. They were securely stored and had been safely administered and accurate records had been kept. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22&23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The services systems and practices promote positive communication with residents, their relatives and supporters and protect residents from abusive or neglectful situations. EVIDENCE: The statement of purpose and the service use guide provide residents their relatives and supporters with information about the complaints procedure that encourages them to speak to the manager at the earliest opportunity to resolve any concerns they may have. There have been no safeguarding referrals made by the service or from other agencies about the care and support residents receive at 2 Foxwood. The staff team have all completed safeguarding vulnerable adults training. Discussions with the staff team indicated they are aware of their roles and responsibilities in protecting residents from abuse or neglectful practice. The staff team receive regular supervision from the manager, which highlights training needs and would identify poor care practices. Every month a senior manager from the organisation visits the home to carryout checks to make sure the service is safe and is offering residents the Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 17 care and support they need and want. These visits form part of the organisations safeguarding processes. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27&30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment is good providing residents with a safe and homely place to live. EVIDENCE: Since the last site visit the service has been redecorated, new PVC windows have been fitted and a new central heating system including radiators. The environment is very comfortable, attractive and homely with all areas having been personalised to reflect residents’ interests. The bathroom needs some attention as parts of the tiling is damaged and parts of the shower area were damaged with mould like discolouration visible. We discussed this with the manager of the service and the area service manager who agreed remedial work would be carried out to address some of the issues. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 19 The environment was clean, tidy and well presented demonstrating a clear commitment by the manager and staff team to provide a pleasant, comfortable and safe environment for residents to live in. The rear garden is well maintained and is an attractive and safe place for residents to spend time. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35&36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager and the staff team meet the holistic needs of residents. Further work is needed to provide specialised training to the staff team so they have the necessary skills and knowledge to support residents with their changing needs. EVIDENCE: There are two members of staff on duty throughout the day and one supporting residents through the night. There are appropriate numbers of staff available to support residents with their holistic needs. The organisation’s human resource department manages recruitment and selection processes centrally. All main staffing files are held at their head office with an information sheet being available at the service. Examination of records held in the service and discussion with managers during the site visit indicates residents are protected by a robust recruitment and selection process. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 21 Members of the staff team spoken with demonstrated a good understanding of residents’ needs and where enthusiastic about their roles. Records and discussions with members of the staff team indicate they receive regular supervision and feel supported by the manger and the organisation. We discussed with the manager and area service manager the need to provide specialised training to enable the staff team to continue to offer appropriate and safe support to residents as their needs change. The area service manager informed us a review was taking place to identify training needs of the staff team. We observed members of the staff team supporting residents in a friendly, professionals and affectionate manner. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,41&42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from a service that is well run and has a person centred approach to the care and support they provide. EVIDENCE: The manager has worked at the services for a number of years and has the necessary skills experience and qualifications to manage a care service. Since the last site visit there have been significant changes within the senior management team of the organisation resulting in a more visible and supportive approach to the manager and the staff team of 2 Foxwood. The manager and members of the staff team spoken with felt positive about the changes and felt it would help them to improve their service. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 23 The staff team are effectively supervised and managed resulting in residents receiving an individualised care service. An issue regarding the way in which a resident’s disability car is used by other residents’ and the manner in which the use is paid for was raised with senior managers of the organisation. They explained they had highlighted this issue and were taking steps to ensure all dealings were transparent and protected the legal rights of all parties. A selection of health and safety records where examined such as fire safety, utility safety checks and maintenance records, accident/incident records. All indicated the manager and the staff team work proactively to maintain a safe environment within their areas of responsibility. Regulation 26 visits and accompanying reports are being undertaken at regular intervals with the reports being available for examination at this site visit. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 2 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 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 3 3 X 2 3 X Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 YA5 Regulation 5 Requirement The terms and conditions in respect of accommodation provided to residents must include an up to date amount of fees to be paid. This is to ensure residents and their supporters are confident the service is providing the type and level of care required. Remedial work must be carried out in the bathroom to ensure residents are able to undertake their personal care in a hazard free and pleasant environment. All financial arrangements made on behalf of residents must be adequately recorded including decision-making information. This is to ensure there is a clear audit trail to safeguard residents from financial abuse. Timescale for action 30/01/08 2. YA27 23 20/02/08 3. YA41 12 30/01/08 Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 26 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 YA19 Good Practice Recommendations Some healthcare records would benefit from greater information regarding the emotional and mental impact specific conditions have on residents. Including how it may affect their behaviour and how staff are to react and support them through these difficult times. Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Merseyside Area Office 2nd Floor South Wing Burlington House Crosby Road North Waterloo, Liverpool L22 OLG 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 Foxwood (2) DS0000025266.V355135.R01.S.doc Version 5.2 Page 28 - 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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