Care Home: Grandison Road (77)

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What the care home does well The staff team work very hard to support service users to be the decision makers in their lives. Important information about the home and the type of care and support that can be provided has been produced in a format suitable for service users needs. Service users support plans provide good information about the type and level of support they need how they like to live their lives. Service users are encouraged and supported to develop these plans and to look at them as their property. The information held in these plans support the staff team to provide safe and helpful care to service users. Service users are involved in looking at the care plans every month to make sure the care and support being offered is what they need. Service users are encouraged to take part in activities and to be part of the local community. The staff team work hard to make sure they are given the opportunities to take part in hobbies, pastimes, further education courses and work placements. Service users healthcare needs are supported and monitored and when necessary health care professionals help and advice are sought. Autism Initiatives who run the home support the staff team to go on training courses to help them to gain the skills and knowledge they need to offer service users the best possible care and support. There are good management systems in place to support the staff team to make sure service users and their own health and safety is looked after. The staff team respect and value service users and during our visit to the home we observed members of the staff team supporting them in a respectful, sensitive and affectionate way. We observed service users with members of the staff team and they appeared comfortable and relaxed. We spoke with service users who told us they liked living at the home and enjoyed the company of the staff team. What has improved since the last inspection? Since our last visit the home has been decorated with new furniture being provided in all areas of the home. This has resulted in service users living in a well maintained, comfortable and attractive environment. The area manager and the staff team continue to work hard to make sure policies and procedures are written in way which is suitable for service users to understand and use. What the care home could do better: An application to register the newly appointed manager should be made to CQC as a matter of urgency. This is to ensure service users continue to benefit from a consistent approach to the care and support they receive. The management team should continue to work toward developing ways to involve service users in the recruitment of staff members to the home. Key inspection report Care homes for adults (18-65 years) Name: Address: Grandison Road (77) 77 Grandison Road Walton Liverpool Merseyside L4 9SU     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: Helen Carton     Date: 1 0 0 9 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 27 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) 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. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Grandison Road (77) 77 Grandison Road Walton Liverpool Merseyside L4 9SU 01512701435 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.peterhouseschool.org Autism Initiatives care home 2 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: 2 Date of last inspection Brief description of the care home 77 Grandison Road is registered to provide support to two people. The accommodation and support is provided by Autism Initiatives. The organisation provides a variety of services to adults and children who have autism. These include residential care, day care, supported tenancies, outreach, domiciliary care, respite and educational services. Autism Initiatives is a voluntary organisation with charitable status. 77 Grandison Road is a domestic sized property which promotes the principles of ordinary community living. The home is run on a semi-independent basis in order to assist the people using the service in moving towards long-term independence. People using the service are encouraged to fully access all local facilities and resources, including college Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 2 Brief description of the care home courses and employment. The house provides a communal kitchen, bathroom and living area. Each of the people using the service has their own room decorated according to their own taste. A copy of the most recent CQC inspction report is available from the home on request. The current fee for residing at 77 Grandison Road is 1200 per week. Care Homes for Adults (18-65 years) Page 5 of 27 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: As part of the inspection process we sent the manager of 77 Grandison Road an Annual Quality Assurance Assessment (AQAA) document, which was completed and returned to us prior to our visit to the home. This document was to provide information about the service at 77 Grandison Road and to tell us where they felt they had made improvements to the way they support service users and the staff team. We spent approximately four hours at the home. As part of the inspection process surveys were sent to service users and five members of the staff team, a total of two were returned. The last inspection on this service took place on 27/07/07 We visited the home to enable us to look at the records and to discuss how the home Care Homes for Adults (18-65 years) Page 6 of 27 supports service users in all aspects of their lives. As part of this process we spoke with the area manager, members of the staff team and spent time with service users to find out their views on living at 77 Grandison Road. Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well: What has improved since the last inspection? Since our last visit the home has been decorated with new furniture being provided in all areas of the home. This has resulted in service users living in a well maintained, comfortable and attractive environment. The area manager and the staff team continue to work hard to make sure policies and procedures are written in way which is suitable for service users to understand and use. Care Homes for Adults (18-65 years) Page 8 of 27 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 9 of 27 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 10 of 27 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. The home proactively works to make sure information is accessible and meaningful to service users. With care needs being fully assessed prior to an offer of a placement being made. Evidence: The home has a detailed statement of purpose which the management team with help from service users has produced in a format which is meaningful and interesting to them. No one has moved into the home since we last visited however Autism Initiatives has a detailed assessment process. This is to make sure the staff team can support prospective service users safely and effectively and also ensure that they are compatible with the needs and lifestyle choices of people already living at the home. Care Homes for Adults (18-65 years) Page 11 of 27 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. Service users benefit from a staff team who actively promotes and supports them to be in control of their lives and direct the functions of the home. Evidence: We looked at a sample of support plans and risk assessment information for service users living at 77 Grandison Road. We found all documents to be individualised and to reflect service users care needs and lifestyle choices. They offered the staff team very clear information about how service users wish to be supported in their daily lives and the routines which are important to them. Service users are supported and encouraged to be part of the support planning and risk assessment processes resulting in the staff team viewing these documents as service users property. The level of detail in support plans shows the staff team are fully committed in supporting service users to lead purposeful and fulfilling lives as Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: independently as possible. Support plans and risk assessments are reviewed regularly with service users to make sure the support being offered are meeting their changing needs and expectations. Service users and the staff team are encouraged to comment on support being offered to make sure changes made are effective and focus on positive experiences rather than negative. This type of approach reflects Autism Initiatives and the staff teams commitment to providing service users with an enabling supportive environment in which to live. Service users have daily record, which are maintained by both them and members of the staff team. The format of these records reflects the individual needs and lifestyle choices of service users. Information recorded centres on the support and social needs of service users and demonstrates the choices and decisions made by them in their daily lives. As part of the person centred approach to the support being offered service users are encouraged to produce activity plans on a weekly basis. This information allows the staff team to focus their support at the times and manner required by service users. Care Homes for Adults (18-65 years) Page 13 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users individual rights to live an ordinary and meaningful life in both the home and the community, and to enjoy all the rights and responsibilities of citizenship is promoted and protected by Autism Initiatives and the staff team. Evidence: Records show service users are encouraged and supported to access community and leisure facilities regularly including training courses and work placements. Service users are supported to be in control of their daily lives and to make decisions about how they spend their time. Service users produce a weekly activities plans which details social and leisure plans as well as household tasks such as food shopping and cleaning. This approach ensures service users are in control of their daily lives and are the decision makers. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: A member of the staff team is also the designated activities coordinator who seeks out activities and places the information in a file for service users to view. It is then their decisions as to what they would like to take part in. Service users enjoy regular holidays which are celebrated and remembered through photo albums and reminiscing. Artwork completed by service users is displayed in their bedrooms and in the main lounge/dining area. This results in service users taking ownership of their home and the staff team respecting and value them as individuals and as citizens. The staff team support service users to maintain positive relationships in their lives with detailed information being held in their care files. Service users are supported to be as independent as possible and take the lead in all aspects of their daily lives including meal planning, cooking, cleaning and laundry. Care Homes for Adults (18-65 years) Page 15 of 27 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. Service users healthcare needs are effectively met by a staff team who respect and value them as individuals. Evidence: Currently service users living at the home do not require help and support with their personal care needs. The staff team support service users to access health care services when required and will seek advice and support from health and social care professionals to ensure the support and care being provided is meeting their needs. Regular reviews of service users health needs take place allowing changing needs to be identified and acted upon quickly and effectively. Resulting in service users being confident they are being supported by a staff team who are alert to their general wellbeing and fully understand how they should respond and take action. Service users are supported to take responsibilty for the administration of some of their medication. This is monitored closely and service users are aware of their responsibilities to inform the staff team when they have taken medication. There are Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: detailed medication policies and procedures in place and the staff team have received appropriate training. Care Homes for Adults (18-65 years) Page 17 of 27 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. The home proactively seeks the views and opinions of service users promoting an open culture where there can be confidence they are safeguarded from abuse and neglectful practice. Evidence: 77 Grandison Road is run by Autism Initiatives who have a detailed corporate complaints and concerns policy with clear procedures for the manager and the staff team to follow. Service users spoken with told us they felt confident raising any concerns or complaints they may have with the staff team, area manager or other significant people in their lives. Service users benefit from living in a service that has an open culture that supports them to express their views and concerns in a safe and understanding environment. There are clear safeguarding procedures in place with the staff receiving regular training about their roles and responsibilities regarding safeguarding the people they support. Service users benefit from the open culture operating at 77 Grandison Road and are supported by a staff team who place their protection and safety as a priority. Care Homes for Adults (18-65 years) Page 18 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users live in comfortable and safe environment which meets their care and social needs. Evidence: There is a good size lounge/dining area available for service users to use. On the first floor there are two large single bedrooms and a bathroom. The home has been redecorated and refurbished to a very high standard since we last visited. With all areas of the home offering service users a comfortable, homely and pleasant place to live. Service users are supported to personalise the home to reflect their taste and interests. We noted that pieces of their art work is displayed in the lounge and dining room area. This promotes service users ownership of the building ensuring they view 77 Grandison Road as their home. The kitchen area is well equipped, clean and tidy with the laundry facilities integrated into the kitchen. We were invited to view two bedrooms which were pleasantly decorated and furnished and reflected service users needs and interests. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: There is a small paved area to the front of the house with off road parking for one car at the side. The rear garden is small with high fencing for privacy. All areas of the home viewed were clean and tidy. Care Homes for Adults (18-65 years) Page 20 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported by a well trained and skilled staff team resulting in positive outcomes with regard to individualised care and support. Evidence: The staff team at 77 Grandison Road has been stable for a number of years with few changes taking place. This provides continuity for service users and enables them to build positive long term relationships with the people supporting them. Monthly staffing meeting are held which include a person centred plan which acts as a support and reminder to staff of the aims and values of the company and how support to service users is to be provided. It allows the staff team to reflect on good practice issues and to celebrate successes. All staff has gained National Vocational Qualification (NVQ) level 3 in care with two members of the team working toward level 3. Currently two members of staff are undertaking a training course at John Moores University which is being funded by Autism Initiatives. The area manager and the company support the staff team to attend relevant training course as they recognise the benefits to service users being supported by a skilled and trained staff team. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: The company has a robust and efficient recruitment process which ensures all required safety checks such employment references and criminal record bureau (CRB) checks are carried out prior to people starting work. This ensures service users are supported by people with the necessary skills, training and experience and are committed to promoting positive life experiences and outcomes. We discussed with the manager the need to look at ways in which service users can become more involved in the recruitment process. Each newly appointed member of staff undertakes a detailed induction training programme which includes information about the company including policies and procedures. Initially core training is provided covering areas such as health and safety, safeguarding adults and basic food hygiene. Further more specialised training and service specific training is provided following supervision with the area manager. Bank staff employed by the company provide cover for vacant posts, sickness and annual leave. Members of the staff team and the area manager were observed supporting and engaging with service users in a sensitive and affectionate manner. Care Homes for Adults (18-65 years) Page 22 of 27 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. Management systems within the home promote the health, safety and the welfare of service users. Evidence: Currently there is no registered manager the area manager is currently visiting every two weeks to offer the member of staff undertaking management duties support. Following the inspection visit the area manager informed us a manager has been appointed and an application to register them with CQC will be made in the near future. Each month service user consultation meetings take place, which gives them the opportunity to discuss with their key worker what is going well in their lives and other things they would like to concentrate on. Holding these meetings shows commitment by the staff team to involve service users in all aspects of the service and to listen to and act on their views. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: Service users are supported to make decisions for themselves and are encouraged to build positive relationships with people through college courses and work placements. Developing these relationships and contacts also helps to support the quality assurance procedures of the company ensuring the continuing development and quality of the service being provided. Accident and incident are fully recorded and acted upon when necessary. Health and safety information is well maintained with information being easily accessible to the staff team. Care Homes for Adults (18-65 years) Page 24 of 27 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 37 8 An application for registration of a manager must be made to the Commission. 14/09/2007 Care Homes for Adults (18-65 years) Page 25 of 27 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 37 8 Application to register a manager must be made. This is to ensure service users health and welfare is promoted and protected by a suitably qualified and competent manager in day to day control of the service. 30/11/2009 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 26 of 27 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 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!