Care Home: Huntsmans Wood (8)

What the care home does well 8 Huntsman`s Wood continues to provide a homely, relaxed and comfortable environment for three people with very complex needs. The home is domestic in style and staff help the service users to take part in a range of activities that they enjoy. The home is well managed and staff are committed to meeting the needs of the service users. What has improved since the last inspection? A third person has been successfully and carefully introduced to Huntsman`s Wood since our last visit. New kitchen units and tiling have been fitted to create a more modern and pleasant environment. What the care home could do better: There are no requirements or recommendations as a result of this report. Care still needs to be taken with the recording of medication. CARE HOME ADULTS 18-65 Huntsmans Wood (8) 8 Huntsmans Wood Croxteth Park Liverpool Merseyside L12 0HY Lead Inspector Peter Cresswell Key Unannounced Inspection 21th July 2008 10:10 Huntsmans Wood (8) DS0000025286.V366168.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 Huntsmans Wood (8) DS0000025286.V366168.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. Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Huntsmans Wood (8) Address 8 Huntsmans Wood Croxteth Park Liverpool Merseyside L12 0HY 0151 259 3152 9999 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) www.c-i-c.co.uk. Community Integrated Care Ms Sandra Phillips Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd May 2006 Brief Description of the Service: 8 Huntsmans Wood is home for three adults with learning disabilities, all of whom also have physical disabilities. The home, a spacious bungalow in the Liverpool suburb of Croxteth Park, is run by Community Integrated Care (CIC, referred to as the ‘owners’ in this report), a large not-for-profit organisation, and the building is owned by Maritime Housing. The home has three bedrooms, a large lounge and a back garden. The home is not far from bus routes and local shops. Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. This was the first inspection of the home for two years. Last year we completed an Annual Service Review based on information we had about the home. This inspection included an unannounced site visit. We spoke to the Registered Manager and the service users, whose communication is limited, and briefly to two staff. We looked at all parts of the home and examined care plans, medication, fire safety records, financial records and recruitment files. We arranged for some survey forms to be given to relatives but none had been returned by the time we wrote this report. What the service does well: 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. Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 6 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 Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 7 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): 2, 4. Quality in this outcome area is good. Material is available to ensure that prospective service users and their families have information about the home. People are thoroughly assessed and gradually introduced to the home before admission, ensuring that the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Huntsman’s Wood has a service user guide and a Statement of Purpose which have not had to be changed since the last inspection. Over the last year a third person has been introduced to Huntsman’s Wood and is now living there, having previously lived in a nursing home. She came to the house for day visits for several months before finally moving in. The move was only finalised when it was clear that the three people concerned were compatible. Fees are negotiated individually with Liverpool PCT and each service user makes a contribution from their benefits. Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 8 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, 8, 9, 10. Quality in this outcome area is good. Care plans provide staff with the information they need to care for the service users. Service users are involved as far as possible in every aspect of the home’s life. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We examined the case file for the newest person to come to live at Huntsman’s Wood. The file was comprehensive. It included a full pen picture and details of her normal routines for the morning, afternoon and evening. There was a detailed care plan, using a CIC template, that included sections on hygiene, oral care, mobility, moving and handling, continence, eating and drinking. Daily reports are completed though they are not especially detailed. The care plans are reviewed every three months and these were recorded on file. Relatives and other professionals are involved in the major annual reviews. The reviews are recorded and if any changes are agreed then the plan can be readily changed as plans are now stored on the computer. Risk assessments cover all potential risks faced by the people in the home. They are signed by all staff. The people who live in the home have limited communication but the staff make every effort to involve them in decision making by finding out what they want to do and what they enjoy. The essential lifestyle plans contain a lot Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 9 of information about how people communicate and their likes and dislikes. Documentation is securely stored in the office. Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 10 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. Support staff help service users to take part in appropriate activities that they enjoy. Meals meet the individual tastes and needs of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People’s likes and dislikes are set out in some detail in their case files. The service users have limited (though very different) means of communication but are sometimes able to express their views about things they have experienced or which staff suggest to them. One service user went out to the shops with two members of staff when we visited. The staff said that the service user enjoys this sort of trip, which is typical of the kind of everyday activities that the service users enjoy. Activities are tailored as much as possible to people’s individual preferences, to the extent that they are able to express them. One service user, for instance, enjoys going to the pictures and football matches, but the other two would get little from such visits. Other regular activities include swimming and a disco. Families are consulted about individuals’ religious and cultural needs and are met as appropriate. The owners, CIC, provide a holiday budget but this has been reduced recently. If a service user Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 11 wants, for instance, a holiday abroad they would have to pay most of this themselves. Families are closely involved with the people who live at Huntsman’s Wood and they are always made welcome when they visit. One of the service users goes to stay with her family for two of three days of every week. Another was going to spend several days over her 40th birthday with relatives in the south of England. A member of staff was going to accompany her on the trip. We had made survey forms available to relatives but had not been returned by the time this report was written. The service users can have whatever food they choose, though one has a PEG feed. The food of the other two needs to be liquidised and the manager said that if they eat out most cafes and restaurants are happy to help to prepare the food in this way. The staff have established through trial and error the things that the service users most enjoy. Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 12 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, 21. Quality in this outcome area is excellent. Staffing arrangements during a hospital stay ensure that service users are cared for by people with whom they are familiar. Medication is properly administered, ensuring the service users’ safety. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One of the service users had recently been in hospital for several weeks. His care plans had been taken to the hospital and staff from the home had stayed with him in the hospital throughout the day, with the co-operation of hospital staff. This helped to provide a familiar, supportive environment during what might have been a difficult time for the service user. Staff were observed treating the people who live in the home with respect, dignity and genuine affection. Service users have a Health Action Plan on file and are seen regularly by a General Practitioner. Files also record regular check ups by an optician, chiropodist and dentist. One service user had seen a speech therapist and a dietician (after a 30 week wait) and detailed notes about swallowing were on the file. None of the service user have pressure sores but occasionally such problems emerge after a stay in hospital. If this happens the district nurse is called immediately. Medication is kept in a secure, locked cupboard that is fixed to a wall. The community pharmacist provides much of the medication in a monitored dosage system, with tablets in blister packs and pre-printed Medication Administration Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 13 Record (MAR) sheets on which staff record all medication. The pharmacist delivers the medication to the home. The medication we examined during the site visit was accurately recorded. It is important that where medication is to be administered ‘as required’ (PRN) full details of the circumstances in which it is to be given are recorded. This is especially important in Huntsman’s Wood as the people who live there cannot always communicate their feelings. Information on the wishes of the service user and their family is contained in the individual’s file. Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 14 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. Huntsman’s Wood has satisfactory complaints and adult abuse procedures to protect the interests of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: No complaints have been made since the last inspection. The home has a suitable complaints procedure Staff are trained in adult protection issues and the home has a copy of the Liverpool multi-agency adult protection protocol. Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 15 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, 28, 29, 30. Quality in this outcome area is good. The home is clean, well maintained, and on the whole well decorated, providing a homely environment for the people who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: 8 Huntsman’s Wood is a bungalow in a quiet residential area of the Croxteth Park estate in north Liverpool. The building is clean, well maintained, odour free, and well decorated. The bathroom has specialist equipment to enable service users to bathe with dignity and there is lifting equipment to meet their needs. Everyone has their own spacious and comfortable bedroom with a specialist bed. People are able to move around freely in their wheelchairs, as the bungalow is quite spacious and uncluttered. Patio doors lead from the lounge on to the large back garden. The tall trees in the wood at the back of the home do make the rear of the house rather gloomy at times but the council has so far refused to thin them out. Since our last inspection the kitchen units and tiling have been replaced, so the kitchen is bright and modern. There is also a new sofa in he lounge. The interior is redecorated every three years and the service users can choose, to their best of their ability, the colour scheme. Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 16 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, 33, 34, 35, 36. Quality in this outcome area is good. Staff recruitment and training procedures help to ensure that well trained staff are available to meet the needs of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Six support staff, including the manager, work at Huntsman’s Wood. There is a vacancy and where necessary any gaps in the rota are being covered by a bank worker (who used to work in the home and is now training to be a nurse). One new member of staff has started since the last inspection. There was evidence in the home that all of the proper checks had been carried out on the staff before they were employed, though some of the actual documents, such as the CRB certificate, are kept in the local CIC office. Only one reference was on file and the manager said that the central office would be pursuing the second one (whose name was on the application form). Applicants are interviewed by the manager in the home so that they can meet the service users before they are offered a job. The rota provides for three members of staff at all times during the day, with one member of staff on duty at night. When one of the service users is away the daytime staffing is reduced to two. The manager said that experience, and assessment of the service users’ needs, shows that one support worker is adequate at night but this does need to be kept under review. Three of the staff have NVQ2 or above (the manager has NVQ4) so the home meets the standard for 50 of staff to have this Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 17 qualification. Two of those without NVQ have been put forward for training by the manager. Recent training has included Safeguarding Adults (POVA), ‘Eating with dignity’ and Moving and Handling. The ‘Eating With Dignity’ training is to be provided by a speech therapist and will be attended by the service users (if they wish) and some relatives. The manager and staff have access to CIC’s training facilities as well as courses run by outside organisations, such as the city council. Training planned for the immediate future includes Basic Food Hygiene, the Protection of Vulnerable Adults, Dental Health Awareness and First Aid. The manager is a moving and handling trainer and an NVQ assessor. All staff have been trained to use the PEG feed system. It is important that the impetus of training is maintained and that all staff get the opportunity to obtain NVQs. Staff receive one to one supervision with the manager every two months and these sessions are recorded. Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 18 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. The home is well managed. Up to date safety checks help to maintain a safe environment for the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager has an NVQ4 and is experienced in supporting disabled people and managing homes like Huntsman’s Wood. Regular audits of policies and procedures are carried out as part of a rolling programme of quality assurance. The service manager (senior management) carries out regular visits in accordance with Regulation 26 and produces reports of her visits. Periodically a different service manager does the visit to give a different perspective and a degree of quality control. Annual questionnaires are sent out to relatives and the results are compiled on a national basis. Feedback from relatives is received informally as well. The costs of the vehicle used by the home is shared between the three people who live there. Service users’ savings are kept in a central account and a record is kept of how much each person has. Interest is divided on a pro rata basis. The home itself keeps a record of individual savings. A record is also kept of any money spent from Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 19 personal allowances. This system operates in all CIC homes has been notified to a CSCI Regulation Manager. Fire safety records were up to date and up to date gas and electrical safety certificates were in place. Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 3 5 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 3 33 3 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 4 3 3 3 3 3 3 x 3 3 x Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 21 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. 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. Refer to Standard Good Practice Recommendations Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection North West Region CSCI Preston Unit 1 Tustin Court Port Way Preston, PR2 2YQ 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 Huntsmans Wood (8) DS0000025286.V366168.R01.S.doc Version 5.2 Page 23 - 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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