Care Home: Manor Place (60)

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What the care home does well The service is provided to meet the needs of people who have autism and as such all routines, activities and planning are thought through with the specific needs of the residents in mind. Residents are supported to use local facilities on a regular basis. There is a good emphasis on residents using and developing their independent living skills and residents gave examples of how they are making choices about their lifestyle and making choices in the running of the home. Residents are well supported to remain healthy and staff are supporting them to attend health appointments on a regular basis. Staff also support the residents with their emotional needs. The staff team is small and all staff have worked at the home for a number of years. Residents have therefore had the opportunity to form relationships with the staff and staff have got to know the residents needs well. The home is nicely presented, well maintained, clean and safe. What has improved since the last inspection? The manager has started to provide staff with supervision meetings. This gives staff the chance to discuss ways of working, to look at ways of developing the service and to improve their practice. The manager has carried out risk assessments so at to give staff guidelines on how to support the residents with any issues which include taking some risk. What the care home could do better: The quality of care planning could be improved so as to clearly show what the needs of the residents are and how these are to be met. A system for checking on the quality of the service should be used and this should include seeking the views of the residents. CARE HOME ADULTS 18-65 Manor Place (60) 60 Manor Place Bromborough Wirral CH62 4TX Lead Inspector Debbie Corcoran Key Unannounced Inspection 16th October 2007 4:00 Manor Place (60) DS0000018994.V347339.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 Manor Place (60) DS0000018994.V347339.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. Manor Place (60) DS0000018994.V347339.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Manor Place (60) Address 60 Manor Place Bromborough Wirral CH62 4TX 0151 645 5761 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) pat.hood@was.demon.co.uk Wirral Autistic Society Patricia Sarah Anne Hood Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Manor Place (60) DS0000018994.V347339.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 2 service users to include:*up to 2 service users in the category of LD (Learning Disability) 13th February 2007 Date of last inspection Brief Description of the Service: 60 Manor Place is a small home registered to provide care for up to two people with a learning disability. The service is provided by Wirral Autistic Society. The house is a semi-detached two storey property, with single bedrooms and a shared bathroom. The house has a large garden / orchard that is fully accessible. The home is situated in a residential area in Bromborough Pool Village. Local amenities include a sports centre and leisure facilities, transport, public houses, entertainment complexes and various shops. The current range of fees for living at Manor Place are between £927 and £936.27 per week. Manor Place (60) DS0000018994.V347339.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit to the home was not announced beforehand. An expert by experience also attended the inspection. The expert spent time talking with the residents and finding out about their experiences. Their findings have been used to inform the findings of the inspection. During the visit both of the people living at the home were met and spoken with. The manager and a member of the staff team were spoken with. Care plans, health and safety records and other relevant records were examined in some detail. A tour of the home was carried out which included all areas. The manager of the home returned a quality assurance assessment to CSCI prior to this the visit and some of the information in this has been used to inform the inspection. What the service does well: The service is provided to meet the needs of people who have autism and as such all routines, activities and planning are thought through with the specific needs of the residents in mind. Residents are supported to use local facilities on a regular basis. There is a good emphasis on residents using and developing their independent living skills and residents gave examples of how they are making choices about their lifestyle and making choices in the running of the home. Residents are well supported to remain healthy and staff are supporting them to attend health appointments on a regular basis. Staff also support the residents with their emotional needs. The staff team is small and all staff have worked at the home for a number of years. Residents have therefore had the opportunity to form relationships with the staff and staff have got to know the residents needs well. The home is nicely presented, well maintained, clean and safe. Manor Place (60) DS0000018994.V347339.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. Manor Place (60) DS0000018994.V347339.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 Manor Place (60) DS0000018994.V347339.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. Information on the services and facilities at the home is available to enable prospective residents to make an informed choice about living there. Although not practically assessed, systems are in place for ensuring an assessment of needs is carried out for new residents before admission to the home. EVIDENCE: A copy of the home’s statement of purpose was not available at the time of the visit. The manager forwarded this following the visit. A service user guide is in place in the form of an information leaflet. This should be produced in formats suitable to the needs of the people using the service. Standard 2 is a key standard to be assessed however, there have been no new residents to the home for a number of years and it therefore could not be practically assessed. Wirral Autistic Society do have assessment documents to be used when a person has been identified to move to the home. At the last inspection the manager was been able to provide a good level of information on the referral, assessment and introductory procedures which would be put into action for any new resident. This included describing the assessment Manor Place (60) DS0000018994.V347339.R01.S.doc Version 5.2 Page 9 process, the inclusion of the prospective resident and where appropriate their representative, the referring agency and any specialist input. Each of the residents has a contract with the home which describes the conditions of their residency. These have been signed by the resident and or their representatives were appropriate. Manor Place (60) DS0000018994.V347339.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, 8, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each of the residents has an individual plan. These provide information on the person’s needs. Risks to the safety and well being of people living at the home are assessed and plans are put in place to manage these. Residents are encouraged and supported to make their own decisions and to participate in decision making in the home. EVIDENCE: Each of the residents has a care plan. These are referred to as a ‘profile’ or ‘review’ and this can be misleading. The ‘profile’ includes information on the person’s likes and dislikes, skills and needs and covers areas such as the person’s religious and cultural needs, communication skills, social interaction, personal care skills, independent living skills and health and medication needs. Manor Place (60) DS0000018994.V347339.R01.S.doc Version 5.2 Page 11 Each resident also has a plan referred to as ‘care plan’ and this is based solely on identifying targets for the person’s development and is somewhat limited. It is strongly recommended that the manager reviews the care planning documentation in order to ensure a clear care planning system is in place. When appropriate, guidelines for supporting a resident with particular challenges or needs are included in their records. Residents have a comprehensive review of their support on an annual basis. Where a resident is involved in activities which pose a risk to their safety then a risk assessment is carried out. The risk assessments cover different aspects of the persons support. The risk assessments include information on what the potential risk is and what steps need to be taken to prevent the risk from occurring. Risk assessments were not dated and therefore it was not possible to determine when they had been completed, whether or not the information in them was up to date and the frequency at which it had been reviewed. Residents are encouraged to make choices as to the running of the home and are making their own decisions as to their daily support. Residents have meetings with staff about the home. During discussions with residents they confirmed that they are using and developing their independent living skills. This was further evidence of this in their daily records. Examples of this are that residents are encouraged and supported to carry out housework tasks, to prepare a shopping list and do the weekly shopping, to prepare and cook meals on a regular basis. Manor Place (60) DS0000018994.V347339.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): 11, 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. Residents are supported with their personal development and supported to pursue social and leisure activities and use the local community. Residents are encouraged to choose their food and meals and are encouraged to eat a healthy balanced diet. EVIDENCE: From discussions with residents and it is clear that they are well supported in using and developing their independent living skills. For example residents are supported to manage their own matters where possible and to shop, cook and carry out household tasks. During discussions with residents they described a lifestyle of going out socially on a regular basis and having a clear weekly routine of leisure and educational activities and using local community resources on a regular basis. Residents described lots of indoor activities and interests which they pursue. Manor Place (60) DS0000018994.V347339.R01.S.doc Version 5.2 Page 13 Relationships are encouraged and this was confirmed during discussions with the residents. Residents are encouraged to develop and maintain relationships in day centres, social groups and in using community facilities. The manager reported that the support provided to residents is ‘person centred’ whereby the individual resident is at the centre of determining how they are supported and what their lifestyle is. Residents and staff are reported to have regular ‘house meetings’ to discuss the running of the home and resident’s records included a ‘decision making consent form’ which is a form completed with each of the residents to show that they have been consulted on and agree with how they are supported with issues such as self administering medication, managing their own money, going out on their own, staying in on their own, cooking on their own, who they wish to attend review meetings. These agreements are reviewed on a regular basis. Residents are encouraged to make choices of meals and food and are involved in planning meals, shopping for food and food preparation. There was a good supply of fresh food and fresh fruit available at the time of the visit. Manor Place (60) DS0000018994.V347339.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. Residents are well supported with their health and physical care needs and with their emotional well-being. Medication is managed appropriately. EVIDENCE: Residents records include information as to how to support the person with their physical, emotional and personal care needs. It is recommended that this information is clearly documented in a care plan. Residents are supported with healthy living and exercise and are supported to maintain a healthy balanced diet. Records indicated that residents are supported to attend regular health related appointments. Residents are supported to visit a General Practitioner or district nurse when this is required and are supported to visit a dentist, optician etc on a regular basis. This information is well documented. Manor Place (60) DS0000018994.V347339.R01.S.doc Version 5.2 Page 15 Policies and procedures are in place for the receipt, storage, administration and disposal of medications and Staff have been provided with medication training. Medication storage and administration was checked for one of the residents and was found to be appropriate and safe. Manor Place (60) DS0000018994.V347339.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. Staff act upon the views and wishes of the residents. Policies, procedures and practices are in place to safeguard the residents. EVIDENCE: The home has a complaints procedure which is time scaled appropriately and includes contact details for the Commission. Residents have been informed of how to make a complaint and confirmed that they know who to speak to if they are not happy. Residents feel that care staff listen to what they say and act on this. There have been no complaints or adult protection issues at the home. A policy and procedure for adult protection was available. A copy of Wirral Social Services adult protection procedures were also available. The manager has been provided with training in adult protection but none of the care staff team have been provided with this. The manager reported that this training has been booked for all staff. A record of key events is maintained for example incident reports and accident reports. These were checked and found to be appropriate and raised no particular issues. Manor Place (60) DS0000018994.V347339.R01.S.doc Version 5.2 Page 17 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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a well presented, well maintained, safe and clean environment for residents. Each resident has their own room and these are personalised. Health and safety precautions are taken to protect residents and staff. EVIDENCE: The home is in keeping with others in the area and is an ordinary domestic property. The home provides adequate space and there are gardens areas both at the front and rear. There is one lounge area and a dinning area. The presentation of the home is good and all areas were found to be well maintained. Décor, furniture and fittings were all of a good standard. Each of the residents has their own room and these were noted to be personalised with the resident’s own belongings. The home has health and safety practices and procedures. These are aimed at ensuring the home is safe and clean and free from hazards to the health and safety of residents and staff. Manor Place (60) DS0000018994.V347339.R01.S.doc Version 5.2 Page 18 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by a small well established staff team who have been provided with a good level of training. EVIDENCE: During discussions with residents they gave good feedback on the staff team. Staff are supporting the aims and objectives of the home in encouraging residents to make choices, develop their independent living skills and use their local community. The staff team is small and well established. The 3 members of care staff on the team have worked at the home for a period of between 3 years and 8 years. There have been no new recruits for over 3 years and therefore recruitment practices were not assessed on this occasion. However, as at the previous inspection the manager was informed that evidence of staff recruitment should be maintained at the home. Manor Place (60) DS0000018994.V347339.R01.S.doc Version 5.2 Page 19 Staff training records were not available during the visit. However there have been no new members of staff to the home since the last inspection visit when it was noted that staff had been provided with good training opportunities and in topics such as; as first aid, moving and handling, supporting people who have autism, communicating with people who have autism, equal opportunities and behaviour management. As there was no access to staff training records it could not be determined how up to date some of the training is. The manager should carry out an audit of staff training and ensure that all staff have up to date training. A copy of the audit should be forwarded to CSCI. Two out of the three members of staff on the team have attained a National Vocational Qualification (N.V.Q) in care. During discussions with residents they gave good feedback on the staff team and a member of staff appeared to listen to what the residents wanted and respond to this. There has been some progress in providing staff with regular one to one supervision meetings and staff have recently undergone an annual appraisal. The manager should however review the frequency of staff supervision meetings so as to ensure that staff have the opportunity of formal supervision six times per year to meet the national minimum standards. Manor Place (60) DS0000018994.V347339.R01.S.doc Version 5.2 Page 20 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, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and is run in the best interests of the residents. Procedures, practices and checks are in place which aim to safeguard and protect the health and safety and well being of residents and staff. EVIDENCE: The registered manager of the home has worked for Wirral Autistic Society for over 23 years. The manager reported that she is near completion of an National Vocational Qualification (N.V.Q) level 4 qualification. There was little evidence available to indicate that a quality assurance system is in use. There were only old and infrequent quality assurance visit reports available. Quality assurance should include seeking the views of residents and staff as to the quality of the service provided. There was little evidence that Manor Place (60) DS0000018994.V347339.R01.S.doc Version 5.2 Page 21 this is taking place. It is recommended that a quality assurance system is introduced which involves seeking feedback form residents. The home has numerous policies and procedures in relation to the health and safety of residents and staff and staff are provided with training in core health and safety related skills. Fire safety and health and safety practices are adopted. Records of fire and health and safety checks were checked and found to be up to date. Manor Place (60) DS0000018994.V347339.R01.S.doc Version 5.2 Page 22 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 3 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 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 2 X X 3 x Manor Place (60) DS0000018994.V347339.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 YA23 Regulation 13 (6) Requirement Staff must be provided with training in adult protection so as to safeguard residents. (Previous requirement not met) Appropriate evidence of the staff recruitment and selection procedures must be available at the home so as to demonstrate that these procedures protect residents. (Previous requirement not met) A quality assurance system must be introduced which measures success in achieving the aims and objectives of the home. Timescale for action 16/12/07 2. YA34 17 (2) schedule 2 16/11/07 3. YA39 35 16/12/07 Manor Place (60) DS0000018994.V347339.R01.S.doc Version 5.2 Page 24 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 YA6 Good Practice Recommendations The manager should review the current system of care planning and consider introducing a new system which makes explicit what the needs of the residents are and how staff need to meet these. Records should be signed and dated appropriately. The manager should carry out an analysis of staff training in order to ensure that all staff have relevant up to date training. A copy of this should be forwarded to CSCI. The manager should ensure that staff are provided with regular, recorded supervision meetings. 2. 3. YA6 YA35 4. YA36 Manor Place (60) DS0000018994.V347339.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Merseyside Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Manor Place (60) DS0000018994.V347339.R01.S.doc Version 5.2 Page 26 - 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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