Care Home: Oxford Road

Similar services:

• Clover House
• Parkside
• Park Lodge
• Mere Hall View
• St Bonaventures
• Hudson Road
• Whitewalls
• Home Farm

What the care home does well Students needs are assessed before a decision about them moving into the home is made to ensure that it is the right place for them to live. Care plans, which have been developed for each of the students, describe the support that they need to help them make choices and decisions and take responsible risks as part of an independent lifestyle. Students personal and healthcare needs are recorded, understood and met to ensure that they stay well.Students have the information and the help that they need to complain and make sure they are safe from abuse or neglect. The commission have not received any complaints about the home since the last inspection. The service employs people of various age and gender and from different ethnic groups. Available at the home was an equal opportunities policy and procedure, which promotes equality for all. Staff are involved in an ongoing programme of training, which is relevant to the work that they carry out including NVQ in Care Level 2 or above. A good set of polices and procedures were available at the home. The polices provided clear information which help staff make the right decisions and take actions which are law and in the best interests of the residents. The procedures clearly described the steps that people need to take to fulfil the policy. Records that were examined at the home were well organised, up to date and accurate ensuring that residents health, safety and welfare are safeguarded. What has improved since the last inspection? Some bedrooms have been redecorated and items of furniture, which were showing signs of wear and tear, have been replaced to ensure the comfort and dignity of students. A pharmacist now prints items of prescribed medication and the instructions for administering the medication onto the MAR sheet. What the care home could do better: All assessments should be fully completed in detail to ensure that all the information is available to decide if the persons needs can be met at the home, and so that a care plan can be put together which reflects those needs. Staffing arrangements at night must be reviewed to enable students more choice and freedom after 10pm at night. More appropriate ways of managing residents money should be introduced which ensure their privacy, dignity and independence. Where appropriate students should be supported to manage their own finances with the assistance from staff. Comments made by students showed that although there are good activities at the home they would like more games, a computer room, a snooker table, to go to the cinema more and to play more football.Students reported that they sometimes go with staff for the shopping, some students where unsure where the food was brought. Students should be more involved in shopping for food and given a choice of food at meal times and as part of an independent lifestyle. Parts of the home identified in the report should be repaired, cleaned or replaced to ensure the comfort and dignity of the students. The basement, which was previously used by residents, is currently out of use following a recent flood. The basement which consists of several rooms should be repaired and appropriately equipped to provide residents with more shared space for social gatherings, leisure and recreational activities at the home. All toilets in the home should be in a good state of repair and made available for students to use. CARE HOME ADULTS 18-65 Oxford Road 39 Oxford Road Birkdale Southport Merseyside PR8 2EG Lead Inspector Mrs Janet Marshall Unannounced Inspection 11th October 2007 03:00p Oxford Road DS0000005361.V348362.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 Oxford Road DS0000005361.V348362.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. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oxford Road Address 39 Oxford Road Birkdale Southport Merseyside PR8 2EG 01704 564595 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) Speciality Care (REIT) Homes Ltd Vacant post Care Home 16 Category(ies) of Learning disability (16) registration, with number of places Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 16 LD That the registered providers, Speciality Care (Rest Homes) Ltd do not rent, sub-let or otherwise use or permit the use of the registered premises to accommodate overseas students, staff or other persons Date of last inspection Brief Description of the Service: The home is a large detached Victorian property in Birkdale, Southport that has places for up to sixteen young people (16-25 yrs old) with learning disabilities. All are students at Arden College. Students must attend Arden College to use residential services. The company running the home and the college is called Speciality Care Homes Limited and it is a private company. Each student has their own bedroom and share 3 lounges, 1 kitchen and 4 shower/toilet areas. There is a large garden to the rear of the property, which is well maintained and used by the Colleges gardening course students. There is parking to the front of the property, both on the forecourt and on the street. The home has good access to public transport to Southport, Liverpool and Preston. It is about 5 minutes drive from Southport town centre and there has good access to leisure & shopping facilities. The fees for the home range from £29,722 up to £65,868 for a 38 week a year placement. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection visit (site visit) at the home this inspection year. The inspection visit was unannounced and took place over one day for a total of 8 hours. An Expert-by-Experience also assisted in the inspection process. An Expert-by Experience is a person who because of their shared experience of using services and/or ways of communicating visits a service with an inspector to help get a picture of what it is like to live in or use the service. This was a key inspection. The Commission considers 22 standards for Care Homes for Adults as Key Standards, which have to be inspected during a Key Inspection. The report has been put together using information gathered from a number of sources including information that the commission have received about the service since the last inspection and details provided in the Annual Quality Assurance Assessment (AQAA). The AQAA, which is in two parts, a selfassessment and dataset, has replaced the pre-inspection questionnaire. The document, which was sent out to, the service was completed and returned to the commission before the site visit took place. A number of surveys were sent out to people as part of the inspection seven service user surveys were returned, comments from them have been used in the report. The inspection also involved an unannounced visit to the home (site visit). Records that were examined, students comments and observations made during the visit have also been used as evidence for the report. A number of residents were case tracked. This process involved talking to staff, looking at the environment and a selection of residents records such as assessments, care plans and daily notes to get an idea about peoples experiences and to find out if they are receiving the care and support that they need and which have been agreed by their representatives. What the service does well: Students needs are assessed before a decision about them moving into the home is made to ensure that it is the right place for them to live. Care plans, which have been developed for each of the students, describe the support that they need to help them make choices and decisions and take responsible risks as part of an independent lifestyle. Students personal and healthcare needs are recorded, understood and met to ensure that they stay well. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 6 Students have the information and the help that they need to complain and make sure they are safe from abuse or neglect. The commission have not received any complaints about the home since the last inspection. The service employs people of various age and gender and from different ethnic groups. Available at the home was an equal opportunities policy and procedure, which promotes equality for all. Staff are involved in an ongoing programme of training, which is relevant to the work that they carry out including NVQ in Care Level 2 or above. A good set of polices and procedures were available at the home. The polices provided clear information which help staff make the right decisions and take actions which are law and in the best interests of the residents. The procedures clearly described the steps that people need to take to fulfil the policy. Records that were examined at the home were well organised, up to date and accurate ensuring that residents health, safety and welfare are safeguarded. What has improved since the last inspection? What they could do better: All assessments should be fully completed in detail to ensure that all the information is available to decide if the persons needs can be met at the home, and so that a care plan can be put together which reflects those needs. Staffing arrangements at night must be reviewed to enable students more choice and freedom after 10pm at night. More appropriate ways of managing residents money should be introduced which ensure their privacy, dignity and independence. Where appropriate students should be supported to manage their own finances with the assistance from staff. Comments made by students showed that although there are good activities at the home they would like more games, a computer room, a snooker table, to go to the cinema more and to play more football. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 7 Students reported that they sometimes go with staff for the shopping, some students where unsure where the food was brought. Students should be more involved in shopping for food and given a choice of food at meal times and as part of an independent lifestyle. Parts of the home identified in the report should be repaired, cleaned or replaced to ensure the comfort and dignity of the students. The basement, which was previously used by residents, is currently out of use following a recent flood. The basement which consists of several rooms should be repaired and appropriately equipped to provide residents with more shared space for social gatherings, leisure and recreational activities at the home. All toilets in the home should be in a good state of repair and made available for students to use. 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. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 8 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 Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 9 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Students needs are assessed before a decision about them moving into the home is made, however assessments for some people lacked information, which is needed to show that their needs will be fully met there. EVIDENCE: Most of the students were placed at the home in September of this year. The AQAA showed that before a student is accepted and offered a place a full assessment is carried out. Assessments for four students were looked at in detail as part of the case tracking process. Their files included assessments carried out by previous carers, schools and local social and healthcare authorities. Those that were looked at were detailed and covered things such as students likes and dislikes, personal care and support, educational needs, independence training, social and medical needs. Information given in the AQAA and discussion with the manager during the inspection showed that part of the assessment process before students are placed at the home involves a five day residential assessment which takes place at an assessment unit which is linked to Arden College and located close to 39 Oxford Road. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 10 A selection of completed assessments, which were carried out by staff at the assessment unit, was looked during this inspection visit at as part of the case tracking process. Some were more detailed than others. Those that were detailed included a good amount of information about students skills and areas of need such as independence, communication and behaviour. There were however some which provided very little information and others had some sections, which were incomplete. The manager was advised to ensure that all assessments are fully completed in detail so that they have available all the information that is needed to decide if the persons needs can be met at the home, and to enable them to put together a care plan which reflects those needs. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Students are not given maximum opportunities to exercise choice and control over their own lives, which compromises their independence. EVIDENCE: Each of the students had a care plan which were kept securely in the office. The manager said that students are able to see them whenever they ask. Examination of a selection of care plans showed that they have been put together using information gathered from pre – admission assessments. Care plans viewed covered the persons likes and dislikes, goals and aspirations and how best to support them with things such as communication, interests and hobbies, education and independent living skills. The manager explained that the plans, which were quite basic, would be further developed on an ongoing basis as part of the reviewing process, which the manager advised usually, begins approximately six weeks into the placement. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 12 None of the students spoken with during the inspection understood what a care plan was or how they are used to influence their care. This was discussed with the manager who said that she and the staff team are working closely with students to promote their understanding and involvement in their plans of care, a process that they were not familiar with prior to moving into the home several weeks ago. Person centred plans were not mentioned either in the AQAA or by people during the inspection visit. Consideration should be given to implementing more Person Centred Plans as a way of supporting people to have more choice and control over their own lives. Person centred planning would also give students the opportunity to invite who they choose to a meeting about themselves, something they said is not currently happening. The AQAA and discussion with the manager during the inspection did however show that regular student reviews will take place and students, their family/carers, social workers and other professionals will be invited to attend. The manager explained that this process has not yet begun due to the short period of time that the students have been living at the home. The AQAA showed that students are supported to make choices and decisions. Examples of how this is done included the use of total communication (symbols, pictures, speech, written word and signing) to aid students to make choices and decisions and the use of communication passports on individuals showing their preferred choice of communication, their likes and dislikes. Examples of these were seen during the inspection visit. During discussions none of the students were able to give an example of choices they make although college meetings where referred to when progress and opportunities to try new things were discussed. During the inspection visit students were given some choice about leisure activities however those choices were limited because of things such as what was on offer, cost, staff support time, numbers wanting to go, space in vehicles etc. Surveys completed by students showed that they are involved in making decisions in the home. During the inspection visit students were observed preparing for bedtime. One man wanted to spend time answering questions however a member of staff told him he wouldn’t have time he would have to have a shower before bed. The manager reported that all students have to be ready for bed and in their rooms by 10.00pm each night when the evening staff team leave and 2 night duty staff begins. Other than the bathrooms students are unable to use any other parts of the home after this time. The reason given for this was that there are only two night staff on duty throughout the night, each monitoring one of the two floors were students bedrooms are located. Staffing arrangements at night must be reviewed to enable students more choice and freedom after 10pm at night. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 13 Some students are responsible for managing small amounts of their own money, larger amounts for all students are managed by either a senior member of staff or the manager of the home. Care plans, which were viewed, included information about the help that students need to manage their money. Students money and records, which were held by the home, were checked and found to be in good order. The home had available a number of policies and procedures for ensuring the protection of students finances. Some procedures, however which were carried out during the inspection, undermined students independence, privacy, and dignity. For example students collected and discussed their money in the office whilst other students and staff were present. This practice was discussed with the manager who was advised to look at alternative ways of managing residents money so that they their privacy, dignity and independence is fully promoted at all times. A member of staff appeared to have little understanding of the concept of people being supported to manage their own money. Students should be supported to manage their own finances with the appropriate assistance from staff. Risk assessments were part of each students care plan. Risk assessments are important so that students can take risks as part of an independent lifestyle. Risk assessments were available for students for such things as travelling, handling money and activities both inside and outside the home. Risk assessments for four students were looked at. They detailed activities, which pose a risk to the student and information about the support that staff need to provide to enable them to take risks safely. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 14 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, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Students are involved in a range of activities both in and outside the home, although more activities could be offered to satisfy the needs of students. EVIDENCE: Each student had a care plan that showed the level of support and how best to support them with tuition. Their likes and dislikes, interests and hobbies were also part of their care plans. The AQAA and discussion with the manager showed that all students attend Arden College Monday to Friday supported by staff. A selection of records which were viewed during the inspection visit showed that weekly tutorials are held both at college and at home and involve students to enable them to discuss their timetable. One student described this as an opportunity to discuss ‘how I’m getting on’ Individual targets are set for students both at college and at home so that there progress can be consistently monitored. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 15 None of the students reported having work experience. During discussion students said they would like to have work experience. Staff should help students with this so that they are given the opportunity to experience and develop employment skills. Students said that they are given opportunities to do various things during the evening, however flexibility was limited on the evening of the inspection visit and dependant on staff support. Comments made by students showed that although there are good activities at the home they would like the following, more games, a computer room, a snooker table, to go to the cinema more and to play more football. Students reported being supported to go for personal shopping at the weekend. Evening and weekend activities are mostly in groups. People appeared to enjoy the activities on offer, for example, drives out in the van, bowling, walks round to the local shop and a walk round the block. Students said they had enjoyed a recent trip to Blackpool. A mid week disco, meeting other learning disabled people is a regular event. However time constraints means there is a limitation on staying much later than 9.00pm. People reported being able to try things at college and from the rota. Three students go to church, staff were unsure if they would be able to support more, another person expressed an interest in going to church. Arrangements should be made to enable staff to support those students who wish to attend church. People reported keeping in touch with friends and family when they go home at end of terms. One person took a call from her Father during the inspection. The AQAA and discussion with the manager showed that regular contact is kept with students family and carers and visitors are welcome at the home. The AQAA and records viewed at the home showed that students are encouraged to take part in the daily upkeep of their home to promote independence. During the inspection they were seen helping with domestic tasks such as laundry, cleaning and cooking. It was observed during the inspection that most tasks needed confirming or recorded or some equipment or resources collecting from the office, this might impact personal responsibility and power. All control or decision making appeared to happen around the office. The ‘house tasks rota’ was displayed using pictures and/or symbols Velcroed to different people and their staff supporters. Throughout the inspection students were observed referring to this, however it was noted that the rota was too high for some students to reach and kept in a narrow busy space and some of the pictures were not understood by students. A photo relating to the house equipment or person doing task the may be more helpful. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 16 Students reported opening and keeping personal mail and being able to talk with staff Students are provided with a key to their room although one student reported having a key but it was lost, he said it hadn’t been replaced for him. The student should have his key replaced to promote his independence. A student said that staff knock before entering his room and he liked to keep his door open. His room appeared personal to him with his local team logo and family photos, although he did say he wasn’t allowed to put pictures up on his wall. There appeared to be limited opportunities to develop home cooking skills. People reported the food being ‘OK’ and “you can have seconds” Surveys completed by six students showed that they like the food one student reported not to like the food. On the evening of the inspection all the students had their meal together at the same time in the dining room. The meal, which was sampled, was served warm. The AQAA showed that varied menus with a choice of food are available although on the evening of the inspection no choice was offered. A student said, “You can ask staff if you want a drink”. Sometimes people go with staff for the shopping if they are on the rota, some students where unsure where the food was brought. Students should be more involved in shopping for food and given a choice of food at meal times and as part of an independent lifestyle. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 17 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. Students personal and healthcare needs are understood and met. EVIDENCE: Pre admission assessments and care plans, which were looked at, showed that students health and personal care needs are assessed and well supported. Discussion with the manager and examination of healthcare records show that the process of registering students with local GPs and other healthcare services is well underway involving students. Each students care plan included a section for recording and monitoring their general and specialist healthcare needs. Care plans, which were viewed, detailed students health, personal care and support needs The AQAA showed that staff support students with healthcare appointments and that they are aware of the importance of students dignity, ensuring personal care is carried out in the privacy of the students own room or a bathroom Students are given choices for personal care for example the choice of male or female support and are encouraged to carry out their own personal care and are given help where needed. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 18 They are encouraged to make choices about what clothes they wear, whether to take a bath or shower. What time students go to bed is determined by night staff arrangements. The manager explained that two waking night staff commence their shifts at 10pm and at this time all students have to be in their rooms. This is because the two night staff sit on each of the 2 landings were students bedrooms are located and because of this there is not sufficient support for students to occupy other communal parts of the home after 10pm each evening. The manager said that medication is only administered by staff once they have completed the appropriate training. Medication provided by boots the Chemist with printed medication administration record (MAR) sheets. Medication was kept in a lockable cabinet. Medication and MAR sheets where examined and found to be in good order. A recommendation was given as part of the last inspection to ensure that all Medication administration records be recorded safely to ensure the safety of students. This was because some items of prescribed medication and instructions for administering them had been handwritten onto MAR sheets by one member of staff at the home and all handwritten information should be checked and signed for by two staff members to ensure that the information is correct. The supplying pharmacist printed all MAR sheets, which were examined during this inspection visit. Each of the students have a healthcare book which described feelings, healthcare needs, body parts and other medical information to enable students to communicate how they feel, or if they have pain or if they wish to see a doctor. The books are put together using pictures, symbols and large clear print to help students understand the information. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 19 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. Students have the information and the help that they need to complain and make sure they are safe from abuse or neglect. EVIDENCE: There has been no complaints received by the Commission about the home since the last inspection. Information provided in the AQAA and discussion with the unit manager and the students showed that there have been no complaints made at the home in the last 12 months. The AQAA showed that available policies and procedures are in place at the home to protect students from abuse, harm and neglect Pictorial policies and procedures, which were on display in the main hall way included how to complain, talk about bullying, abuse and being scared. Some of the information was displayed too high for students to see this should be repositioned making it more accessible to them. The AQAA and a selection of staff training records, which were looked at showed, that staff attend POVA training The AQAA stated that students attend weekly tutorials where they are encouraged to give their views on college, the home, staff and other students. All students families and carers given information on how to complain if they wish to. All surveys completed by students showed that they know who to speak to if they are unhappy. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 20 A copy of the local authorities protection of vulnerable adults procedure was avaialbe at the home. The AQAA and a selection of staff training records which were looked at showed that all staff that work at the home have completed protection of vulnerable adults training. Completted surveys showed that all students feel safe at the home. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 21 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 & 30 The quality outcome in this area is adequate. This judgement has been made using available evidence including a site visit. Parts of the environment need to be improved to enhance the comfort and dignity of the students. EVIDENCE: The home is a large detached Victorian house on a popular road in Birkdale, Southport close to the town centre. There is a large driveway at the front of the house and a large garden at the back. The home is close to shops, pubs and other community facilities including transport links such as bus stops and the train station. During this inspection visit all communal parts of the home and a selection of students bedrooms were viewed. A number of bedrooms have been redecorated since the last inspection. Carpets in the communal lounges were worn and heavily stained in parts and radiator covers in the lounges were damaged and worn in most parts. These should be repaired, cleaned or replaced to ensure the comfort and dignity of the students. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 22 Other than their own rooms residents have use of just two lounges, which are both situated, across the hall from each other on the ground floor. The lounges both had TVs and each had a couple of 3-4 seated sofas. The sofas in both lounges were very dirty and worn and there didn’t appear to be enough seating for everyone to sit in. The sofas should be cleaned or replaced to ensure the comfort and dignity of the students. The basement, which was previously used by residents, is currently out of use following a recent flood. The basement which consists of several rooms should be repaired and appropriately equipped to provide residents with more shared space for social gatherings, leisure and recreational activities at the home. There were two toilets situated close to the office one displayed a sign for students and the other for staff use only. The students toilet was dark, the light bulb was not working. The toilet smelt unpleasant, the floor was soaked in urine and the toilet had no seat. The lock on the door did not work from inside. The staff toilet, which was locked, and a key kept in the office was clean and well equipped. Discussion took place with the manager about the practice of using separate toilets for students and staff the reason given for this practice was ‘that this is how it has always been’ the manager was advised review this arrangement and arrange for the necessary improvements to one toilet so that students have the use of all the toilets in their home. Detailed in the AQAA were a number of policies and procedures for ensuring a clean and hygienic environment for all. Related policies and procedures, which were also seen at the home included, Infection control, the use of protective clothing and disposal of waste. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 The quality outcome in this area is adequate. This judgement has been made using available evidence including a site visit. Staff recruitment and training procedures ensure that students are well supported and protected. EVIDENCE: The AQAA showed that there are thirteen care staff and the manager working at the home. Discussion with the manager showed that there are a number of staff vacancies, she reported most if them have been filled by new staff that are expected to start work at the home as soon as CRB clearances have been obtained. Permanent staff as overtime and agency staff are currently covering vacant shifts. The staffing rota, which was viewed, showed that there are a minimum of six support staff on duty throughout the day and evening and two waking night staff. There was an equal opportunities policy and procedure available at the home. The AQAA showed that the service employs people of various age, gender and ethnicity. The manager confirmed that a number of new staff have started work at the home since the last inspection. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 24 The AQAA showed that the service carry out strict checks before allowing people to start work at the home. Examination of a selection of staff personnel files for new staff showed that references and CRB checks were carried out before they started work at the home. The AQAA showed that four staff have achieved an NVQ in care Level 2 or above and another member of staff is working towards it. Records seen at the home showed that training records are kept for all staff. Discussion with staff on duty and the AQAA showed that staff were inducted into their role and that they have completed mandatory training in moving and handling, food hygiene, first aid and fire awareness and protection of vulnerable adults. Information provided in the AQAA and discussion with staff showed that they receive regular “one to one” supervision from the manager and a record is kept of things discussed and regular staff meetings are held and minutes of the meetings are kept. Surveys completed by students showed that they are treated well by staff and they feel well cared for. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 25 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 to the benefit of the residents and staff. EVIDENCE: Since the last inspection Greta Morphet has resigned as the acting manager of the home. Gill Naylor is the newly appointed manager. Records held by the commission show that the company notified us of this change. Prior to becoming the manager Mrs Naylor worked at the home for a number of years as the unit manager responsible for the day-to-day running of the home. Mrs Naylor has a number of qualifications which are appropriate to her position as manager including NVQ Level 4 in Care, employing people and performance management and is currently working towards NVQ Registered managers award. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 26 The manager also undertakes regular training to update her knowledge and skills whilst managing the home. The manager has the support of two senior support workers. Mrs Naylor said she has obtained from the Commission an application for her approval as the Registered manager of the home but has not yet completed it. The manager was advised to complete and forward onto the Commission her application to ensure that the home has a registered manager as soon as possible. Since her appointment the manager has addressed most of the requirements given as part of the last inspection report. Examination of a selection of records showed that she maintains records required by regulation. She showed a real enthusiasm and a commitment to ensuring high standards of care. As part of the homes quality monitoring system residents, relatives and advocates are invited to complete surveys, which gives them the opportunity to put forward their views and make comments about aspects of the service for example, the manager and staff, the quality and choice of food, and the environment. The manager explained that the results of the surveys are used to monitor the quality of the service. Also As part of the homes quality assurance process and in accordance with Regulation 26 of the Care Homes Regulations a representative for the home visits the premises monthly. They interview residents and staff, check records and inspect the environment. It is important that this is done to check the standard of care in the home. Following the visit a report detailing the visit is written. Records show that the visits and reports are being carried out each month as required. The health safety and welfare of residents are well protected this was supported by a comprehensive set of policies and procedures, which were detailed in the AQAA and available at the home. Information provided in the AQAA and examination of a selection of health and safety records showed that the required health and safety checks have been carried out on the environment at the required intervals, for example fire system checks, gas and electricity checks and environmental risk assessments. Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 27 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 X 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 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 x 15 3 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 28 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 29 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 YA2 Good Practice Recommendations All assessments should be fully completed in detail to ensure that all the information is available to decide if the persons needs can be met at the home, and so that a care plan can be put together which reflects those needs. Staffing arrangements at night must be reviewed to enable students more choice and freedom after 10pm at night. More appropriate ways of managing residents money should be introduced which ensure their privacy, dignity and independence. Where appropriate students should be supported to manage their own finances with the assistance from staff. Students should be more involved in shopping for food and given a choice of food at meal times and as part of an independent lifestyle. Parts of the home identified in the report should be repaired, cleaned or replaced to ensure the comfort and dignity of the students. The basement, should be repaired and appropriately equipped to provide residents with more shared space for social gatherings, leisure and recreational activities. All toilets in the home should be in a good state of repair and made available for students to use. 2. 3. YA7 YA7 4. 6. YA17 YA24 7. YA24 Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Merseyside Area Office 2nd Floor South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Oxford Road DS0000005361.V348362.R01.S.doc Version 5.2 Page 31 - 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!