Care Home: Palmyra

What the care home does well The AQAA completed by the manager says; `We have a list of local GPs to the home. Service users who have come from this area stay with the GP they have been with before moving into the home. Staff assist and accompany all service users to attend GP, Chiropodists , Opticians etc. Two service users have diabetes staff accompanied one of them to a talk on what they should be doing to keep them healthy and more in control of the sugar levels. All physical as well as mental health is monitored on a daily basis and any changes are noted within the care plan and would be discussed at the staff handover`. We found this to be the case. Those people spoken with were very aware of the external psychiatric support they were receiving. They were able to discuss recent medical reviews and the care notes detailed any appointments that had been made. One person who has a neurological disease has received input form physiotherapy and speech therapy as well as regular reviews by the consultant and community psychiatric nurse. Another person told us about regular check ups at the GP for blood pressure monitoring and how the staff were encouraging healthy eating and weight management so that they felt better about themselves and more in control of their health. This shows that peoples health is well monitored and they are encouraged to live healthy lifestyles. We looked at the way medication is managed in the home. One person is supported to self medicate and the appropriate risk management strategies were in place with regular spot checks agreed so that compliance could be monitored. Those people spoken with said that medication was managed well and that they are always given their medicines on time. Staff are trained by attending medication courses and these are updated on aregular basis. Both staff spoken with and the training records confirmed this. There is a complaints procedure available for people in the home. This is displayed in the residents information and around the home. Those spoken with were very relaxed around staff and said that they were listened to so that any concerns could be addressed. There are no recorded complaints on file but the manager was able to explain how complaints would be managed internally. We looked at how the service manages allegations of abuse or mistreatment. All staff have undergone training and those spoken with could identify different kinds of abuse and displayed a good understanding of the importance of alerting people in authority in the organisation. We looked at the homes policies and procedures and reviewed these with the manager and advised that they are updated as the homes copy of the local authority procedures are from 2006. This was completed during the inspection and will be shared with all staff at the next staff meeting. This ensures that all staff have up to date information regarding current good practice. This helps ensure that residents are kept safe in the home. What the care home could do better: We looked at the medication records and saw that there were some entries which were handwritten but not signed by two members of staff which would be recommended as good practice to ensure that errors are not made. The displayed complaints procedure needs updating to include the contact numbers and address of external complaints bodies such as Social Services and also the Care Quality Commission. The statement that `the care commission will investigate complaints` was also discussed with the manager and should be removed as it is misleading and detracts from the complaints process explained. We found that staff and the manager were not up to date with the importance of alerting outside bodies and in particular the local safeguarding team who are responsible for coordinating any response and investigation. This is important as staff need to understand the `wider picture` as this helps them to appreciate how they may be involved in such an investigation. Random inspection report Care homes for adults (18-65 years) Name: Address: Palmyra 38 Great Georges Road Waterloo Liverpool Merseyside L22 1RD three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Michael Perry Date: 2 1 0 4 2 0 1 0 Information about the care home Name of care home: Address: Palmyra 38 Great Georges Road Waterloo Liverpool Merseyside L22 1RD 01519490529 01519207210 manpal@makingspace.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Valerie Brown Type of registration: Number of places registered: Conditions of registration: Category(ies) : Making Space North West care home 14 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Conditions of registration: 14 The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia - Code MD The maximum number of service user swho can be accommodated is: 14 Date of last inspection Brief description of the care home Palmyra is registered to provide support and accommodation for 14 adults who require support to manage their mental health. It is situated in a residential area of Waterloo and is well placed for accessing local community and leisure facilities, shops and Care Homes for Adults (18-65 years) Page 2 of 8 Brief description of the care home transport. The building is a large detached Victorian house that fits in well with other houses in the area. All bedrooms are single and provide washbasins but no en-suite facilities. A number of shared areas are available, these include a smoking lounge, a smaller nonsmoking lounge, dining room and private garden. Staff are available twenty four hours a day to provide support. In addition to care staff, the home also employs cooks and cleaning staff, although the people living there are also encouraged and supported to take part in household tasks where possible. The building is owned by Riverside Housing, a local housing association who are responsible for maintaining the premises. The home is operated by Making Space, an organisation and registered charity who provide services for adults who need support with their mental health. Care Homes for Adults (18-65 years) Page 3 of 8 What we found: We carried out a random or targeted inspection of the service looking at two of the main outcomes groups and standards that the home are expected to achieve. These outcomes are around health and personal care and also how the home deals with complaints and how they would manage any allegations of abuse and keep people safe. Before we went on the inspection we sent out some survey forms to staff and people living in the home so that we could get some initial feedback. Eight staff and six resident surveys were returned. We also asked the manager to complete a self assessment of the service, called an AQAA, which gave us some useful information of where the home is up to and what progress needs to be made. During the site visit, which lasted 4 hours, we looked at care records and spoke with both staff and people living in the home. Overall we found good standards are being maintained in these key areas. What the care home does well: The AQAA completed by the manager says; We have a list of local GPs to the home. Service users who have come from this area stay with the GP they have been with before moving into the home. Staff assist and accompany all service users to attend GP, Chiropodists , Opticians etc. Two service users have diabetes staff accompanied one of them to a talk on what they should be doing to keep them healthy and more in control of the sugar levels. All physical as well as mental health is monitored on a daily basis and any changes are noted within the care plan and would be discussed at the staff handover. We found this to be the case. Those people spoken with were very aware of the external psychiatric support they were receiving. They were able to discuss recent medical reviews and the care notes detailed any appointments that had been made. One person who has a neurological disease has received input form physiotherapy and speech therapy as well as regular reviews by the consultant and community psychiatric nurse. Another person told us about regular check ups at the GP for blood pressure monitoring and how the staff were encouraging healthy eating and weight management so that they felt better about themselves and more in control of their health. This shows that peoples health is well monitored and they are encouraged to live healthy lifestyles. We looked at the way medication is managed in the home. One person is supported to self medicate and the appropriate risk management strategies were in place with regular spot checks agreed so that compliance could be monitored. Those people spoken with said that medication was managed well and that they are always given their medicines on time. Staff are trained by attending medication courses and these are updated on a Care Homes for Adults (18-65 years) Page 4 of 8 regular basis. Both staff spoken with and the training records confirmed this. There is a complaints procedure available for people in the home. This is displayed in the residents information and around the home. Those spoken with were very relaxed around staff and said that they were listened to so that any concerns could be addressed. There are no recorded complaints on file but the manager was able to explain how complaints would be managed internally. We looked at how the service manages allegations of abuse or mistreatment. All staff have undergone training and those spoken with could identify different kinds of abuse and displayed a good understanding of the importance of alerting people in authority in the organisation. We looked at the homes policies and procedures and reviewed these with the manager and advised that they are updated as the homes copy of the local authority procedures are from 2006. This was completed during the inspection and will be shared with all staff at the next staff meeting. This ensures that all staff have up to date information regarding current good practice. This helps ensure that residents are kept safe in the home. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 5 of 8 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 6 of 8 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 20 We looked at the medication records and saw that there were some entries which were handwritten but not signed by two members of staff which would be recommended as good practice to ensure that errors are not made. We would recommend that the complaints procedure displayed in the home is updated with reference to comments on the report. We would recommend that the manager and staff update themselves with the reporting and investigation processes with regard to outside agencies and their role. 2 22 3 23 Care Homes for Adults (18-65 years) Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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