Care Home: Rock Grove (34)

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What the care home does well 34 Rock Grove provides a comfortable, friendly, safe and relaxed home for the three residents who live there. The residents` enjoy going out to different places and going away for short holidays and the staff team support them to do these things. The service has records that show they find out information about a person before they come and live at the home this information helps the staff team to offer the best care and support to residents of the home. Since the last site visit there have been few changes to the staff team, which gives residents the opportunity to get to know the people who will be supporting them with their personal care and their emotional and mental health needs. The residents are supported to have things in their room that make them happy such as pictures, videos and TV`s. What has improved since the last inspection? Since the last site visit the management team at the home have reviewed how they record information. This has resulted in reports about residents` daily routines being written in a professional and respectful manner.The service has produced a complaints`, concerns and compliments logbook to give residents, their relatives, supporters and other professionals who visit the home the opportunity to comment on the service they are providing. The service manager responsible for supporting the manager of the home carries out monthly visits to make sure residents are being supported and cared for properly. A record of these visits is kept in the home. What the care home could do better: Where possible more information about residents past life experiences should be sought to make sure the care and support being provided meets their needs. Care and health care records should be updated following any significant change or deterioration in a residents` health. CARE HOMES FOR OLDER PEOPLE Rock Grove (34) 34 Rock Grove Old Swan Liverpool Merseyside L13 2DY Lead Inspector Helen Carton Key Unannounced Inspection 4th September 2007 09:30 X10015.doc Version 1.40 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 Rock Grove (34) DS0000025168.V343496.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 Older People. 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. Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rock Grove (34) Address 34 Rock Grove Old Swan Liverpool Merseyside L13 2DY 0151 702 5555 0151 702 5566 sandra.clark@pss.org.uk www PSS.org.uk Personal Service Society 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) Mr John Murphy Care Home 3 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (3) of places Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The manager requires to undertake relevant management training to NVQ level 4 or equivalent in line with the NMS 34.3 and 34.5. The maximum number of service users to be accommodated at any one time is three (3) 6th March 2007 Date of last inspection Brief Description of the Service: 34 Rock Grove is a care home providing personal care and accommodation for three older people who have learning disabilities. The home is part of The Shared Living Project (SCOPE), which is managed by Personal Services Society (PSS). The home is located in the Old Swan area of Liverpool and is close to shops, pubs the post office and other amenities. The home is a purpose built bungalow, which was first registered in 1996. The bungalow has three bedrooms, a shower room and bathroom. There is a good size lounge with a separate kitchen dinette area. The home has a small front and larger rear gardens both are well maintained and easily accessible. The weekly accommodation fees for living at 34 Rock Grove is £377.17p. Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A site visit of four and a half hours was made to the home as part of the key inspection. A small amount of time was spent with residents and observing the day-to-day routines of the home. The inspector looked around the building to assess its suitability to provide a comfortable, safe and homely environment for the enjoyment of all residents. A selection of records kept by the service where looked at and the inspector also checked the requirements made at the last inspection to see if they had been completed. The main focus of the site visit and the inspection process was to understand how the home was meeting the needs of the residents and how well staff were themselves supported by the management of the home. This was to make sure they had the skills, training and support to provide the best care to residents. What the service does well: What has improved since the last inspection? Since the last site visit the management team at the home have reviewed how they record information. This has resulted in reports about residents’ daily routines being written in a professional and respectful manner. Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 6 The service has produced a complaints’, concerns and compliments logbook to give residents, their relatives, supporters and other professionals who visit the home the opportunity to comment on the service they are providing. The service manager responsible for supporting the manager of the home carries out monthly visits to make sure residents are being supported and cared for properly. A record of these visits is kept in the home. 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. Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 & 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The statement of purpose and service user guide provides good information about the services and facilities provided by the home allowing prospective residents the opportunity to make informed decisions about whether the service can meet their holistic needs. EVIDENCE: The statement of purpose provides detailed information about the services the home can and cannot provide. Allowing people who may wish to live in the home to make an informed decision as to whether 34 Rock Grove can meet their care and social needs. The service user guide provides good information about the facilities and services provided by 34 Rock Grove including accommodation charges and the Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 9 skills and qualifications of the manager and staff team. This document is reviewed and amended each year. Each resident has a contract detailing the services and level of support they will receive including fees to be charged. Each resident receives a letter from PSS who run the home every year detailing increases in accommodation fees. There have been no admissions to the home since the last site visit. However documentation shows detailed assessments have been carried prior to people moving into the home. Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 & 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning and risk management strategies and care practices adopted by the service support residents’ holistic needs. EVIDENCE: Care plans have been developed for the residents and provide the staff team with good information and guidance about their care needs. Information is also provided about daily routines and the type and level of support residents need with daily tasks. Care plans provide detailed information about the health care needs of residents and clearly shows when health care professionals’ such district nurses’ are supporting them. At the time of the site visit the care plans and accompanying documentation had recently been reviewed. The service manager was advised to ensure recent changes in residents’ health care needs are fully detailed in the reviewed documentation. Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 11 Where necessary behaviour support plans have been produced to enable the staff team to support individual residents who may be presenting with inappropriate or aggressive behaviours in the safest and most supportive way. Examination of daily records indicate staff are supporting residents in a consistent way in line with the information held in support plans and behaviour management plans. The service manager was advised to ensure when an aggressive incident occurs detailed information is recorded including the time the incident started and when it ended and how the resident presented when the aggressive behaviour had ended. This information will allow the manager and the staff team to support the resident safely and effectively and be aware of possible triggers to future incidents. Examination of daily diaries indicates reports are written in a nonjudgemental, factual and sensitive manner. Examination of the care plans showed detailed plans regarding how residents wish to be cared for if they become very ill or die. The service manager was advised to look at the way these documents are written to ensure when decisions are being made on behalf of residents they are discussed with family members or friends who are involved in their lives. The inspector examined a sample of residents’ medication and the corresponding Medication Administration Record (MAR) sheets. They were securely stored and had been safely administered and accurate records had been kept. Members of the staff team were observed supporting residents in a sensitive supportive and affectionate manner. Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service supports residents to live their lives as they choose and to participate in age appropriate activities and maintain positive relationships. EVIDENCE: The home has produced activity plans, which reflect the activities that each individual resident enjoys and are mindful of their age and physical abilities including luncheon clubs and tea dances. Residents said they were looking forward to going to Blackpool in October to see the lights. Essential Lifestyle Plans provide information on what residents enjoy doing and those things that cause stress and anxiety. Further work on these documents including information about their past life experiences would support the staff team to provide appropriate, sensitive and safe care and support. Care plans detail information about residents’ religious beliefs and how these are to be incorporated in their funeral arrangements. Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 13 Each resident has a menu sheet that is filled in after each meal this allows the manager to monitor the likes and dislikes of residents and ensures residents are offered healthy eating options. Residents are supported to access short break holidays with PSS funding holidays up to one week including the staffing costs. If individual residents wish to have more holiday breaks through the year they are financial responsible for them. Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s systems and practices promote positive communication with residents, their relatives and supporters and protect residents from abusive or neglectful situations. EVIDENCE: No complaints have been made to or about the service since the last site visit. The statement of purpose and the service use guide provide residents their relatives and supporters with information about the complaints procedure and encourages them to speak to the manager at the earliest opportunity to resolve any concerns they may have. Since the last site visit the manager and service manager have produced a complaints and complements logbook that is held at the service. Examination of the logbook indicates two compliments have been logged. There have been no safeguarding referrals made by the service or from other agencies about the care and support residents receive at 34 Rock Grove. Half of the staff team have completed safeguarding adults training with the remaining staff undertaking it by the end of September 07. Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 15 Discussions with the staff team indicated they are aware of the roles and responsibilities in protecting residents from abuse or neglectful practice. Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within the home is good providing residents with an attractive, safe and homely place to live. EVIDENCE: The home has a kitchen/dining room and a good size lounge all communal areas are nicely decorated with the lounge furniture being comfortable. One resident has purchased a specialist chair for the lounge to make their time in the lounge more comfortable. New curtains have been fitted to all windows with new blinds having been ordered to provide privacy in bedroom and communal areas. One bedroom has been decorated since the last site visit. Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 17 The home has a shower room and a long bath to offer residents choice in their personal care needs. Examination of records indicate appropriate safety checks are made at the required intervals on equipment used by the staff team to support residents such as lifting hoists, washing machine and the drier. The home was clean, tidy and homely and met the care and physical needs of the residents living there. Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home employs sufficient staff to meet the holistic needs of residents however specialist training needs to be provided to ensure they are aware of the conditions that service users may develop as they get older. EVIDENCE: Examination of the rota and discussions with the manager and members of the staff team indicates there are sufficient staff members on duty at any one time to meet the needs of the residents. This includes a member of staff being on wakeful night duty from 10pm until 8am. Since the last site visit members of the staff team have carried out the following training; issues of mental capacity, safeguarding adults and continuing with National Vocational Qualifications (NVQ) training at levels 2 and 3. The service manager told the inspector herself and the manager where attending specialist training courses about conditions relating to older people who have a learning disability. This information will then be passed to the PSS training department so suitable internal courses can be arranged for the staff team. No new staff members have been employed at the service since the last site visit. The service does not hold full staff files as all recruitment files are held Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 19 centrally at the organisation’s head office. This arrangement has not been formally agreed with the Commission the service manager assured the inspector a letter formally requesting this arrangement is to be sent to the Commission as a matter of urgency. All staff files were examined as part of the last site visit they were well maintained and indicated the organisation has a robust recruitment and selection process. The service manager was advised to ensure where criminal convictions are present on Criminal Record Bureau (CRB) checks a risk assessment is carried out and detailed records are kept regarding decisions made. Members of the staff team spoken to during the site visit demonstrated a clear understanding of their roles and responsibilities and spoke respectfully and sensitively about the support and care they offer to residents. Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from a service that is well run and has a person centred approach to the care and support they provide. EVIDENCE: The registered manager has worked at the home for a number of years and has gained the NVQ level 4 Manager’s Award he is also a qualified NVQ Assessor. Since the last site visit the service manager has purchased a combined fax and telephone to support the manager in his role. There is still a payphone available for residents to make and receive calls in the office/sleep in room. The staff team use this phone for out of hour purposes. Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 21 The home carries out regular health and safety checks with regard to work practices and environmental issues such weekly kitchen safety checklist completed and the contents of the first aid box checked weekly. Examination of records indicates regular maintenance and safety check are carried out on utilities and equipment used to support residents such as the ceiling track hoist, fire safety equipment, gas and electrical supplies and equipment. Regulation 26 visits and accompanying reports are being undertaken at regular intervals with the reports being available for examination at this site visit. Rock Grove (34) DS0000025168.V343496.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 Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 2 3 X X 3 Rock Grove (34) DS0000025168.V343496.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 OP29 Regulation 17 Requirement The registered persons must ensure staffing information detailed in schedule 4 of The Care Homes Regulations is available in the home for inspection. This requirement remains outstanding. 2. OP30 18 The registered persons must ensure specialised training is provided to the staff team to enable them to support residents in the safest and most appropriate manner. With particular regard to conditions related to older people who have a learning disability. 30/10/07 Timescale for action 30/10/07 Rock Grove (34) DS0000025168.V343496.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 OP8 Good Practice Recommendations More detail in care and healthcare plans about past life experiences and any deterioration in residents physical and mental health will ensure support, care and supervision offered meets their changing needs. A review of the language used in plans drawn up for when residents become ill or die is advised. This is to ensure information held in these documents reflects residents’ actual or perceived wishes and this information has been verified with their families or supporters. The car ownership agreement drawn up between two of the residents should be legally reviewed. This is to ensure both parties are legally protected. Where adverse information is disclosed in CRB checks a risk assessment should be carried out to ensure there is a clear audit trail to any decisions made with regard to the offer of employment. 2. OP11 3. OP34 4. OP29 Rock Grove (34) DS0000025168.V343496.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Merseyside Area Office 2nd Floor, South Wing Burlington House Crosby Road North Waterloo 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 Rock Grove (34) DS0000025168.V343496.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. 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