Care Home: Southport Road, 119

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What the care home does well We met people who live in the home and found them to be relaxed and at ease with the staff who were on duty. We looked at the care files of the people who live in 119 Southport Road and found the staff team have worked hard with them developing care plans that are unique to each person. This means that they receive the right amount of support, and care that meets their needs. Individual support plans are in place and we noted best practice had been followed in finding out about people`s cultural needs and family contacts. We found that people are encouraged to take part in the activities they enjoy and to stay in contact with family and friends. During the visit we observed people being offered choices and there was a lot of information in records about their preferred rising and retiring times, their favourite foods and activities and how they communicate. There are procedures in place so that people who live in the home are able to express their concerns and be listened to. There are safeguarding and "whistle-blowing" procedures to ensure that suspected abuse of a service user will be reported and investigated. We looked at how staffing is arranged and found that a settled staff team is providing personalised support to the people who are living in the home. We found that the management and administration of 119 Southport Road is based on openness and respect. This ensures that the home is run in the best interests of the people who live there. What has improved since the last inspection? We looked at the annual quality assurance assessment where the manager has told us about how the service has improved recently. We found evidence of these improvements during our visit. Some of the examples were that policies and procedures have been reviewed and written in user friendly formats. There have been ongoing improvements to person centred care planning to ensure they contain the right amount of relevant information about how to support people properly and safely. There have been further achievements in staff training with regards to mandatory training, NVQs and LDAF. A number of environmental improvements have been made including a new fire system, decoration of bedrooms, new flooring and new garden furniture. People who living in 119 Southport Road have been involved in choosing colours and wallpaper for their home. What the care home could do better: We have recommended that more attention be given to training that will meet the specific support needs of people who live in this home, which may pose risks to their wellbeing. In this way people`s rights will be further protected in their home and staff will improve their skills on how to support them properly and safely. Key inspection report Care homes for adults (18-65 years) Name: Address: Southport Road, 119 119 Southport Road Lydiate Liverpool Merseyside L31 2JW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Patricia Thomas     Date: 1 9 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought 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 The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Southport Road, 119 119 Southport Road Lydiate Liverpool Merseyside L31 2JW 01515262849 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Expect Limited Name of registered manager (if applicable) Lynn Thompson Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 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: Learning disability - Code LD The maximum number of service users who can be accommodated is: 3 Date of last inspection Brief description of the care home 119 Southport Road is a small home registered to provide accommodation and support for three adults who have learning disabilities. There are currently three people living there. The home is run by Expect Limited. This is a local organisation that provide support to adults with learning disabilities or mental health support needs. This includes support with in all areas of daily living including personal care, leisure and health and safety. Staff are available 24 hours a day, there is a minimum of two staff on duty during the day and night. The property is owned by Liverpool Housing Trust Care Homes for Adults (18-65 years) Page 4 of 26 3 Over 65 0 Brief description of the care home who has to take care of maintaining the premises. The home is a detached bungalow in a residential area of Lydiate and blends in well with other houses in the local area. Accommodation includes, 3 single bedrooms, a through lounge / dining room, 2 bathrooms, a kitchen, enclosed rear garden and staff room / sleep in room. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two stars (**). This means that people who use this service experience good quality outcomes. This visit was just one part of the inspection. We looked at information we have received about this home since our last review of the service. Before the visit took place we (the commission) asked the manager to complete a questionnaire, the annual quality assurance assessment (AQAA). It gives us information about how the home is meeting the needs of the people who use the service and includes plans for future development. The AQAA was returned to us when we asked for it and gave us a lot of detailed information about the home. During our visit, we looked at various records and walked round the home. We met the people who live at 119 Southport Road and spoke with staff who work there. They gave us their views about 119 Southport Road. Care Homes for Adults (18-65 years) Page 6 of 26 We used a system called case tracking. This is a way of inspecting that helps us to look at services from the point of view of some of the people who use them. We track peoples care to see whether the service meets their needs. Care Homes for Adults (18-65 years) Page 7 of 26 What the care home does well: What has improved since the last inspection? 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 on page 4. Care Homes for Adults (18-65 years) Page 8 of 26 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a good system to introduce people to the home with information given and needs assessments done. In this way people have the information they need about the service and the home will be able to demonstrate the persons needs can be met before they move in. Evidence: We looked care records to find out how people are introduced to the home and found there is a good system in place. Care records contained a full assessment of each persons health and personal care needs, their abilities and social preferences. Staff obtain information from the person, their families and representatives and from health and social services departments to ensure in depth assessments will be in place before the person moves in. This means that the home is able to demonstrate that the service is able to meet each persons needs in the way they prefer. Each person (and their representatives) are given the service user guide and statement of purpose which gives them information about the home and helps to inform their decision about moving in. People are encouraged to visit the home before they move in to meet service users and staff and look around the premises. Care Homes for Adults (18-65 years) Page 11 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have guidance about peoples changing needs and personal goals in their individual care plans to give them information about how to support them properly and safely. Evidence: We looked at care records for three people and tracked aspects of their care to check that their needs are being met in their home. Person centred care plans and essential lifestyle plans had been written to guide staff about how to support each person properly, safely and in the way they prefer. These plans identified the persons individual needs and goals and had been based on the outcomes of their pre admission assessments and ongoing review of their support needs since moving in. There was a good system in place for identifying and managing risks to each person to ensure they will be safe in their home and in the community. Staff have policy guidance on supporting people in a way which respects their privacy and confidentiality. In speaking with staff we found they understood the support needs of people who live in the home and showed respect for their right to make decisions Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: about their lifestyle and be given all the support they need to do this within the risk management strategies in place and the persons capacity and awareness. Care Homes for Adults (18-65 years) Page 13 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples rights, needs and choices are respected in their daily life in the home. Evidence: There was evidence in care notes that people are given support to do the things they enjoy in the home and community. Their preferences are clearly stated in their support plans and staffing levels are flexible to help them have access to local shops and amenities and to go on outings to places of interest. Peoples preferred rising and retiring times and daily routines were clearly stated in their care plans for staff guidance, which means the home supports peoples right to choose. There was good evidence that people have ongoing contact with their families after they move in and those who have no family have advocates to provide ongoing independent support and representation. Care notes we looked contained the contact details of peoples families and professional contacts. The manager said that for those who wish to follow their chosen religion, staff will help them to go to places of worship Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: and have visits from local ministers. This gave evidence that staff have awareness of each persons right to follow their chosen faith and to access local amenities. We spoke with staff, read catering records, menus and support plans. There was good evidence that the health and wellbeing of people living in the home is well supported by a nutritious, varied and balanced diet. There was evidence that people are offered choices and alternatives and given the foods they prefer. The home does not employ a chef and support staff do the cooking and have attended food hygiene training courses. The manager said the food shopping is done on a daily basis and there were good stocks of basic provisions on the premises. Care Homes for Adults (18-65 years) Page 15 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal care in the way they prefer and require and their health needs are met. Evidence: Personal care support plans showed us staff had guidance about how to give people personal care in the way they prefer and which is respectful of their privacy and dignity. All the people living in the home are registered with local G.P.s and records showed us they have access to specialist health and paramedical services in the community. There were clear records about each individuals contact with health professionals and the outcomes. There was recorded evidence of health care plans and regular monitoring of peoples condition and progress. There is a procedure for managing medication and records show staff have received relevant training. Medication is kept in a locked, secured cupboard and medication administration records were up to date. We checked the medication for one person against medication administration records and all prescribed medication was in store at the time of the visit. Medication management in the home is independently audited each month by the organization as part of the quality monitoring system. Records are Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: kept of audits, areas for improvement if appropriate and remedial action if needed. Care Homes for Adults (18-65 years) Page 17 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the safeguarding procedures in their home and their complaints are taken seriously. Evidence: The home has a complaints procedure which is given to people who live there and their families/advocates. The procedure is in easy read format to assist people living in the home who may have concerns. In this way the people will know their concerns will be taken seriously and action taken to make improvements if needed. The home has safeguarding and whistle-blowing procedures and staff have been well vetted and have received safeguarding training and updates. This means they understand the indicators of abuse and how to report suspected abuse for investigation. There are systems in place to manage peoples personal allowances and clear records are kept of spending with receipts kept for all purchases made on behalf of each person. Money held in safekeeping is checked between at change over of staff and signed for and each persons personal allowance accounts are independently audited to ensure that all money will be accounted for. Care Homes for Adults (18-65 years) Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean and comfortable home which is well maintained. Evidence: 119 Southport Road is a single storey bungalow with three single bedrooms, a lounge/dining room and a well-equipped kitchen with dining area. We walked round the building and found it to be decorated and furnished in a modern and homely style and peoples bedrooms are highly personalized. There is a large bathroom, and a shower room, (wet room) with toilets and wash hand basins. There is a ramp at the front of the home and a parking area. There is an enclosed garden at the back which is well maintained with grassed areas, planting and a patio with garden furniture. There is an ongoing maintenance programme and work done recently in the home includes : installing of a new fire system, new fire doors and fitting new flooring in some areas. The lounge is due to be decorated. People who live in the home have helped to choose the colours and wallpaper for communal areas and their bedrooms. The home does not employ domestic staff and this work is carried out by support workers who have received infection control training. For their guidance, there are procedures for controlling infection and control of substances hazardous to health. The home was clean and well organised during the visit. People who live in the home appeared relaxed and were moving freely around their home. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home are supported by a well vetted staff team who work well together. Evidence: We looked at staffing arrangements in the home and found that a staff roster is kept which gives the names of people who are on duty on each shift. There were three people in residence during our visit and there were two support workers and the manager on duty. Support staff carry out cooking and cleaning duties and a contract gardener is employed. The manager said that staffing levels are flexible to accommodate service users outings and medical appointments. We looked at training records. The manager said there is a lot of training available and mandatory training is currently being updated. The manager told us that the training officer from head office carries out staff appraisals each year to review training needs. and we saw records of regular supervision (one to one) sessions between the manager and staff to monitor their performance and keep them up to date with best practice. There were two support workers on duty during the visit, one has just completed LDAF (Learning Disability Award Framework) and her colleague has a National Vocational Qualification at Level 2. In keeping with the capacity and assessed needs of people who are living in the home, more specialist training is recommended, for example for dysphagia. Also, staff should receive training in deprivation of liberty safeguarding to Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: ensure peoples rights will be fully supported in their home. We looked at two staff files and found that people have been vetted and have satisfactory criminal records bureau clearances. There was evidence of personal identification, satisfactory references and employment histories on file. This helps to ensure that only people who are suitable will be employed in the home. The manager said there is a low turnover of staff in the home and the team works well together. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed in the best interests of people who live there. Evidence: The manager has applied to be registered with the Commission for Social Care Inspection and is due to start a management and leadership National Vocational Qualification. She has many years experience working in care services and has worked in this home for about two years. There was evidence of good systems in the home for managing information as records were easy to find and up to date. The home has a quality monitoring system which is based on regularly obtaining information from service users and their representatives and making improvements as needed. The manager carries out reviews of care records and risk assessments. In addition, regular quality audits are carried out by managers from other homes in the organization and from head office. Reports on the outcomes of these audits were seen and areas for improvement (if appropriate) would be recorded in the findings. The areas looked at include record keeping, finances, medication, health and safety and the environment. Records showed us that staff have training and guidance in safe working practice. New Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: staff receive this as part of their induction. Records and direct observation gave us evidence that there are good systems for managing infection and for risk management in the home. There are systems for recording accidents and incidents which are reviewed by the health and safety officer at head office. Risk management strategies are put into place when needed to help ensure peoples safety. To help ensure the building is safe and suitable for people who live there, the manager arranges for regular servicing and checks on equipment (including gas, electricity, portable appliances, water and fire equipment). We looked at the certification for these checks and found them to be up to date. The fire records were up to date and records showed us the alarm system is tested every week by staff and regular fire drills take place to ensure the alarms are working efficiently and evacuation arrangements are safe. Care Homes for Adults (18-65 years) Page 23 of 26 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 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, Care Homes 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 35 Staff should receive training in dysphagia and deprivation of liberty safeguarding to ensure they have all the skills they need to support people properly and safely. Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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