Care Home: Warwick Road Short Break Services

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What the care home does well The home provides a very high standard of accommodation so that service users are comfortable during their stay. The care plans are written focussing on individual`s needs, the way in which they like things done, what staff should help them with and what they should not so that they remain as independent as possible. People who stay at the home are supported to carry on with their usual activities during their stay so they can keep to their usual routine and keep in touch with friends. When people are staying at the home for respite, they have the opportunity for access to community nurses, physiotherapists and speech and language therapists so that their care needs can be fully assessed and monitored. People who stay at the home and their families have various chances to comment on the standard of care/support provided. There are systems in place to respond effectively to concerns or complaints so that people feel they are listened to. Staff have all received up to date training so that their knowledge and their working practice is current and they can provide care and support to people safely. What has improved since the last inspection? This is the first inspection since the home was registered. CARE HOME ADULTS 18-65 Warwick Road Short Break Services 9 Warwick Mews Macclesfield Cheshire SK11 8SW Lead Inspector Ms Julie Porter Unannounced Inspection 4 December 2007 17:30 Warwick Road Short Break Services DS0000069989.V353976.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 Warwick Road Short Break Services DS0000069989.V353976.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. Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Warwick Road Short Break Services Address 9 Warwick Mews Macclesfield Cheshire SK11 8SW 01625 424868 01625 425907 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) http/www.cheshire.gov.uk Cheshire County Council Daniel John McCabe Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - code PC to service users of either gender, whose primary care needs on admission to the home care within the following categories: Learning disability - code LD The maximum number of service users who can be accommodated is 4 Date of last inspection New service Brief Description of the Service: The Warwick Road Short Break service is housed in a small domestic style care home. It is registered to provide care for up to four people with learning disabilities at any one time. The home has four large bedrooms and two bathrooms/shower rooms. Bathrooms are situated next to bedrooms 1 and 3 and can be accessed either from the bedroom or the hallway. Suitable locks are fitted to doors to ensure privacy when the bathrooms are being used. One bedroom has a ceiling-track used when people with physical disabilities are staying to ensure that staff can help them move more easily. One bedroom is used for emergency admissions. The home is situated on the outskirts of Macclesfield town centre on a fairly new housing development; apartment accommodation and sheltered housing is located nearby. The local bus service runs to Macclesfield from the bottom of the road. Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on the 04 December 2007 and lasted 3 hours. The visit was carried out by one inspector. This visit was just one part of the inspection. Before the visit the home manager was asked to complete a questionnaire to provide up to date information about services in the home. CSCI questionnaires were also made available for people using the service, families, and health and social care professionals, such as nurses and social workers, to find out their views. Other information received by CSCI since the service was registered was also reviewed. During the visit various records and the premises were looked at. One of the people staying in the home was also spoken with and gave their views about the service. What the service does well: The home provides a very high standard of accommodation so that service users are comfortable during their stay. The care plans are written focussing on individual’s needs, the way in which they like things done, what staff should help them with and what they should not so that they remain as independent as possible. People who stay at the home are supported to carry on with their usual activities during their stay so they can keep to their usual routine and keep in touch with friends. When people are staying at the home for respite, they have the opportunity for access to community nurses, physiotherapists and speech and language therapists so that their care needs can be fully assessed and monitored. People who stay at the home and their families have various chances to comment on the standard of care/support provided. There are systems in place to respond effectively to concerns or complaints so that people feel they are listened to. Staff have all received up to date training so that their knowledge and their working practice is current and they can provide care and support to people safely. Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available to people wishing to use the service so that they know that their needs can be met there. EVIDENCE: The home has a comprehensive statement of purpose and service user guide. An information pack has been produced to help people with making a decision whether to use the service on offer or not. All referrals to use this service are made through the social work team in accordance with individual need. One care plan/support plan was checked during the visit; it provided the staff at the home with useful information regarding the individual before their stay was agreed. People who are offered a service have the opportunity to visit the home, stay for tea and stay overnight before they decide if they wish to go to the home for short break, except if they are admitted due to an emergency situation. A contract was seen on one person’s file of what they could expect during their stay in the home. Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Support plans accurately reflect the individuals’ needs so that they get the care/support that they need during their stay. EVIDENCE: One persons’ plan was checked during the visit. This contained information about the person, the support they needed and the way in which they liked the support to be given. The plan covered all aspects of the person’s personal care routines, bathing, dressing and eating and what they could do for themselves. Other information was also available about the person’s life, what they had achieved and what they hoped to achieve. The person’s likes and dislikes had been recorded. A folder is available in the home describing what is available in the local area, such as pubs, places of interest, walks, gardens, cinema, bowling, the local disco and places to eat. This is used with the people staying to help them when planning activities. Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 10 Menus are planned with people when they arrive so that staff are aware of any changes to their likes and dislikes since the last visit. The plan inspected contained risk assessments for that person. However, as the person needed support with every aspect of daily living, a risk assessment for “running away” was not relevant. This was discussed with the manager who amended the records immediately. Information received following the visit confirmed that risk assessment processes have been discussed with staff. Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 11 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 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are given support to continue with their usual activities when they stay at the home so they can continue with their usual routines and maintain their skills and friendships. EVIDENCE: The service provides short breaks for people either living at home with relatives or people needing extra support in the short term. People staying in the home usually continue with their usual activities such as going to day centres, college or work placements. During their stay people visit local shops, restaurants and pubs. As this is a new service, the staff and manager are still trying the “match” individuals who have similar interests so that visits can be planned for the same time and they can be supported with their chosen activities. Some people staying at the home have the opportunity to try new things. Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 12 Information is available in the home regarding different ethnic groups and their cultural needs. Staff were spoken with and appeared knowledgeable regarding the cultural and dietary needs of different individuals staying in the home. The evening meal was prepared and served during the visit. The occasion was calm, unhurried and relaxed. Staff were seen sitting with the people staying in the home either helping them or encouraging them to eat. Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 13 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People staying in the home have their health monitored by staff to ensure they get the care/support they need. EVIDENCE: The home has been purpose built very recently and the equipment such as ceiling tracking, hoists, specialist bathing facilities and any assistive technology such as the door alarms are all still under warranty. Staff were observed during the visit and appeared to have appropriate relationships with the two people staying in the home. One person who obviously knew the manager from along time ago was heard joking with him, was “chatty” and able to say how she felt about staying in the home for respite. This was her first visit and she said that the house was “nice” and the staff “alright you know.” Evidence was seen on support plans and the visitor’s book that health professionals including physiotherapists, occupation therapists and speech and Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 14 language therapists have visited the service to support staff and residents with new situations and new unknown circumstances. During their stay people using the service generally retain their own general practitioner. However, we were told some difficulties have occurred with people using the service who usually live in the Congleton area. The manager is currently looking to resolve this matter with a local practice in the case of an emergency that does not need hospital treatment. Policies and procedures are in place on medicine administration and all staff have received training so they can give medicines to the service users safely. People staying in the home can look after their own medicine subject to a risk assessment. Medicines are stored in lockable containers in the person’s own bedroom and given discreetly. One medication record was inspected and staff had signed the chart as the medicines had been given. There was no record kept on the medicine record to show the amount of total medication received into the home on the day of the person’s arrival and so an accurate audit of the medication could not be made. Past medicine records were checked; this information had been recorded in the past and must have been an oversight on this occasion. Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 15 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A variety of systems are available to ensure the views of people using the service are obtained and acted upon. EVIDENCE: There is a Cheshire County Council complaints policy and procedure for people using the service and their relatives to use. Information is available in different languages and different formats i.e. large print, Braille, audiotape. There was a book available to everyone visiting the home to make comments on what they think of the service. A few extracts are as follows, “I have had a good laugh”, “had lots of fun with my friend”, “I have enjoyed the food and the showers”, “thank you for looking after our son.” Following each visit, people using the service are also asked to formally comment about their stay. Records show the date of the stay, the staff comments on how the visit went and the person’s comments how the visit went. There was evidence provided to show that the manager of the home is monitoring these outcomes, for example some visitors wanting more activities or different activities. A complaints/compliments logbook is available in the home and contained four compliment cards/letters. No complaints have been received by the home or the Commission for Social Care Inspection regarding the service. Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 16 All staff have received training relating to protecting vulnerable adults as part of the processes to train all staff in readiness for the home opening in June 2007. No adult protection referrals have been made. Staff were spoken with during the visit and knew what to do if they saw or suspected that any of the people staying at the home were being harmed or abused. There was a copy of the guidance about safeguarding adults, “No Secrets” available in the home. Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has recently been built to a high standard so the people who stay there live in safe, comfortable surroundings. EVIDENCE: The home has four large bedrooms all located on the ground floor. Each bedroom is furnished with a divan bed, wardrobe, chest of drawers, and a bedside cabinet with lockable facilities. Bedrooms also have hand basins within a vanity unit. Bedrooms 1 and 3 have been designed to provide accommodation for people with physical disabilities and have ceiling track hoists. These two bedrooms also have direct access to the adjacent bathroom/ shower rooms. People using bedrooms 2 and 4 go into the bathrooms from the hallway and doors are fitted with suitable locking devices to make sure that people’s privacy is maintained when they are using the bathrooms. All bedrooms are decorated to a good standard and carpeted. Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 18 There are two large sofas in the lounge that can comfortably seat four people and there is adequate floor space so that people in wheelchairs can be included in the hub of activities. From the lounge, patio doors open on to a paved area and a secure enclosed garden. There is a large separate dining room that can accommodate everyone staying in the home and the staff on duty at the time. The kitchen is domestic in style with a range of floor and wall mounted units. Electrical appliances include fridge, freezer, electric hob, split level oven, dishwasher, toaster and kettle. The kitchen has a number of lockable cupboards and drawers to store any equipment that might be assessed as constituting a risk for intended service users. There is a separate laundry that has two industrial washers and dryers; within this room there are secure storage areas for cleaning materials. The respite service is linked via a lockable door to the manager’s office/sleep in room and the offices for other network services. This door has two signs “fire door keep locked” and “fire exit”. Advice should be sought from the fire authority as a matter of urgency as to the purpose of the door to make sure that the people staying at the home and the staff are safe. Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 19 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 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust recruitment processes and high levels of training and supervision ensure that a competent staff team supports people. EVIDENCE: This is a new service in Macclesfield and staff were recruited specifically for the role from staff already employed within Cheshire Social Services. Staff records up to senior staff are held securely in the home and Cheshire County Council’s recruitment policy was followed. Before the home opened staff attended a 2 day induction programme that included fire safety training, medication administration, report writing and emergency admission procedures. Staff have also attended training relating to adult protection, emergency aid, moving and handling and food hygiene. Information provided by the manager on 25 October 2007 stated that all seven of the staff team had achieved a National Vocational Qualification (NVQ) at level 2 or above. Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 20 Staff spoken with during the visit were complimentary regarding the level of training and support they receive. Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 21 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 and 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 so it provides a service that is run in the best interests of the service users. EVIDENCE: The manager of the home is registered with the Commission for Social Care Inspection and was available throughout the visit. Staff were complimentary regarding the support and guidance he offers. One member of staff was spoken with clearly enjoys her work in the home. During the inspection the following records were checked and found to be in order; accident records, fire alarm testing, fire drills and emergency lighting. Servicing agreements are in place for all equipment in the home. A sample was inspected and found to be in order; the fire extinguishers were checked in Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 22 July 2007 and the fire protection equipment serviced in November 2007. Electricity and gas supply was looked at as part of the building regulations when the home was built. The manager has good processes in place to monitor the systems that support and protect the people using the service and staff performance. He audits any accidents and injuries caused to the people staying in the home. He checks medication records during each person’s stay. He audits the finance sheets for the home, for personal finances and household budgets. The comments/ complaints and compliments are reviewed and signed by the manager and a record of the action taken kept. All staff working in the home have achieved mandatory training and a NVQ at level 2 or above. Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 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 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 4 X X 4 X Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? None 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 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 YA20 Good Practice Recommendations Information regarding the quantity of medicines brought to the home should be recorded at each visit, so that an accurate audit can be made at any time during the person’s stay. Advice must be sought from the fire authority regarding the purpose of the door between the respite service and the offices. 2 YA24 Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Warwick Road Short Break Services DS0000069989.V353976.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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