Care Home: Watford Road (16)

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What the care home does well PSS, the Bradley Project and 16 Watford Road constantly reviews its practice and is always striving to improve the service offered to the people either living in the home or to prospective residents. The service is flexible and reflective and the home`s management team have looked at where they are now and where they want to be in the future. This helps to ensure that the home is able to respond to changing needs, which in turn enables people to maintain as much independence as possible. There is a strong commitment from everyone working at the home that helps to ensure that the quality of care is provided to an excellent standard. People are treated with respect and dignity. We found that staff members were able to demonstrate an awareness of the diverse needs of the people they were caring for. Positive and warm relationships were seen to exist between the resident present during the visit and staff members. A wide choice of meals are offered and the standard of catering is very good. The quality of record keeping within the home is being maintained to a very good standard; this helps to ensure that people`s needs are identified and addressed quickly. What has improved since the last inspection? There were no issues identified following the previous inspection visit. What the care home could do better: We consider that 16 Watford Road is an excellent service so rather than state what they could improve we would expect that the home continues to review its practice in order to ensure that the very high standard of care provided to the residents at the present time is maintained and where possible improved upon. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Watford Road (16) 16 Watford Road Anfield Liverpool Merseyside L4 2TR     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Paul Ramsden     Date: 0 4 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. Copies of the National Minimum Standards – Care Homes for Older People 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Watford Road (16) 16 Watford Road Anfield Liverpool Merseyside L4 2TR 01512636107 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): karen.moore@pss.org.uk Personal Service Society Name of registered manager (if applicable) Pauline Lynes Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia - Code MD. The maximum number of service users who can be accommodated is: 3. Date of last inspection Brief description of the care home 16 Watford Road is terraced house in the Anfield area of Liverpool that provides accommodation and personal support for three people that have mental health needs. All accommodation is provided in single bedrooms. There is sitting room and a kitchen/diner on the ground floor. Two of the bedrooms are situated on the first floor and one on the ground floor. The home has a walk in shower on the ground floor and bathroom on the first floor. Toilets are located on the ground and first floors. Care Homes for Older People Page 4 of 24 care home 3 Over 65 0 3 Brief description of the care home To the rear of the property there is a small patio garden, which is easily accessible to the residents. The home is staffed twenty- four hours a day. A seven-day holiday is included in the weekly fees and staff support the residents to access community facilities and maintain and develop new interests/hobbies. The current fees for the home are £322 per week. A copy of the inspection report can be provided upon request. Care Homes for Older People Page 5 of 24 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced visit took place on the 4 February 2009 and lasted for a total of three and a half hours. Paul Ramsden, Inspector, undertook the visit on behalf of the Commission for Social Care Inspection. Any references to us or we in the report refer to the Commission. Feedback on the findings of the inspection was given to the home manager as it progressed. This visit was just one part of the inspection. Prior to the visit the home manager was asked to complete an Annual Quality Assurance Assessment [AQAA] to provide up to date information about the service provided in the home. This is a very detailed questionnaire that provides us with a lot of information about the service before the visit. Any other information received since the previous inspection was also reviewed. Care Homes for Older People Page 6 of 24 During the visit various records and the premises were looked at. When looking at the documents relating to the type of care each person needs [assessments and care plans]we use a system called case tracking. This is a method that allows us to follow or track a particular situation in order to ensure it was dealt with appropriately. A resident and the members of staff on duty were spoken with; they gave their views about the home and the service provided. Some of these comments have been quoted in the report. 16 Watford Road is part of the Bradley Project that consists of four supported houses and two small care homes, one of which is No 16. Although the home has a registered manager who is responsible for the day to day management the assessments and care plans are completed by the project manager with input from the home manager and the staff members. There are currently two people living in the home; a third person is having trial visits but no decision about a permanent move has been made yet. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. Information and opportunities to visit before moving in are available and residents are assessed before moving in to ensure their needs can be met at the home. Evidence: The home provides a range of information to prospective residents; these include the Statement of Purpose and Service User Guide. These contain all of the information required and should provide prospective residents with enough details about the home and what is available there. These are available in a different format if needed. People are free to visit and look around prior to choosing to live there if they want to; they, or their representative can contact the manager if they have any questions. Pre-admission assessments demonstrating that the residents individual needs had been assessed in an accurate and consistent way had been carried out for the person who may be moving into the home. The project manager carries out the assessments Care Homes for Older People Page 10 of 24 Evidence: and will visit people in their own home, another care home or hospital to gather the necessary information before admitting someone. This provides an opportunity to make sure their individual needs can be met. When someone is funded by the Local Authority they also provide an assessment of the persons needs prior to admission. This provides background information as to the reasons why a move to the home is needed and is very useful when combined with the homes own assessment. Intermediate care is not provided at 16 Watford Road. Care Homes for Older People Page 11 of 24 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents care plans seen were very well maintained and provided all of the information needed for staff members to be able to take appropriate action to meet an individuals needs Evidence: The project manager is responsible for drawing up a residents plan of care. The care plans seen were all up to date and were written in a person centred style that would enable someone reading it to have a very good idea of what help and assistance someone needed at that time. We felt that they provided staff members with all of the necessary information for them to look after a persons needs. Care plans were being reviewed by the staff members on a weekly basis; a formal review is then undertaken every eight weeks. Where necessary plans are amended or re-written. The manager and staff members spoken with could show that they had a good understanding of the people they were supporting and they were able to meet their diverse needs. They were alert to changes in mood or behaviour and fully understood Care Homes for Older People Page 12 of 24 Evidence: how they should respond to any changes. Care staff work to a high standard in order to ensure that residents receive the care they need. They monitor a residents health and emotional needs daily and there was evidence to show that people were receiving the appropriate support from district nurses, GPs etc. A key worker system is in place [This is a system used in the majority of homes and involves particular staff members working more closely with certain residents]. The changing needs of individuals are discussed as and when required. We were able to see this in practice during the visit and from the care plans. It was seen throughout the visit that residents were being treated with warmth, courtesy, respect and good humour by staff. One of the staff members spoken with said; Although No 16 is a care home, it is still peoples own home, we consider that this reflects the ethos of the home in general. All personal care is carried out in the privacy of a residents bedroom or one of the bathrooms. PSS has a written policy on the receipt, administration [including self administration], safekeeping, handling, recording and disposal of medication within its homes. Medicines are administered using a blister pack system provided by a local pharmacist. The arrangements for the administration of medicines during this inspection visit were considered to be good and the residents were being given their medication as prescribed. All staff members have received medication training. Care Homes for Older People Page 13 of 24 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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. Residents using the service are able to participate in a variety of social and other activities and can maintain contact with family and friends. Evidence: Because of its size routines within the home are very flexible; the people living there can spend their time in the lounge or in the privacy of their own room. People can maintain any social interests they have and activities; including meals or days out are easily arranged. On the day of the visit one of the residents was at a day centre. Residents are able to maintain their own religious beliefs and would be provided with support from staff members if they wanted to attend their church. Meals are flexible and are planned with the people living in the house; a record of meals is kept. Residents are able to participate in the preparation of meals if they choose to do so. The relationships between the resident who was in the house at the time of the visit and the staff members supporting him were very relaxed; he was asked what he wanted to eat for lunch and it was obvious that they knew his likes and dislikes. Family members are free to visit and they often have a meal with their Care Homes for Older People Page 14 of 24 Evidence: relative. Care Homes for Older People Page 15 of 24 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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. Residents and relatives are able to complain/make suggestions and action would be taken to respond to their concerns. Adult protection training is provided for staff in order to ensure the continued safety of residents. Evidence: There is a written complaints procedure for the home, there is a book to record any issues raised by residents and visitors. A pictorial system is also available; this record showed that the home had not received any complaints since the previous inspection. We have not received any complaints either. The home has an adult protection [now referred to as safeguarding] procedure that complies with all of the relevant legislation and good practice guidelines. This is designed to ensure that any possible problems that arise are dealt with openly and people are protected from possible harm. No safeguarding referrals have been made since the previous inspection. Staff members undertake training in this area. Care Homes for Older People Page 16 of 24 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, 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. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The facilities and accommodation within the home are of an excellent standard, this means that residents live in a very comfortable and homely environment. Evidence: !6 Watford Road is maintained to an excellent standard, the lounge is comfortable and homely and the kitchen is well equipped. Residents are encouraged to see the home as their own and they enjoy maximum independence in a discrete non-institutional setting. They are fully involved in decisions about decor and any changes in their communal and personal accommodation. Each resident has their own large bedroom; these were comfortable, well furnished and contained many personal items, including Sky TV and music systems. The home also provides adaptations for use by residents with mobility problems. This includes a ground floor shower room. Domestic washing and drying facilities are available. Care Homes for Older People Page 17 of 24 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. Staff members work positively with residents and families to improve the quality of life of residents living in the home. A robust staff recruitment process is in place to protect residents from possible harm. Evidence: Care staff on duty and rotas seen demonstrated that staffing levels and the skill mix of staff was able to meet the needs of the residents within the home. The staff members were cheerful and friendly and the relationships with the residents who was present during the visit was warm and friendly. We saw that the staff team worked well together and relationships between them were relaxed and positive. Due to the size of the home there are occasions when there is only one staff member present; although there are lone worker systems in place the company is planning to improve the system by introducing a new electronic call device called ROMAD; this will enable staff members to request assistance from anywhere in the house. Staff members receive regular training. The home has a training plan that covers all mandatory and other training for the year. Staff training records were well maintained The home manager confirmed that the four staff members working in the house are either qualified to National Vocational Qualification [NVQ] level 2 or 3 in care, a Care Homes for Older People Page 18 of 24 Evidence: recognised qualification for people working in the care profession or are undertaking this qualification. Staff personnel files are held at Head Office; because there have been no new staff members since the previous inspection visit the recruitment files were not looked at. Instead we discussed the process that is followed with the administrator that deals with this. She was able to explain the procedure in detail and confirmed that nobody would start with the company until all of the appropriate checks had been undertaken. PSS consider that the recruitment of good quality staff members is an integral component in delivering an excellent service. The result of this is that the current team have the skills, knowledge and experience to meet the diverse needs of the residents they are supporting. New staff members undertake a thorough induction training programme which meets the Skills for Care Induction Standards. Care Homes for Older People Page 19 of 24 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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 being very well run and managed on a day to day basis, this helps to ensure that the needs of the residents are met and that there are appropriate procedures in place to maintain their safety. Evidence: The manager is registered with us and has a number of years experience. She was able to demonstrate her ability and competence in order to ensure that the home was well managed. She displays a clear sense of direction and best practice and regularly attends courses/training in order to keep her practice up to date and to fulfill her management responsibilities. She has completed her NVQ in management. The manager can clearly demonstrate an awareness of the needs of the residents living in the home and how to manage the staff team. A project manager and administrators at PSSs head office support the manager. This is a strong and committed team who work hard to ensure that the quality of care provided is maintained at as high a level as possible. Care Homes for Older People Page 20 of 24 Evidence: PSS fully recognises the importance of a quality assurance system in order to ascertain whether residents and families are happy with the standards of care being provided. They are a proactive organisation that acts upon the results of consultation with people; this helps to ensure that good practice is developed and maintained. One of the residents attends the Bradley Projects clients meetings; this enables people to comment on the service being provided. The systems for the care of any residents monies held by the home are maintained to a good standard. All staff members are supervised on a continuous basis; in addition they all receive formal supervision and have staff meetings on a regular basis. This helps to ensure that the high quality of care provided to residents is maintained. The home has a comprehensive range of policies and procedures to promote and protect both residents and staff members health and safety. The manager explained that wherever possible residents attend training courses and one of the people living in the house was due to attend both Health and Safety and Food Hygiene courses in the immediate future. The fire and maintenance records seen demonstrated that the appropriate service contracts were in place. The fire safety log book showed that the tests on the system and emergency lighting were being carried out at the recommended intervals and that drills and training were also up to date. Care Homes for Older People Page 21 of 24 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 Older People Page 22 of 24 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 Care Homes for Older People Page 23 of 24 Helpline: 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 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - 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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