Random inspection report
Care homes for adults (18-65 years)
Name: Address: 2 Upland Road 2 Upland Road Bromsgrove Worcestershire B61 0EQ three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Sally Seel Date: 0 9 0 6 2 0 1 0 Information about the care home
Name of care home: Address: 2 Upland Road 2 Upland Road Bromsgrove Worcestershire B61 0EQ 01527874012 Telephone number: Fax number: Email address: Provider web address: maggie.mole@new-dimensions.org.uk www.dimensions-uk.org Name of registered provider(s): Name of registered manager (if applicable) Ms Margaret Love Farroll Mole Type of registration: Number of places registered: Conditions of registration: Category(ies) : Dimensions (UK) Ltd care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 4 The maximum number of service users who can be accommodated is: 4 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: Learning disability (LD) 4 Date of last inspection Brief description of the care home Upland Road is a traditional detached bungalow approximately one mile from Bromsgrove town centre, providing a home for four people. There is easy access to public transport and the town centre, and the home has its own vehicle for people to use. Upland Road aims to promote independence and dignity for people who have a
Care Homes for Adults (18-65 years) Page 2 of 13 Brief description of the care home learning disability, in a homely environment. One person has a significant physical disability. People who use the service are encouraged to participate in the running of the home and share in the general household activities within their capabilities. Dimensions (UK) Ltd is now the care provider for the service, having registered with the Commission for Social Care Inspection on 1st April 2006. Information about the home can be found in the statement of purpose and service user guide which can be found in the home and requested from the manager of the home. Interested parties can request up to date information in relation to the fees charged for liviing at this home by contactinig the home direct. Care Homes for Adults (18-65 years) Page 3 of 13 What we found:
The focus of inspections undertaken by us, the Care Quality Commission (CQC) is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. The purpose of the visit to the home was to complete a random inspection as the last key inspection of the home was undertaken on the 2nd May 2007. Excellent outcomes for people were reported at this key inspection. This random inspection was to review the standards of care being provided to ensure that the health and welfare of people who live in the home continues to be actively promoted. The inspection was undertaken by one inspector who visited the home over the course of half a day with no prior notice being given to the manager or staff at the home. We did not look at all the standards at the time of this random inspection. On the day we visited the home three people were living there. The home provides care and support for people by the reason of a learning disability. Discussions with people living at the home were not always appropriate on the day we visited. This was due to the short amount of time we spent at the home and being unfamiliar to people who have various communication needs. On the day we visited the registered manager was away from the home but we spent time talking with the deputy manager and a member of staff who was also on duty. We looked at information that tells people about what the home is like to live in, care records, accident records and complaints procedures. We also examined the monthly visits that are made to the home by a person appointed by the provider to measure the quality of services that people who live there are currently receiving together with staff rotas and files. The registered manager of the service had previously completed an Annual Quality Assurance Assessment (AQAA). The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. Some of the registered managers comments have been included within this inspection report. We also received completed survey forms from one person who lives at the home and two staff working at the home. The information from these sources helps us understand how well the home is meeting the needs of the people using the service. Some of the comments from the surveys have been included within this inspection report. We provided the deputy manager with some feedback at the time of our visit and have summarised below what the home does well together with what they could do better. We have also made one good practice recommendation at the end of this report which should be considered to make sure people who live in this home are continuing to receive excellent outcomes. Choice of Home.
Care Homes for Adults (18-65 years) Page 4 of 13 Within the statement of purpose and service user guide there is sufficient information to tell people about what the home would be like to live in. We saw that this included facilities within the home, how peoples needs would be assessed, services on offer, staffing, management and complaints procedures. We also noticed that the statement of purpose and service user guide have been updated so that people can be confident that the information they receive is accurate. This enables individuals to make an informed decision about whether the home is right for them. It was also good to see that the service user guide has pictures to illustrate the written word as this is a home for people who have learning difficulties so have a range of reading needs. The home has one vacancy at the time of our visit as there are currently two females and one male who live at the home. Individual Needs and Choices. We looked at the care records for two people who live in the home and examined care plans together with accompanying risk assessments for meeting each persons daily needs whilst maintaining safety aspects. As at the last key inspection we saw that plans are informative and detailed for meeting individuals personal care, health needs, communication, socialising and other identified needs. The plans included details of peoples strengths and needs, goals aimed for and how these will be achieved. Care plans have been reviewed so that peoples changing needs are met accordingly. Each person is allocated a key worker who has responsibility for ensuring aspects of care and support is in place. Records indicate key worker meetings take place regularly so that any changes in peoples needs are monitored and met in a timely way. For example, we looked at the personal path maps which we saw give a good insight into individuals aims and goals. These told a story and were an excellent way of involving people with the help of staff in completing to give meaning to a persons life which individuals can understand with the help of their key workers. These are reviewed to make sure that goals aimed for are being achieved and to reflect any changes required helping a person to reach their goals. It was good to see that care plans are person centred which means that people are able to direct their own care pathways so that the care and support they receive from staff is what suits individuals best. We saw that a persons likes and dislikes, culture and background, daily needs, health issues, interests and relationships that are important to them are known by staff. Staff told us in their survey that we received what the home does well:Spends the time required to support people to make choices about ordinary everyday things. Communication plans are in place within the care records we looked at with pictures in place to show what people enjoy doing. As with care planning we found risk assessments to be in place for identified needs with safety mechanisms in place, in areas, such as, behaviour, communication, eating and drinking, mental health, medications, safety in vehicle, purchase of rings and watches. All
Care Homes for Adults (18-65 years) Page 5 of 13 risk assessments were personalised with specific clear instructions in all areas for staff to follow ensuring peoples safety at all times. Daily records are maintained and these provide a good clear summary of a persons daily events which include, if individuals are unwell, visits from other professionals, how people spend their day and personal care provided. Lifestyle. As already stated we were unable to clearly ascertain all of the views of people who live in this home in relation to activity opportunities due to their differing communication needs. Therefore records were examined in order that we could be satisfied that the provider is meeting their obligations in this area. Information that we saw indicates that there are a range of activities undertaken including enjoyed music, made own bed and drink, watched a film, watched TV, go for a walk, swimming, meals out, cinema, bowling, day trips, safari park etc. One person who lives in the home told us in their survey what the home does well:Take me shopping for CDs and albums. Within the two care records that we looked at we saw that individual menus of what people have chosen to eat on a daily basis are noted. The meals noted upon these menus looked varied and nutritious. It is positive that staff have understanding of the principles of people receiving their five a day in relation to being offered fruit and vegetables so that peoples health and wellbeing is being supported in what food is offered to people. One person in their survey told us they would like to have more fresh coffee. Health and Personal Care. As at the previous inspection and stated above the care records that we looked at indicate that people living at this home have access to a range of specialist community services should they require them. These include general practitioners, opticians, chiropodists, dieticians and psychologists. Health care plans were seen to be in place for identified needs such as epilepsy. Weight records in one persons care records that we looked at showed that staff are not always regularly checking this persons weight. This persons weight was last recorded in March 2010 and it highlighted that the person had lost some weight. We would have expected to see further weight recordings after this last one but none had been recorded to ensure that this person is not losing or gaining a significant amount of weight that could be an indicator of an underlying health needs. This is particularly essential for people who have limited communication, understanding and or may not be able to consistently express if they are unwell. The assistant manager acknowledged that peoples weights need to be checked regularly and assured us that this would be done. Complaints The Care Quality Commission (CQC) have not received any complaints about this home in the last twelve months.
Care Homes for Adults (18-65 years) Page 6 of 13 We were advised on the day we visited and in the AQAA (Annual Quality Assurance Assessment) we received that no complaints have been made in the last twelve months directly to the home. We were shown the complaints log and saw that the last two complaints were receive in 2008 which were resolved within appropriate timescales and methods. One person confirmed in their survey that they knew how to make a complaint and who they should speak to if they were unhappy. We were told that there have been no safeguarding referrals made and we saw that staff have received training in the protection of vulnerable adults. This should make certain that staff know how to recognise abuse and how to report this so that people living in this home are fully protected from harm. Environment We did not look around all of the facilities within the home at the time of this visit. However, the home is in a residential area and blends in with the other houses in the road. There is a homely atmosphere within the building and generally the standard of decoration appears to be good. We looked at one persons bedroom as they invited us to and saw that it was personalised with their items that were important to them. There were no malodours on the day we visited and generally the environment looked clean. One person in their survey said that the home is always fresh and clean. Staffing. We examined one staff file, in order to see if the homes recruitment and selection practices safeguard people living at the home. These contained copies of completed applications, two written references and we found checks had been completed in relation to the Criminal Records Bureau (CRB). This should make sure that staff employed are able to work with vulnerable people and peoples living in the home are protected from harm. We looked at the staffing rotas which confirm that there are two staff on each shift and one member of staff undertakes sleep in duties overnight. On the day we visited there were two staff on duty as already mentioned earlier in this report. We were told that there is one staff vacancy at present and regular bank staff work at the home when required. However, if another person comes to live at the home then staffing levels would need to increase as was reported at the last key inspection. A person who lives in the home responded in their survey, what they thought the home could do better:More staff. A staff survey told us:- Care Homes for Adults (18-65 years) Page 7 of 13 It would be nice to facilitate everything in the way of activities for everyone but the home doesnt have a one to one ratio. Also the responses we gained from the two staff surveys to the question, Are there enough staff to meet the individual needs of all the people who use the service, Usually. We saw that there is a training plan which indicates the training staff have received together with when staff require to refresh their training. The mandatory courses that were noted included, first aid, health and safety, manual handling, fire safety, prevention of vulnerable adults (POVA) and food hygiene. We also saw that some specialist courses had been completed, such as, autism, eating and drinking and epilepsy. The AQAA tells us that all seven staff have received training in infection control and 100 of staff have received safe food handling training. We also saw that four out of the seven staff have their National Vocational Qualification (NVQ) Level 2 which meets the requirement of 50 of staff holding this qualification. This should mean that staff should be able to meet the needs of the people living at the home individually and collectively. Management As at the previous key inspection the registered manager is qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives. We looked at the monthly visits that are undertaken by a representative of the organisation which measure the quality of services for people who live at 2 Upland Road. These informed us that people who live in the home are enabled to share their views together with staff, the homes environment is inspected together with care records, financial management, various policies and procedures, complaints and compliments. This ensures that good outcomes are achieved in the best interests of people living at this home. What the care home does well:
The statement of purpose and service user guide are information guides that tell people what it would be like to live at the home and what facilities are offered. Both the statement of purpose and service user guide reflected that they had been reviewed and updated accordingly. This means that all of the information supplied is relevant and does not mislead people. Staff support people well with their personal and health care whilst ensuring all care practices are person centred. Encouragement is provided to people to be independent and to take part in activities that hold meaning to them. People can personalise their own rooms to reflect preferences and tastes so that they live in a comfortable environment. Staff training is completed in a timely manner so that people can be confident that their individual and collective needs are met by qualified and skilled staff.
Care Homes for Adults (18-65 years) Page 8 of 13 The manager has recognised in their AQAA what needs to be improved so that excellant outcomes are maintained for people who live at 2 Upland Road. What they could do better:
The weights of people who live in the home must be recorded on a monthly basis as per their care plans. This will ensure that staff are able to see in a timely way if individuals are gaining and or losing weight which could indicate underlying health conditions that would otherwise go undetected. The AQAA tells us that the registered manager has recognised the areas which they are looking to improve upon and should be followed through in the next twelve months and some of these are:- To continue with the vegetable section with the use of large pots so person who has poor mobility and posture difficulties can help to maintain area. To finish the front garden area again with larger pots and trees (Topiary) hopefully this will succeed this year as all died due to weather last year. - Home needs to have full compliment of staff to enable full support of choices and options of new activities/pre-planned activities. Home needs to employ staff to vacant hours when able to do so and organisation needs to employ more flexible regular relief staff. - To continue with building friendships for the People we Support living at Upland Road - To continue to promote peoples rights, privacy and dignity - To plan individual holidays for the People we Support to meet their wishes and interests and support needs. One person would like to try a coach holiday - To continue to research new options and encourage participation in developing life style skills. To put the training from Deprivation of Libertys, Positive behaviour support and assisted support into practice once all staff have attended training - Staff to continue to work toward independence and develop self awareness for people we support - Staff to encourage more involvement by person when assisting in personal care (once staff have been on the training being provided for assisted support and positive behaviours) - Staff to continue with the use of Health Action Plans and continue to document health appointments. Staff to improve documentation inside these files by asking other health care professionals to make their note along side staffs. - To continue to improve upon established links with the local community - To recruit to vacancies preferably with male staff
Care Homes for Adults (18-65 years) Page 9 of 13 - To continue to work on a flexible rota system to encompass the needs and wishes of the people we support - To book training for mandatory/service specific courses around the individual needs of the people we support - Organise another team building day - Staff to attend training on personalised risk assessments, diversity, Deprivation of Liberty - To improve staff awareness for people we support life skills, all staff to attend personalised risk assessment training. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 10 of 13 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 11 of 13 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 19 The recording of individuals weights needs to be completed in a consistent manner so that any losses and or gains in a persons weight is identified in a timely manner to make sure there are no underlying medical conditions which would otherwise go undetected. Care Homes for Adults (18-65 years) Page 12 of 13 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial 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. Care Homes for Adults (18-65 years) Page 13 of 13 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
