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Inspection on 06/02/08 for 228 Kingsbury Road

Also see our care home review for 228 Kingsbury Road for more information

This is the latest available inspection report for this service, carried out on 6th February 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Each person has a care plan so that staff have the information they need to help them to meet people`s needs. Interactions between the people living there and staff were friendly and relaxed. The home is comfortable, clean and safe and provides a range of rooms including a lounge and music room so people have a choice of rooms to use. The people living there are supported to take part in a range of household activities and be as independent as possible.The manager and staff have worked hard to put things right and make it a nicer home for people to live in. The people living there are supported to go to health care appointments so that their health care needs are met and they are well. Each person has their own bedroom and this is decorated in the way they want it. Each person has the things they like in their rooms. Staff have the training they need so they know how to help the people living there to be well and happy in their home.

What has improved since the last inspection?

What support people need during the night had been risk assessed and this was written down in their care plan. This helps staff to know what each person needs during the night so they are safe. Behaviour guidelines were dated and often reviewed to make sure that they are still relevant for the individual. Some more work had been done in making the house more homely and comfortable. Some rooms had been painted and some new furniture had been bought. Risk assessments had been done for all rooms in the home. This means that staff know what to do to make the home as safe as possible for the people living there.

What the care home could do better:

There are two staff on during the day; this is not always enough staff to help the people living there to do the things they would like to do, when they want to do it. An extractor fan should be fitted in the kitchen so it is more pleasant for people to eat their meals. Requests for repairs and replacement of items should be responded to soon. This will improve the home for the people living there. The home should be extended so that there is a laundry inside the home. This will mean people will be able to help more with doing their washing. The amount of time the manager spends doing management tasks should often be reviewed. If needed they should be changed to make sure that there is enough time to manage the home so that the people living there benefit from a well run home.

CARE HOME ADULTS 18-65 Kingsbury Road, 228 Erdington Birmingham B24 8QY Lead Inspector Sarah Bennett Key Unannounced Inspection 6th February 2008 09:40 Kingsbury Road, 228 DS0000065003.V356247.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 Kingsbury Road, 228 DS0000065003.V356247.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. Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingsbury Road, 228 Address Erdington Birmingham B24 8QY 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) 0121 382 5493 Caretech Community Services Limited Vacant post Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th February 2007 Brief Description of the Service: 228 Kingsbury Road is an adapted domestic property in Erdington, a residential area of Birmingham. The home offers accommodation over three floors. On the ground floor there is a lounge, relaxation room, kitchen/diner and WC. On the first floor are three single bedrooms, and a bathroom. On the second floor is a staff sleep in room/office. The home has a rear garden, and a laundry is located in out buildings. People require full mobility to live in this home. The service provides care and support to three adults who have a learning disability, and some behaviour that challenges. The service users guide stated that the fees range from £1061.00 - £1526.23 per week. These include accommodation, food, lighting, heating, laundry and staff. The information included in this report applied at the time of inspection and the reader may want to obtain more up to date information from the care service. The CSCI inspection reports are available in the home. Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The visit was carried out over one day; the home did not know the inspector was going to visit. This was the homes key inspection for the inspection year 2007 to 2008. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) 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 provision that need further development. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home and the manager completed a questionnaire about the home – Annual Quality Assurance Assessment (AQAA). Two people who live in the home were case tracked this involves establishing individuals experience of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking people’s care helps us understand the experiences of people who use the service. The people who live at the home, the manager and the staff on duty were spoken to. Due to the needs of the people living there they were unable to verbally communicate their views about the home. A tour of the premises took place. Care, staff and health and safety records were looked at. What the service does well: Each person has a care plan so that staff have the information they need to help them to meet people’s needs. Interactions between the people living there and staff were friendly and relaxed. The home is comfortable, clean and safe and provides a range of rooms including a lounge and music room so people have a choice of rooms to use. The people living there are supported to take part in a range of household activities and be as independent as possible. Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 6 The manager and staff have worked hard to put things right and make it a nicer home for people to live in. The people living there are supported to go to health care appointments so that their health care needs are met and they are well. Each person has their own bedroom and this is decorated in the way they want it. Each person has the things they like in their rooms. Staff have the training they need so they know how to help the people living there to be well and happy in their home. What has improved since the last inspection? What they could do better: There are two staff on during the day; this is not always enough staff to help the people living there to do the things they would like to do, when they want to do it. An extractor fan should be fitted in the kitchen so it is more pleasant for people to eat their meals. Requests for repairs and replacement of items should be responded to soon. This will improve the home for the people living there. The home should be extended so that there is a laundry inside the home. This will mean people will be able to help more with doing their washing. The amount of time the manager spends doing management tasks should often be reviewed. If needed they should be changed to make sure that there is enough time to manage the home so that the people living there benefit from a well run home. Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 7 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. Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 8 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 Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 9 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users have the information they need so they can make a choice as to whether or not they want to live there. EVIDENCE: Records sampled included a service users guide that had recently been updated. It was produced using pictures making it easier to understand. It included the relevant and required information that the people living there need to understand what the home provides and their rights and responsibilities. The statement of purpose had recently been updated and included the relevant information so that prospective service users would know what the home provides and whether their needs could be met there. There had been no people admitted since the last inspection and there were no vacancies. Therefore, the standard relating to assessment of individual’s needs before they move in could not be assessed at this inspection. Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 10 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, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have the information they need in care plans and risk assessments so they know how to support individuals to meet their needs, communicate what they want and ensure their safety and well being. EVIDENCE: Records of two of the people living there were looked at. These included an individual care plan. This detailed the support that staff needed to give the person with their personal care, health, communication, nutrition, during the day and night, mobility, to promote their independence, social activities, religious/cultural needs, in maintaining relationships and their emotional needs. It was clear that the person had been involved in developing their care plan and in reviewing it to make sure that it continued to reflect the support the person needed. Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 11 Care plans detailed how the person communicates through words, signs or gestures. For one person it stated the key words that they use and what they mean for that person so that staff would be able to understand what they are saying and what they want. This helps to reduce the person’s frustration in making themselves understood. Records showed that work had begun with individuals in developing their person centred plan. This included photographs of the person and pictures making it easier to understand. Daily records sampled and observations throughout the day showed that people are able to choose what activities they do, what they eat and drink, the music they listen to and whether they have a bath or shower. Care plans stated that people should be supported to choose what clothes they wear and be involved in planning the menus. Records showed that people have an opportunity to spend time talking with their key worker about what activities they would like to do, if they are getting the support they need, keeping in touch with their family, decorating their bedroom and how they are getting on with the other people living there. One person’s records said they are happy with the support they receive and are always involved in making choices. Regular meetings are held with all the people living there. Minutes were written using pictures making these easier to understand. They stated’ what do we plan to talk about? What did we talk about? and what we decided’. People talked about activities inside and outside the home, decorating their bedroom and the home, what they wanted to do at Christmas, menus and keeping in touch with their family. Records sampled included individual risk assessments. These detailed what staff needed to do to minimise the risks of moving around the home, travelling in car, financial abuse, the person’s behaviours and how this affects the other people living there, using the community, cooking, bathing and personal care, maintenance staff working at the home, eating, using the microwave, carrying hot liquids, hot surfaces, fire and going swimming. Risk assessments had been regularly reviewed and updated where necessary to ensure they are appropriate in minimising risks to the person. Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 12 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, 14, 15, 16, 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Generally the people living there experience a meaningful lifestyle. This could be improved if staffing levels were increased so there was greater opportunity for people to do the things they want to do. People are generally offered a healthy and varied diet. EVIDENCE: One person goes to a day centre from Monday to Friday. The other people used to go to college but the funding for these placements had been withdrawn. Staff said that this had been difficult for people as they enjoyed going to college doing different things and meeting different people. The manager said that they are looking at other college/day placements and trying to get funding for these. Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 13 Records sampled showed that people go shopping, to the cinema, watch TV and DVD’s, listen to music, played board games and have hand massages. One person said they enjoy walking to the local pub for a drink with staff. One person spent the day at their day centre. The other two people spent the day listening to music, watching DVD’s, doing household tasks and planting up pots for the garden that they had recently bought at the garden centre. Records stated when people refused to do activities or were offered the opportunity to go out but did not want to. Records recorded the individual’s response to activities they did and whether or not they seemed to enjoy them. The AQAA stated that staffing levels do not always allow for people to go out when they want and do the things they want to do. The manager has worked hard with other professionals to request extra funding for one person living there because of their changing needs and this would improve opportunities for people to go out more often. Staff said that the people living there prefer to go on daytrips rather than go on holiday. Because of the needs of the people living there staying in a different environment may be difficult for them and would lead to them being less independent which could cause them to be frustrated and unhappy. Records showed and staff said that people are supported to keep in contact with their family. This may be through visits to their family, visits from their family, telephone calls and buying presents for special occasions. Records sampled showed and it was observed that people often take part in the household tasks helping to promote their independence skills. Staff were observed encouraging people to do things for themselves. People showed the inspector a photo book of them doing a variety of household tasks. One person who has a visual impairment had a talking watch so they know what time it is without having to rely on others to tell them. They also had an audible liquid level indicator so that they can pour their own drinks and maintain their independence. Food records sampled showed that people were offered a varied and healthy diet that included fresh fruit and vegetables. The food records did not always indicate that people had the recommended five portions of fruit and vegetables each day for a healthy diet. Staff showed that they were aware of what people need for a healthy diet and said that people do have this but they do not always evidence this in their recording. Staff sat with people to eat at lunchtime. People had a choice of what they ate and drank and a variety of sauces were offered to individual tastes. Where appropriate people had aids and adaptations including a plate mat and built up spoon so they could be independent in eating their meal. The interaction between staff and the people living there was good and they seemed to enjoy Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 14 talking about the things they do and what it is like to live at the home. Records showed that the people living there had been involved in menu planning. Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 15 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, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements ensure that the personal care and health needs of the people living there are met so ensuring their well being. Arrangements for the management of the medication ensure that people get their prescribed medication at the right time so ensuring they are well. EVIDENCE: The people living there were dressed appropriately to their age, gender, cultural background, the weather and the activities they were doing. Staff were observed encouraging individuals to go and change their clothes when they were dirty so they were more comfortable. Records sampled included an individual health action plan. This is a personal plan about what a person needs to stay healthy and what healthcare services they use. This was produced using pictures making it easier to understand. Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 16 Records showed that people had regular dental check ups, eye tests and foot care from the chiropodist if needed. Where appropriate other professionals were involved in the care of individuals. Records showed that staff followed the advice given by other professionals to ensure that individuals’ health needs were met. Records stated the outcome of health appointments and if any action by staff was necessary to improve the health of the individual. Staff had worked with other professionals to apply for an increase in funding so that the needs of one person could be better met. Records showed that when supporting people to attend health appointments staff had advocated on the individual’s behalf to ensure the best outcome and treatment for them. Records showed that staff regularly monitored individual’s weight. Care plans stated that if the individual had lost or gained a significant amount of weight this should be investigated. This is good as this can be an indicator of an underlying health need. Weight records showed that people’s weight was stable throughout the last year. Medication is stored in a locked cabinet. One person does not take any regular prescribed medication. Since the last inspection a photograph of the person had been put at the front of their Medication Administration Record (MAR). This helps unfamiliar staff know who to give the medication to. Training records showed that staff receive training in medication so they know how to give it, what it is for and how to observe people for any side effects of the medication they take. MAR had been signed appropriately and cross-referenced with the medication in each pack indicating that medication had been given as prescribed. People are prescribed ‘as required’ (PRN) medication. For each of these a protocol was in place stating when, why and how much of the medication is to be given. This ensures that the person only gets the medication when they need it and it is not misused. Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 17 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, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements ensure that the views of the people living there are listened to and acted on. The people living there are protected from abuse, neglect and self – harm. EVIDENCE: The AQAA stated that the home had received no complaints since the last inspection. The Commission had not received any complaints about this home since the last inspection. There was a copy of the complaints procedure in each person’s service users guide so that people would know what to do if they were unhappy with the service provided and how it could be made better. The procedure was produced using pictures making it easier to understand. The Quality Assurance report dated November 2007 stated that staff need to log any concerns of the people living there. Staff had responded to this and recorded when an individual had stated that they were unhappy about the behaviour of another person living there. The manager had spoken to the individual who had the concerns and found ways to resolve this. The AQAA stated and training records showed that all staff have training in adult protection and the prevention of abuse so they know how to keep people safe from harm. Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 18 The manager had completed training in the Mental Capacity Act. This legislation requires an assessment of an individual’s capacity to be made when making a decision about their health and welfare. If they are assessed as not having the ‘capacity’ to make the decision an Independent Mental Capacity Advocate (IMCA) can be appointed to make the decision in the person’s ‘best interests.’ The manager said that this training is to be available for all staff and information is available in the home for people to look at. The people living there can sometimes display ‘difficult’ behaviours. Records sampled included individual behaviour management strategies. These show staff how to work with the person in a positive way that can reduce the likelihood of the person displaying these behaviours, what are the common triggers for the behaviours and how they can be managed so that the person, the other people living there and staff are safe. Individuals’ had signed to say that they agree to their strategy. At the last inspection it was required that the level of injuries sustained by one person living there be monitored. This was monitored and found to be as a result of the person’s self-injurious behaviour. This had been risk assessed and support plans were in place with strategies to minimise the risk of this behaviour on the individual. Records included an inventory of the person’s belongings. These had been updated regularly as the person had bought new things or disposed of things that were broken or could no longer be used. This helps staff to know what belongs to each person and if it should go missing it is easier to track when the person last had it. The finance records of two of the people living there were looked at. The company is the financial appointee for these two people. Records crossreferenced with the amount that was in the individuals’ tin. Each person has a bank account that their benefits are paid directly into. Records showed that they had spent their money on personal items and not on things that should be provided by the company as part of the fees they pay. Receipts were kept of all purchases. Money is held securely in the home. Care plans stated that staff should not go out shopping without the person unless they have agreed to this and should not purchase items for people unless it has been discussed with them. Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 19 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, 26, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Generally the home is well decorated and maintained but improvements could be made so that it is safe, homely, clean and comfortable for the people living there. EVIDENCE: Some rooms in the home were being redecorated. The manager said that they had requested that the hall carpet and the curtains in the kitchen be replaced. A new worktop and sink had been fitted in the kitchen/diner the day before. There was not an extractor fan in the kitchen. When there was a saucepan boiling on the hob the windows were steaming up. An extractor fan should be fitted to improve the ventilation in this room. The AQAA stated and staff said that often requests for repairs and replacement of items do not get responded to promptly. This can have a detrimental effect to the people living there. The AQAA stated that in the next year they plan to Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 20 invest more in the activity room providing a variety of activities and sensory items. Invest in items such a garden shed, table and chairs, gazebo and Barbecue. Redecorate the home and change the lighting throughout the home to domestic homely lighting. This would make it more homely and comfortable for the people living there. The activity/music room was equipped so that this is a stimulating but relaxing room to spend time in. The lounge was decorated in a contemporary style that reflected the ages of the people living there. The carpet had recently been replaced and the manager said they plan to replace the TV cabinet that is worn. One bedroom was planned to be redecorated, as the paintwork is worn. Bedrooms were decorated to individual tastes and interest and reflected the age of the person living there. Bedrooms contained photographs of people important to the person, pictures and many personal possessions. One person living there has a visual impairment. Their bedroom was painted in two different shades of the colour they had chosen to help them differentiate and find their way around easier. The home was clean and free from offensive odours throughout. The laundry is outside in the outhouses. Soiled laundry has to be carried through the kitchen/diner. Staff said that the previous company said they would extend the house to the side so they don’t have to carry laundry through the kitchen or go outside. However, this had not been done and staff said the current company had not yet done anything about it. This should be considered to minimise the risks of cross-infection and provide greater opportunities for the people living there to do their laundry whatever the weather is like. Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 21 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, 33, 34, 35, 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The arrangements for staffing, their support and development are variable, which could impact on the lifestyle of the people living there. The recruitment procedures protect the people living there from harm. EVIDENCE: The AQAA stated that all permanent staff have National Vocational Qualification (NVQ) 2 or above. This exceeds the standard and ensures that staff have the skills and knowledge to work with the people living there. The AQAA stated that newly recruited staff are inducted on the Learning Disability Qualification (LDQ) providing additional knowledge towards the NVQs. This is also more relevant to working with the people living there. One member of staff had recently left and another member of staff was on maternity leave. There are three permanent members of staff working there including the manager. The manager said they have a good team of bank staff who cover the vacancies and the agency staff that work there have done so for a number of years so they know the people living there well. Recruitment was Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 22 taking place and further applicants were to be invited to interview. The staff that are permanent have worked there for several years and know the people living there well and how to support them. The manager said and rotas showed that they never work below the minimum staffing levels so that it is safe for the people living there. The AQAA stated that the current staffing levels are not adequate to allow ready access to community activities for the people living there. The findings of this inspection under the ‘Lifestyle’ standards of this report also show this. However, the manager had applied for additional funding and is taking action to recruit staff to the vacancies. Staff meeting minutes showed that there had been five in the last year. The standard is that there should be at least six a year to ensure staff know about the changing needs of the people living there and are kept updated with ‘best’ practice. However, in July and August 2007 it was stated that a meeting was not held because they were short staffed but staff had an opportunity to raise any issues with the manager. The AQAA stated that they plan to have more regular staff meetings in the next year. The staff records were at the Regional Office being formatted to ensure they included the required information to show that all staff are recruited properly to protect the people living there. The AQAA stated that all staff that are employed within the organisation are subject to a Protection of Vulnerable Adults (POVA) and Criminal Records Bureau (CRB) check. This ensures that ‘suitable’ people are employed to protect the people living there. Training records showed that staff receive training in adult protection and the prevention of abuse, fire safety, medication, moving and handling, first aid, health and safety, food hygiene, managing behaviour, risk assessment, infection control, equal opportunities and visual impairment. Refreshers of some training had been booked for individual staff as needed. The training plan stated that all staff are to have training on autism in March 2008. Staff said that the training is good and they can always get a place on the training that is needed and relevant to the job they are employed for. Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 23 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, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Generally, the management arrangements ensure the people living there benefit from a well run home. They can be confident that their views underpin the development of the home. Arrangements ensure that the health, safety and welfare of the people living there is promoted and protected so ensuring their safety and well being. EVIDENCE: The manager said she plans to finish the Registered Managers Award by April 2008 and has completed NVQ level 4. This will ensure she has the skills and knowledge to be a registered manager. The manager has not yet applied for Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 24 registration with the Commission but was completing her application for this. The manager has two days a week for management tasks and for the rest of her hours works as part of the rota. This should be regularly reviewed to ensure that she has sufficient time to manage the home that will benefit the people living there. There was a computer in the home but this did not have an email facility. This should be provided to make it easier to contact the other homes within the company and the Regional Office staff for advice when needed. This would aid communication within the company and help to ensure the home is better run. The area manager visits the home monthly and writes a report of their visit. These were detailed and included meeting with the people living there and their involvement in the home. Since the last inspection the company has employed a Quality and Performance Manager. They completed a quality audit of the home in November 2007 and wrote a report of their visit. This was detailed and looked at how the home was meeting the National Minimum Standards. An action plan was completed from each group of standards as to how they were going to meet them. It was good to see that progress had been made on completing the recommendations made in the report so improving the service provided to the people living there. Staff complete a health and safety audit of the home every month to ensure that all areas of the home are safe. An electrician tested the portable electrical appliances in November 2007 to make sure they are safe to use. Fire records showed that staff tested the fire equipment regularly to make sure it is working. An engineer serviced the fire equipment regularly to ensure it is well maintained. This would alert staff and the people living there if there were a fire so they would have more chance of being safe. A fire risk assessment was in place that stated what action was needed to ensure the risks of there being a fire were minimised in all each room of the home. A Corgi registered engineer tested the gas equipment in January 2008 and stated that it was safe to use. Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 25 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 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 4 33 2 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 2 14 2 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 26 Yes, one Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA33 Regulation 18(1)(a) Requirement Not met from the previous three inspections but progress made and extra funding applied for. The number of staff provided must be adequate to enable the people living there to undertake activities of their choice, consistent with their peers. Timescale for action 30/04/08 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 YA17 Good Practice Recommendations Food records should evidence that people are offered a healthy diet that includes the recommended five portions of fruit and vegetables each day. This would help to ensure the health and well being of the people living there is good. All staff should be aware of the Mental Capacity Act and the implications it has for the people living there. An extractor fan should be fitted to improve the ventilation DS0000065003.V356247.R01.S.doc Version 5.2 Page 27 2. 3. YA23 YA24 Kingsbury Road, 228 4. 5. YA24 YA30 6. YA37 7. 8. YA37 YA37 in the kitchen so it is more pleasant for people to eat their meals there. Requests for repairs and replacement of items should be responded to promptly. This will improve the environment for the people living there. Consideration should be given to extending the property to provide a laundry inside the home. This will minimise the risks of cross-infection and provide greater opportunities for the people living there to do their laundry whatever the weather is like. The hours that the manager is allocated each week for management tasks should be kept under review. If necessary they should be altered to ensure that there is enough time to manage the home so that the people living there benefit from a well run home. The manager should apply to the Commission for registration to ensure stability in the home and that it is well run to benefit the people living there. An email facility should be provided. This would make it easier to contact the other homes within the company and the Regional Office staff for advice when needed. This would aid communication within the company and help to ensure the home is better run. Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Kingsbury Road, 228 DS0000065003.V356247.R01.S.doc Version 5.2 Page 29 - 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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