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Inspection on 29/03/10 for Barnabas Care Home

Also see our care home review for Barnabas Care Home for more information

This is the latest available inspection report for this service, carried out on 29th March 2010.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

Barnabas Care Home is a domestic house located in a residential area in Shirley, Solihull. The house is suitable to meet the current needs of those that live there. Barnabas provides a comfortable, homely environment which was in a good state of repair. People appeared to be at ease in their surroundings and the atmosphere was relaxed and friendly. On the day of inspection the Home was comfortable, clean, hygienic and well furnished. Bedrooms seen had been personalised with pictures, television and music systems. People seemed to be at ease in their surroundings and spoke freely about life at the Home. The garden was well maintained and ducks roamed freely. People spoke about the pets which include two dogs, a cat, rabbit and guinea pig. One person was seen petting the dog and said he liked all of the pets. Records show and people confirmed that they have a varied and active social life. This includes meals out, trips to the pub, cinema and discos. The Home have purchased a caravan and two holidays are planned for this year in the caravan. Everyone spoken to was looking forward to going on holiday. They also remembered previous holidays and activities that they had undertaken whilst on holiday. The owner has an in depth understanding of people`s needs, likes, dislikes and abilities. People`s relationship with the owner was positive, support and encouragement was offered as needed on the day of inspection. People are encouraged to remain independent and supported to increase their skills and abilities of daily life. People are encouraged to maintain contact with their families and friends. People have access to health care professionals as needed to ensure that their health needs are being met.

What has improved since the last inspection?

Barnabas Care Home was advised of one good practice issue regarding quality assurance systems at the last inspection of the Home. Whilst some ground work has been undertaken to identify a suitable quality assurance system this has yet to be implemented. No other issues for action were identified.

What the care home could do better:

More detail should be included in some parts of care plans to demonstrate that appropriate care and support has been identified and to ensure that these needs are not missed. Individualised health action plans should record the action to be taken to meet people`s health needs, including any mental health and long or short term physical health problems. Quality assurance systems should be developed to demonstrate that people`s individual needs and choices have been taken into consideration when providing care, support and in daily life at the Home.

Key inspection report Care homes for adults (18-65 years) Name: Address: Barnabas Care Home 7 Cole Green Shirley Solihull West Midlands B90 1AD     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Deborah Shelton     Date: 2 9 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Barnabas Care Home 7 Cole Green Shirley Solihull West Midlands B90 1AD 01212436954 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: barnabasb90@blueyonder.co.uk Mr Matthew Chapman care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 3 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) 3 Date of last inspection Brief description of the care home Barnabas Care Home is a small home catering for up to three younger adults who require support and care to enable them to reach their potential within their lives and within society. The home offers warm and friendly care that is provided in a domestic setting. The residents are encouraged to be independent. Two of the residents live at the home on a permanent basis and the home offers a respite facility for one other person for some weeks of the year. The home is situated in a residential area, close to the local railway station and local amenities. Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 3 Brief description of the care home The home is suitable for the needs of the residents currently there, one room is laid out like an independent flat with an en-suite bathroom and patio doors to the garden. Parking is provided at the front of the home. The rear garden is well laid out. The home has two dogs, rabbits and guinea pigs that all residents accept. In practice the residents live in Mr and Mrs Chapmans family home, which is managed more in line with an Adult Placement scheme. In view of Solihull Social Services not having an Adult Placement Scheme, this provision, by default, falls under the more robust National Minimum Standards for Care Homes for Younger Adults 2001. In order not to detract from the small homely service the Commission has made the decision to inspect the home with a lighter touch. Information about the home is available in aUser Guide/information book. Fees are in line with Solihull Social services agreed payments. Care Homes for Adults (18-65 years) Page 5 of 30 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This visit took place over one day and was conducted by one inspector. There were three people living at Barnabas Care Home on the day of our visit. Before we went to the Home we looked at any notifications that the Home had sent us which informed us of events that had impacted on the health and well being of the people who live there. We also reviewed the Homes Annual Quality Assurance Assessment (AQAA). This is a document that the owner of the Home completes which given us information about how the Home is meeting National Minimum Standards, details about training, policies and procedures in place to make sure that people stay safe and well and how the Home plans to make any changes or improvements to the service. We case tracked one person who lives at the Home. Case tracking involves meeting or observing people, reviewing records of their care and talking to any staff who support them in order to focus on outcomes. Case tracking helps us to understand the experiences of people who live at the Home. Care Homes for Adults (18-65 years) Page 6 of 30 We looked at the way medicines and health and safety were being managed, observed the environment that people live in and reviewed training undertaken. The owner who manages the Home on a day to day basis was present and answered all of our questions about the running of the Home. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: More detail should be included in some parts of care plans to demonstrate that appropriate care and support has been identified and to ensure that these needs are not missed. Individualised health action plans should record the action to be taken to meet peoples health needs, including any mental health and long or short term physical health Care Homes for Adults (18-65 years) Page 8 of 30 problems. Quality assurance systems should be developed to demonstrate that peoples individual needs and choices have been taken into consideration when providing care, support and in daily life at the Home. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with information about the Home so they know what to expect from the service. Peoples needs are assessed before agreement is reached to move in so that the Home can be sure that they can meet their identified needs. Evidence: Barnabas provides support and accommodation to two gentlemen who live permanently at the Home. There have been no new people come to live at Barnabas on a permanent basis since the last inspection. A respite care bed is available for up to forty four weeks of the year. One gentlemen had recently moved in for a period of respite care and he was spoken to as part of this inspection process. Before agreement is reached to move in to the Home an assessment of needs and abilities is undertaken and people are invited to visit the Home to meet other people and get a feel for the routines. A care plan provided by social services is made available and then the owner of the Home undertakes his own assessment. People staying for periods of respite care are invited for a few tea visits, where they eat an Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: evening meal and meet the other two gentlemen who live at Barnabas. Anyone who would be staying on a permanent basis would be invited to stay for some weekends before any decision is made about moving in. We were told that it is very important to obtain the views of the people who already live in the Home before any decision is made for people to stay. This helps to ensure that everyone gets on and the relaxed, calm atmosphere continues. Many of the people who stay for short periods at the Home have been doing so for some time now and are well known to everyone. The person staying currently moved in on an emergency basis and was not known to people but had settled really well and appeared to be getting on with everyone. A copy of the Service Users Guide was reviewed. This document is available for everyone to see if they wish. There is not a copy for each person living at the Home. The Service Users Guide has a photograph of one of the people who lives at Barnabas at the front of the Home. This document has not been made available in picture format to assist anyone who is not able to read. Although, we were told by the owner that he sits and reads the document to all new respite people and discusses the document with all people who live at the Home to refresh their memory about the services and facilities at Barnabas House. The Service Users Guide has been updated recently to include a brief infection control policy. We were told that some other updates are required and they will be completed shortly. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this Home are confident that they are supported to live their lives as they choose, with a mutually agreed care plan and risk management plan. Evidence: One person was case tracked at this inspection. This involves looking at their care plans and other documentation relating to their live at Barnabas, talking to them and looking at their living accommodation. A file of information is kept for each person staying at the Home. This includes care plans, risk assessments, journal entries and other important documentation. The information recorded in care plans was brief but it was evident from discussions with Mr Chapman, the owner, that he had an in-depth knowledge of peoples needs, abilities, preferences, likes and dislikes. During discussions it was noted that he was fully aware of peoples health needs and who to contact if any health issues arose. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: Care plans are discussed with the individuals and they are aware of the information recorded. One care plan seen was broken down into headings such as health, day placement, personal care and hygiene, meals, social activities, family contact and finances. Brief details regarding personal care needs were recorded i.e. can run bath unaided, can cut toe nails, care plans record that people have daily shower unaided. People living at this Home have few support needs, we were told that it is mainly encouragement and prompts that are needed. Notes are made for each person and recorded on computer. Information is recorded regarding, for example, activities undertaken, conversations with family, friends or external health professionals. These are then transferred to a journal. This is available for each person to support the care plan. These record details regarding health, attitude and co-operation, outcomes and activities, money, plans and meetings. Detailed information is recorded under each heading. A document called my steps towards my future was available for one person, this is a checklist for self help and support, it was noted that this document requires updating and has not been completed for everyone living at Barnabas. Risk assessments are completed for everyone regarding daily activities in the Home such as running a bath, making hot food or cold snacks and drinks and ironing, amongst other things. Risk assessments are also in place regarding self medication. These are undertaken to identify the potential risks of taking their medication without supervision. Individual risk assessments are available regarding external activities such as visiting football matches alone. People have a key to the front door and to their bedroom. We were told that people are free to come and go as they please, they are requested to take their mobile phone in case of emergency and to have a rough idea of the time that they will be returning. The people living at this Home are able to use public transport links which are located close to the Home and during conversation were aware of which bus to catch to get them to their desired destination. Barnabas is run as a family home with people living with the owner and his wife, Mr and Mrs Chapman. Decisions about daily life are made as they would be in a family home. We were given examples of how people made decisions such as one person sometimes writes a list of food that he would like to be added to the shopping list when someone next goes shopping. Another person likes to go food shopping and help choose what is to be bought. People say when they want to go out and where they want to go. Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: People make decisions about all aspects of their personal life they choose the social activities in which they wish to participate. One person told us that he loves to go to watch the football and sometimes stops off at the pub on the way back. He mentioned some holidays they have planned and some that they have undertaken and made a suggestion for a future holiday. Everyone living at Barnabas was spoken to during this inspection. They appeared to be at ease in their surroundings and had a good relationship with the owner. Care Homes for Adults (18-65 years) Page 15 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to access a range of community and in house activities and to stay in touch with friends and relations so that they can lead a lifestyle which is appropriate to their needs and abilities. Meals are planned on a daily basis by all who live at the Home, this helps to ensure that everyone has the food that they enjoy. Evidence: A discussion was held with the owner, people living at the Home and records were reviewed to identify the social and leisure activities undertaken by people. Records for 2009 show that people went out on various trips, i.e. local soccer fixture, returned to parents home, Christmas party, PHAB club, Gateway, shopping at Sainsburys. Both people living at Barnabas are independent and able to go out alone on public transport. On the day of the visit one person said that he was going to go to the pub for lunch and went out all afternoon. Another person returned from his work placement and said that he was too tired to go out that evening but would go next Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: week when they had returned from their holiday. Both gentlemen were looking forward to going on holiday. It was noted that a five day holiday had been arranged in the caravan for the week of the inspection and another holiday to Cornwall later in the year. Everyone seemed exited about the holiday and talked about the facilities on the camp site. We were told that visits are made to the local cinema as a group or individually. They also go out for a meal as a group at least once a week, this may be a Saturday breakfast, or a Friday or Saturday evening meal at the pub or for Sunday lunch. People are able to go to Church every Sunday, either to a church of their choice alone or with the owners to the local church. We were told that everyone visits church regularly. From discussions with the owner it was noted that people lead varied and active lives and that the activity records only record part of the daily activities that take place for individuals. One person is having a break from his current work placement and is considering his options about returning or arranging a different placement. The other person was spoken to on return from his work placement. He said that he was tired because he had worked hard but had enjoyed his day. We were told that family contact is encouraged. Everyone has their own mobile phone but also has access at any time to the main phone line in the Home. Families are encouraged to be involved in care reviews and are invited to visit at any time. Visits to families and friends are encouraged. Care plans record what activities people are able to participate in regarding cleaning their rooms, for example one person changes his bed linen but requires assistance replacing duvet covers. Both are able to dust their room and take laundry to the washing machine. Both of these gentlemen are able to prepare snacks for themselves such as sandwiches if they go out to their day placements. Daily routines are flexible, although everyone is aware of what time they need to get up in order to get their train or bus to their day placement. Mr Chapman is aware of everyones likes and dislikes and healthy eating plans. Discussions are held around the dinner table about meals for the following day, if requests are made these are generally catered for, although there are no records Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: available to demonstrate this. Mr Chapman said meals are not chosen in advance for the week, they are discussed on a day by day basis as they would be in a family home setting. On the day of inspection the meal to be served was lasagna and stir fry vegetables, one person spoken to expressed that he was really looking forward to his tea. The Homes annual quality assurance document sent to us before this inspection records that We offer life in an adult family home and provide an environment that promotes independence with an appropriate level of support. Residents where risk assessed are allowed to prepare for themselves hot and cold drinks breakfast and snacks of their choosing. Note is taken and acted upon in regard for requests for particular items of shopping for this purpose. Care Homes for Adults (18-65 years) Page 18 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with support and access to health professionals so that they are assisted to stay in good health. Evidence: We met everyone living at the Home during the afternoon or when they had returned from their days activities. People were appropriately dressed for the time of year, their hair was neatly brushed and it appeared that all personal hygiene needs had been met. Care plans record brief details regarding personal care needs i.e. has daily shower, can run bath unaided, can cut toe nails. We were told that people need little support regarding personal care but need monitoring, encouragement and prompting. We looked at health plans and found that there was limited information to show how people should be supported in these areas. However people spoken to were aware of their health care needs. One person spoke freely about a health problem that has recently started occurring. Mr Chapman has taken appropriate action and referred the person to the relevant external professionals. During discussions it was evident that Mr Chapman had an in depth knowledge of everyones needs. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: Both gentlemen living at Barnabas have a well mans check on an annual basis and are offered the flu jab. GP practices conduct six monthly reviews of peoples medication or these take place sooner if needed. Mr Chapman confirmed that he records comprehensive handover notes for any time that he goes away on holiday with his wife when people are asked to manage the Home in their absence. During this inspection it was clear that Mr Chapman offered emotional support to all people living at the Home. This was particularly evident in the support given to the person currently staying at the Home for a period of respite care. The relationship between Mr Chapman and everyone living at the Home was positive and everyone appeared to be relaxed. People are encouraged to become as independent as possible and the level of support provided appeared to be appropriate to individual needs. The systems of storing, administering and recording medicines kept in the Home was looked at to establish that people are protected by robust procedures. Both of the people who live permanently at the Home are self medicating. Risk assessments are in place to demonstrate that they are safe to do so. Mr Chapman checks on a daily basis to ensure that they have taken their medication and then fills out medication administration records. Medication is kept securely in appropriate locations. The person currently staying for respite care does not take any medication. Medication is supplied in blister packs and a months supply is received at the Home. Each person is given a weeks supply and the remaining medication is stored securely until needed. Copies of prescriptions are kept to check against medication received. Once received medications are also checked against the medication administration record and details of medications received are recorded. Details of any verbal contact with the GP are recorded and available for review. Any medication to be returned to the pharmacy is usually taken back by Mr Chapman, there is a returned medications book which is signed when medication is returned. Care Homes for Adults (18-65 years) Page 20 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Procedures are in place for investigating complaints and the owners are trained to recognise and report suspicions of abuse so that people are protected from harm. Evidence: We have received no complaints about the service. The Home have received no formal complaints but are having ongoing discussions about an issue regarding freedom of choice for one person. Appropriate action is being taken to resolve this issue and external professionals are being involved as needed. There have been no adult protection issues raised at the Home. Advocacy services are involved as needed to help people make important decisions. Mr Chapman has attended an update meeting regarding adult protection and is due to attend safeguarding training shortly. The Homes annual quality assurance document records We have an open approach towards complaints and a complaints procedure is in place. On the rare occasion we have had a complaint we have listened to the issues and responded quickly, keeping the appropriate Social Workers informed. Care Homes for Adults (18-65 years) Page 21 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Home is clean, safe and comfortably furnished. Individual rooms are personalised to their chosen style so that people benefit from a homely and comfortable living environment. Evidence: Barnabas Care Home is the family home of Mr and Mrs Chapman and is located in the Shirley area of Solihull. The Home consists of a lounge, dining kitchen, a separate annex which has a large bedroom with seating area and an ensuite bathroom. On the first floor there are the bedrooms of Mr and Mrs Chapman, another bedroom, which is used by Mr and Mrs Chapman, the respite bedroom and the bedroom of a person living at the Home on a permanent basis. There is a large bathroom with toilet, wash hand basin, bath with shower which is shared by the two people whose rooms are on the first floor. Mr and Mrs Chapman have their own bathroom. The loft space is used as the office of Mr Chapman. One person said that he likes to spend time in his room listening to music and watching DVDs. He was happy to show his extensive CD and DVD collection. This person appeared relaxed and played music in his room during the inspection. The Home was clean and no unpleasant odours were noted. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: The garden to the rear of the Home is large and has a pond with ducks. As well as the ducks other pets include two dogs a cat a rabbit and a guinea pig. People spoke fondly about the pets. Furnishings throughout were homely, we were shown all three bedrooms which had all been personalised and were comfortable. We spoke to the person whose bedroom is in the annex, he said he was pleased with his room which he said was large and he liked the patio doors which lead out on to the garden. He told us that he had bought himself a television at Christmas and had a comfortable chair and footstool if he wanted to sit and watch TV in his room. He told us that he helps to tidy his room. Mr Chapman has recently written a short policy regarding infection control. Mr Chapman is aware of who to contact if there are any issues in the Home regarding infection control. People use their own toiletries and towels in bathrooms. This should help to reduce the spread of any infection. Care Homes for Adults (18-65 years) Page 23 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use this service are supported by people who are competent and training to undertake the role. Evidence: Mr Chapman owns, runs and lives at Barnabas House. Mrs Chapman works as a nurse in a local hospital and receives training to update her skills though her work. No other staff are employed. Two people manage the Home each year whilst Mr & Mrs Chapman go on holiday. These people have the relevant experience, are known to the residents and have worked at the Home on this basis for some time. CRB checks are available for both people. No other staff are employed at this Home. Mrs Chapman will manage the Home on some days if needed. There are no plans to recruit any staff to provide support at Barnabas House. Training was discussed with Mr Chapman and it was noted that he has undertaken training regarding First Aid, Nutrition and deprivation of liberty. Other courses have been identified for attendance during 2010 such as fire safety, safeguarding, risk assessing, care of medicines for mental health. It was evident that the owners ensure Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: that they undertake regular training to update their skills and knowledge as necessary to ensure that they can continue to provide care for the people that live with them. Further information about training undertaken by Mr and Mrs Chapman is recorded in the AQAA Mr Chapman is qualified NVQ3. Promoting Independence, NVQ 4 in Care and NVQ 4 Registered Managers Award. His wife who is an RGN and full time Ward Sister is also an NVQ Assessor is supportive in terms of advice . Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a service that is well run. Suitable procedures are in place for maintaining a safe place for people to live in. People feel that their views are taken seriously. Evidence: Mr Chapman is in day to day charge of the Home as he lives on the premises with his wife. This Home is run more like an adult placement with people living in the family home. Quality assurance systems were discussed. It was noted that annual satisfaction surveys are given to the two people that live at the Home and a satisfaction survey is given to respite people. Two feedback sheets for August 2009 were seen and these gave positive feedback. Both were completed by the person with assistance from an advocate or a person from the day centre. Copies of letters of thanks were also available. We were told that the Home is currently investigating the benefits and usefulness of Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: implementing an external quality assurance system. Mr Chapman confirmed that he has been on a training course regarding this and has recently received the information needed to be able to implement the system. Currently there are no other quality assurance processes in place. A selection of records were reviewed to evidence whether the health and safety of staff and the people that live at the Home is maintained. Records show that portable electrical appliance were safety checked in May 09, the five year electricity test was last done in September 2005, the fire alarm system is tested on a weekly basis and the Landlords Gas Safety certificate is dated July 2009. We were told that if people are present when the fire alarm goes if it is treated as a fire drill and everyone has to evacuate. Mr Chapman said that he keeps his food and hygiene training up to date. There have been no environmental health or fire officer visit recently as they were told at their last inspection that this was classed as a family home. Mr Chapman says that there is no stored water in the Home, therefore there is no need to have water tanks chlorinated or water tested. The showers available at the Home are all used on a daily basis and therefore do not need to be run and all toilets are flushed daily as in a normal domestic setting. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 19 More detailed information should be recorded in health care plans to show the action to take to meet health care needs identifiied. Robust quality assurance systems should be developed to show details of audits undertaken and how the Home ensures that the quality of the service provided meets the needs and expectations of those who live there. to show what actions are being undertaken in response to opinions and ideas of the people who live there, and how these are used when reviewing the service provided. 2 39 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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