Inspection on 22/01/09 for 137 Bills Lane

This inspection was carried out on 22nd January 2009.

CSCI found this care home to be providing an Good 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.

Other inspections for this house

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10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 10/07/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 137 Bills Lane 137 Bills Lane Shirley Solihull West Midlands B90 2PQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Julie Preston     Date: 2 2 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: 137 Bills Lane 137 Bills Lane Shirley Solihull West Midlands B90 2PQ Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Joyce Elizabeth Hewitt Type of registration: Number of places registered: 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: 4. The registered person may provide the following categories of service only: Care Home only - Code PC The service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: - Learning Disabilities - Code LD Date of last inspection Brief description of the care home 4 Over 65 0 care home 4 Solihull Care Trust Care Homes for Adults (18-65 years) Page 4 of 27 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: two star good 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: We spent half a day at the home. The people who live there and the staff did not know that we were coming. Before our visit took place we looked at information from the homes Annual Quality Assurance Assessment (AQAA) and any notifications they had sent to us about events that affect the well being of the people who live there. We case tracked two people who live in the home. Case tracking includes meeting people and talking about the care they receive or watching staff supporting them, looking at their care records and medicines and the way that they are helped to make choices and decisions. This assists us to understand the experiences of people who live Care Homes for Adults (18-65 years) Page 5 of 27 in the home. We looked at records of staff training and recruitment, health and safety records and the food people are offered. Time was spent talking to the staff team on duty during our visit. We were not able to gather the views and opinions of people who live in the home due to their complex communication needs. We looked around the building to make sure that it was clean, warm and comfortable. There were no immediate requirements made after our visit. This means that there was nothing urgent that needed to be done to protect people who live in the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 7 of 27 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 8 of 27 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. Peoples have opportunities to visit the home, before they move in so that they can make an informed choice about whether to live there. Information in the service user guide does not accurately reflect the services and facilitates provided. Peoples needs are assessed before moving in to the home so that they can be confident their needs will be met. Evidence: There have been no new people move into the home since our last visit and there are currently no vacancies. The people who live at Bills Lane have done so for a considerable amount of time, so we did not look at their pre admission records as they date back many years. The home has a procedure for assessing the needs of people before they move in so that they can ensure their needs will be met. We looked at the procedure, which included a statement that trial visits would be offered to help people decide whether the home will meet their needs. Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: There is a statement of purpose and service user guide that describes the services and facilities provided in the home. We were told that the documents are made available to people and their families. The service user guide contained inaccurate information about the service provider and has not been reviewed since Solihull Care Trust took over the running of the home. This means that should vacancies arise people would not have access to up to date information about the home. Care Homes for Adults (18-65 years) Page 10 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are effective systems of care planning and risk assessment in place, which should ensure that peoples needs are understood and met. People receive good support to make choices and decisions about their lifestyles. Evidence: We looked at two peoples care plans and risk assessments. These documents describe the support that people need to manage their day to day lives. The plans had information about individual likes and dislikes, for example, preferred personal care routines and food choices. The two plans had been recently reviewed so that they remained relevant to peoples current needs. People who live at the home have complex communication needs so we were not able to ask their opinions about the care they receive. We spoke to three members of staff who all demonstrated comprehensive knowledge of peoples needs, which indicates Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: that care plans have been read and understood. People have communication passports which had been devised by the staff team with the support of Speech and Language Therapists. The passports describe how to communicate with individuals and identify how to recognise the individuals body language or behaviour as a valuable means of communication. Each person has a Me and My Life book. The books contain information and photographs of the person, those that are important to them and activities they have taken part in. A staff member told us that the books help them to remind people of their achievements and experiences. People who live at the home need assistance to manage their money. We looked at two sets of financial records at this visit. Both were accurate and we saw that the records had been checked each day to make sure that no mistakes had been made when recording what people had spent. This should contribute to a safe system of looking after peoples money. Care Homes for Adults (18-65 years) Page 12 of 27 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 good 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 the home experience a meaningful lifestyle that promotes their independence and reflects their personal choices. Evidence: We looked at activity plans and daily records for two people to see if they had regular opportunities to do things that they enjoy. Each person had a record of the activities they like and those that they dont like. The daily records that we looked at showed that people take part in a range of activities both at home and in the local community, either in small groups or on their own, with the support of staff. Activities included going food and clothes shopping, meals out in pubs and restaurants, drives to the countryside, cake making and attendance at a music and movement class. This should contribute towards people having a meaningful lifestyle. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: In addition to the residential staff team, people at the home are supported by a designated team of day care staff. We spoke to both residential and day care staff who confirmed that people are involved (as much as they are able to be) in planning what they do each week. We saw records which showed that this had happened, including activity planners and evaluations of what people had done so that staff could determine whether or not they had enjoyed the experience. Photographs of the staff on duty each day are on show in the entrance hall so that people are aware of who will be in their home and working with them. The homes rota was seen to have been changed recently so that more staff are available during the day to assist people to go out and take part in leisure activities. The home supports people to keep in touch with their friends and families. Care plans that we looked at described how people should be supported to maintain this contact. We saw that people had framed photographs of their relatives and friends in their bedrooms, which staff said was important to them. We looked at menus and the records of food that people eat to make sure that a varied and healthy diet is offered that meets peoples needs and preferences. Staff told us that people had a choice of meal each day and that they went shopping for food each week. This was reflected in the daily records that we looked at. The menu is pinned up in the kitchen and has photographs of each meal so that people can see what is on offer and choose what they eat. The menus that we looked at showed that traditional English meals are planned for, which is in keeping with the cultural needs of people who live at Bills Lane. Two members of staff told us that some people have opportunities to make sandwiches and cakes, however these activities are risk assessed as they would be unsafe for some people who live in the home. People that require soft diets for health reasons are catered for. The staff that we spoke demonstrated good knowledge about how to provide attractive meals for people that need a soft diet. Care Homes for Adults (18-65 years) Page 14 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are effective systems in place to meet peoples personal and health care needs. Medicines are well managed so that people receive their medication in a planned and safe manner. Evidence: We looked at personal and health care records for two people. They contained clear information about peoples needs and preferences of routine and had been recently reviewed to make sure that they were accurate and up to date. Staff at the home have made good relationships with health care professionals. We saw specific care plans relating to supporting people with their communication that had been written by Speech and Language Therapists and records which showed that people have regular contact with healthcare staff according to their individual needs. The outcome of each appointment had been recorded so that staff had up to date information about peoples health. The home has monitoring systems in place for individuals, such as weight and bowel Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: movement charts to ensure that there is an overview of peoples health which should contribute to them staying healthy and well. The two members of staff that we spoke to were able to describe how they supported people with their personal and health care, which indicates that they had read and understood individuals care plans. We looked at the way medicines are managed in the home to check that this was being done safely and to ensure that people receive their prescribed medication. Medicines had been securely stored in a locked cabinet. We looked at the medication records for two people. There were written protocols in place for people who take medicines on an irregular basis. For the period that we looked at, no dispensing errors had been made and the medicines in stock matched the records in place for each person. All staff have received accredited training in the safe handling of medicines and have their competence assessed every six months by a registered nurse. This should ensure that people receive their medication as prescribed so that their health is maintained. Care Homes for Adults (18-65 years) Page 16 of 27 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. There are effective procedures in place to listen to peoples complaints and safeguard them from possible harm. Evidence: There have been no complaints, either to the home or to the commission since the home was newly registered in 2008. We were told that the complaints procedure is made available to peoples families as due to individuals communication needs it would be highly unlikely they would be able to raise concerns themselves. Two members of staff commented that they would observe peoples behaviour and body language as a means of establishing that they were not happy and seek to find out what the cause could be. This shows that staff clearly know people well and understand the importance of recognising non verbal indicators that the person may be unhappy. We looked at staff training records and saw that all staff had completed training in safeguarding vulnerable adults. The homes Annual Quality Assurance Assessment gave information that told us over half of the staff team have completed or are undertaking National Vocational Qualification Training which includes elements regarding the recognition and reporting of possible abuse. We spoke to two members of staff who told us that they understood the importance of the training so that people could be protected from potential harm. Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: Some people who live in the home demonstrate behaviour that requires action by staff to reduce the risk of harm to the individual or to others. Guidelines were looked at which showed that a plan had been agreed to reduce the risk of triggers that might prompt behaviour which is challenging so that people could be protected from harm. Staff were able to to describe the content of the guidelines which indicates that they are aware of the procedures to follow for individuals ongoing protection. Care Homes for Adults (18-65 years) Page 18 of 27 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 warm, clean and well furnished. This makes a pleasant environment for people to live in. Evidence: 137 Bills Lane is situated in the Shirley area of Solihull and is close to shops, pubs, cafes and places of worship. This is important to the people who live there as they make regular use of these facilities. We looked around the shared areas of the home which include two ground floor lounges, a kitchen/dining area, bathroom and separate laundry room. We also looked at the bedrooms of the people we case tracked. The home was warm and clean, well decorated and comfortable. A new sit down shower had been installed in the first floor bathroom, which gives people the option of having a bath or a shower. This room had also been redecorated, giving people a more pleasant environment in which to receive their personal care. The bedrooms that we looked at had clearly been furnished according to peoples personal tastes. For example some people had a double bed and others had sensory equipment fitted. We saw that new curtains and wardrobes had been purchased to Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: replace old or damaged items. Information that we received in the homes Annual Quality Assurance Assessment told us that there were plans to refurbish one of the homes lounges. We noted that the television in this room was in a very low position, which could mean that people may not be able to see it properly. Care Homes for Adults (18-65 years) Page 20 of 27 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. People are supported by a trained team of well established staff who have good understanding of their needs. The home operates a robust system of recruiting staff for the ongoing protection of the people who live there. Evidence: The people who live in the home were not able to express how their opinions about the staff team due to their complex communication needs. We saw that people spent a lot of time with staff, choosing to sit next to them and stand with them. This indicates that people are comfortable with the staff who work with them. The homes rota showed that there were up to four staff available to work with people during the day. This was felt, by a senior worker as being sufficient to meet the needs of people who live at Bills Lane. Some male staff are employed and there are plans to employ more. This is reflective of the gender of people who live in the home. The staff that we spoke to at this visit were knowledgeable about peoples needs and clearly know them well. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: We looked at staff recruitment records for a new worker. The records showed that checks had been made of the persons suitability to work within the home, prior to appointment. This contributes to the ongoing safety and protection of people that live at Bills Lane. The homes Annual Quality Assurance Assessment gave information that told us over half of the staff team have completed or are undertaking National Vocational Qualifications in care. We looked at training records which showed that a rolling programme is in place, organised by Solihull Care Trust. As well as completing health and safety training staff have also experienced sessions in autism awareness and managing challenging behaviour.This should make sure that people are supported by a competent and trained team of staff. Care Homes for Adults (18-65 years) Page 22 of 27 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. The home is being well managed and peoples health and safety is promoted and protected. Evidence: The home has a registered manager who has over forty years experience of social care. The manager is a learning disability nurse (as is the homes house leader) and has also completed a certificate of management in health services. The manager and house leader were not present at our visit, however the staff team were confident in answering our questions and familiar with the process of inspection. This indicates that the staff team are well informed and knowledgeable about their roles. There are systems in place to review the quality of care and service provided within the home. We were shown a quality review that had been completed by the staff team which was required by Solihull Care Trust to measure the homes performance against national minimum standards in care homes. No feedback had been received at the time of our visit, however it was clear from looking at the document that the staff Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: team had been able to provide evidence that practice in the home is in the best interests of the people who live there. For example, a medicines audit had taken place, which identified no areas of medicines management that needed to improve and care plans and risk assessments had been reviewed on a regular basis to make sure that people receive the care and support that they need and like. A representative of the registered provider visits the home on a monthly basis in order to comment on the standard of care provided. These reports had been made available to the staff team so that they could act upon any recommendations made and therefore improve services to the people who live at Bills Lane. A number of checks are made to make sure that peoples health and well being is protected. We looked at some records that show this has happened. The fire alarm system had been tested and serviced on a regular basis to make sure that it was working properly. People had taken part in fire drills so that they had opportunities to practise leaving the building in the event of an emergency. We saw evidence that monthly health and safety checks are completed, which are reported to the registered provider. A member of staff told us that if health and safety issues arise, they are resolved quickly by the registered provider. Training records showed that all staff have taken part in health and safety training. This should contribute towards promoting peoples health and safety. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 1 The service user guide should be reviewed so that people have access to accurate information about the services and facilities provided in the home. The placement of the television in the lounge next to the kitchen should be reviewed so that people are able to see the screen. 2 24 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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