Inspecting for better lives Key inspection report
Care homes for adults (18-65 years)
Name: Address: 155-157 Upperton Road 155-157 Upperton Road Leicester LE3 0HF 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: Judith Roan Date: 1 1 1 1 2 0 0 8 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. They reflect the things that people have said are important to them: 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: ï· Put the people who use social care first ï· Improve services and stamp out bad practice ï· Be an expert voice on social care ï· Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information
Document Purpose Author Inspection report CSCI
Page 2 of 33 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 33 Information about the care home
Name of care home: Address: 155-157 Upperton Road 155-157 Upperton Road Leicester LE3 0HF 01162547706 01162547706 sharon.brealey@mencap.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Royal Mencap Society Name of registered manager (if applicable) Mrs Sharon Mary Brealey Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 8 0 care home 8 learning disability Additional conditions: No Additional Conditions of Registration. Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 33 A bit about the care home The home is located in two connected terraced houses in a popular residential area in Leicester. The property is pleasantly decorated throughout and individual bedrooms are extensively personalised with belongings and decor. The home can accommodate up to eight people with a learning disability. People using the service benefit from easy access to a range of local facilities such as parks, pubs and shops. Care Homes for Adults (18-65 years) Page 5 of 33 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 Care Homes for Adults (18-65 years) Page 6 of 33 How we did our inspection: This is what the inspector did when they were at the care home We randomly selected two people who use the service and tracked the care they receive through review of their records, discussion with them, the care staff and observation of care practices. We also received information from support staff and a health care professional. The homes registered manager also completed an Annual Quality Assurance Assessment (AQAA) a document required by CSCI. The inspection was unannounced and lasted 5 Hours. Care Homes for Adults (18-65 years) Page 7 of 33 People using the service said that Its a nice house they look after you and we go out. I am really happy here. I like all the staff they are good to me. I like it because my family can come to visit. Health care professional said that The staff respond professionally, confidentially and are caring towards individuals. Health action plans are implemented. They communicate well with families and carers. Support staff said We have regular supervision and training is available. Focus on paperwork sometimes reduces the amount of time available to people who use the service. Fees are variable according to need and negotiated prior to admission. There are costs for extras for example hairdressing, toiletries, holidays, chiropody etc. Care Homes for Adults (18-65 years) Page 8 of 33 What the care home does well Upperton Road is a warm and friendly home. You will be made welcome during your visit. Bedrooms viewed were clean and pleasant. They contained personal items. People who use the service are involved with decisions made about them, the home and in developing their support plans People using the service are supported to be as independent as possible. Care Homes for Adults (18-65 years) Page 9 of 33 Support workers will assist people in meeting their personal and healthcare needs. Your privacy will be was respected. Support workers are competent and have good support. The service is well managed. Care Homes for Adults (18-65 years) Page 10 of 33 Records are well maintained and kept secure. Information is available in easy read documents. People using the service feel safe. What has got better from the last inspection Care Homes for Adults (18-65 years) Page 11 of 33 Health & Safety issues have been addressed. Internal decorations have been undertaken and new flooring supplied for a bedroom identified at the last inspection. What the care home could do better The provider must review how controlled drugs can be safely stored to ensure that they and meet the new regulations that came into force in 2007. Care Homes for Adults (18-65 years) Page 12 of 33 Fifty percent of the staff employed within the service need to achieve the National Minimum Standards that hold a National Vocational Qualifications at level two in care or equivalent. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Judith Roan CSCI Capital Business Park Fulbourn Cambridge CB21 5XE Care Homes for Adults (18-65 years) Page 13 of 33 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 14 of 33 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 15 of 33 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 considering using the service will have their needs assessed to ensure that these could be met. Evidence: It is evident from case tracking the records that a through assessment of need was undertaken at the time of admission to ensure that individual needs could be met. The assessments seen as part of the case tracking were detailed and gathered information the individual person making the application, their family, previous placements and the funding authorities. People spoken with confirmed that they had visited the home prior to moving in and had stayed overnight. Pictorial information is available for prospective users of the service Individuals files held contracts made with the provider and the person receiving the service. An additional contract is made with the funding authority. Care Homes for Adults (18-65 years) Page 16 of 33 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
. Support plans are person centred and demonstrate full involvement of people using the service. Evidence: Support plans are in place for people who use the service and are reviewed on a regular basis or as required. Regular forums in which support needs of individuals are reviewed ensure that there is continuous development. Good record keeping ensures that information is shared appropriately. Confidentiality is maintained with all support workers understanding the importance of keeping personal information in secure files. All people using the service have access to their files and confirmed that support plans had been developed with them. The outcomes for people using the service support are positive and that needs are being met within the systems in place at the home. In discussion with support workers it was evident they are very knowledgeable about the needs of the people they support. Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: In reviewing the files and in discussion with individuals using the service it was evident that they were being assisted to develop their skills and participate in everyday activities that they previously were not able to achieve. Several people are independent within the community and are supported to maintain this skill. Learning is achieved by the consistent approaches used by support workers and people using the service having access to a broad spectrum of daily living activities. Risks within activities are considered on an individual basis and plans made to minimise these for each person. Files contained comprehensive risk assessments related to individuals activities. The AQAA states that new risk assessments that are in an accessible format and colour coded are being introduced to ensure that all priority areas of needs are identified quickly. In viewing files it was easy to identify the needs of individuals and to establish the priority. People using the service are encouraged to be as independent as possible with appropriate support. In this way people using the service are included within activities and not excluded because of any behaviour that may arise. People using the service told the inspector said that they were well looked after and no one thought they were denied their choices. We case tracked two care records, which again clearly demonstrated that the ongoing needs of people using the service needs are being monitored and supported whilst living at the home. In discussions with individuals, viewing case files and in observations throughout the inspection it was evident that people make informed choices about their lives and are supported to have independent life styles within their ability. Discussions with staff supported these facts and demonstrated that they were up to date with information about people who use the service. It was evident that people using the service are supported to make decisions about their own lives wherever possible e.g. daily routines, where they want to go on holiday and how their personal needs are met. Regular meetings held in each house record their views on important issues regarding food, holidays, outings etc. Staff said that encouraging people to make informed choices is an essential part of the values of the home. Care Homes for Adults (18-65 years) Page 18 of 33 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
. A wide range of personal, educational and social options are available and promote individual development Evidence: Individuals have a weekly activities programme that is updated to take into account of various events and personal choices. New activities are tried out to extend the choices and experiences for each person. Careful planning is undertaken for all activities to ensure that people who use the service and support workers are protected and enjoy the experience. Experiences are good and varied. It was noted that several people attend day services and that social histories are now held on filers. People using the service are fully involved with day-to-day living tasks within the
Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: home. In observation support workers enable people to carry out tasks and help only when necessary to demonstrate and develop a skill. It was clear that individuals were positive about their achievements. Throughout the inspection the inspector observed positive work with individuals using strategies noted within the support plans in supporting people with their identified needs. The teatime meal was freshly cooked and healthy. Individuals are supported to make healthy choices and have a balanced diet, with opportunities to have the occasional not so healthy treat. Support workers have a good understanding of the needs for people who use the service and use the meal times to develop communication skills with each other. Meals were seen to be a very social event at the home. There is much negotiation between individuals so that meal times can be arranged around social activities. The standard of food prepared at the home is high being produced from fresh produce. A food diary is kept to ensure that a balanced diet is provided. Individuals are supported to maintain good communication with families with one person being supported to visit an elderly parent and another to continue the contact with their previous home area. Records supported these activities. People spoken to during the inspection said that We can do what they liked and enjoyed living at the home. There was evidence of leisure activities going to colleges, discos, local pubs etc. Case records show details about activities undertaken and holidays taken. Residents Meeting notes showed that they have been consulted and trips are planned in the future. Support workers said that The service offers a good choice of social activities and that the home has an informal relaxed atmosphere. The homes location means there is good access to local shops and community facilities. Visitors are welcome at the home and there are no restrictions on visiting times. Although we received no surveys from relatives or advocates people using the service said that We are supported to see our families. Families are encouraged by Mencap to complete regular questionnaires about their views on the service. People using the service are supported to create their own Newsletter Upperton Chronicle and this is sent out to families. Care Homes for Adults (18-65 years) Page 20 of 33 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
. People using the service are positively supported to access local and specialist healthcare services. Evidence: Service users are supported to have regular health checks and there is evidence on files that healthcare appointments are made. The AQAA confirms that people using the service are supported to access health care facilities depending on individual choice. Health action plans are being developed with community healthcare professionals, which is confirmed within the surveys received. Support plans viewed indicate the health care needs of individuals and cover the management of personal care, monitoring weight. Personal support is provided in a discreet manner and with people using the service preferences being a top priority. Medical profiles for people who use the service have clear information. All medication is stored in a locked facility and records were well maintained. Support workers receive training in the management of medication from a pharmacist and undertake refresher
Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: training using a distance learning pack. Training records supported this. The provider needs to seek appropriate advice on the storage of controlled drugs since the change in the regulations last year that requires all care homes to have facilities in place. Medication records were checked and found to be up to date. Medication is kept securely locked away. All incidents are recorded on file to show how the manager/support workers have reviewed practice to minimise future risks. Care Homes for Adults (18-65 years) Page 22 of 33 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
. Practices within the service fully protect people who use the service and ensure that they are listened to. Evidence: The service has comprehensive policies and procedures in relation to handling concerns and complaints. People who use the service were all clear about how to make a complaint saying they would speak with the manager or a member of their family. Support workers undertake abuse awareness training as part of their induction/foundation training. Several have completed this as part of their National Vocational Qualification. The inspector checked out their understanding during the inspection. The open approach of the registered manager enables people who use the service to feel comfortable if there was a need to make a complaint or express a concern. The AQAA confirms that there have been no complaints since the last inspection. The AQAA also states that Mencap has comprehensive compliments and complaints procedures which are currently being extended to be include a more robust and behaviour led feedback and complaints management system. In discussions during the inspection it was concluded that people using the service felt safe and that support workers had a good understanding of their role and were aware of policies and procedures.
Care Homes for Adults (18-65 years) Page 23 of 33 Evidence: Care Homes for Adults (18-65 years) Page 24 of 33 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 provides a warm family setting with individual space that is well maintained clean and hygienic. Evidence: The home consists of two house joined at first floor level decorated to a good standard. There are adequate rooms to enable everyone to have their own personal space. Several communal areas are used for joint activities and each bedroom has sufficient room for personal hobbies. Communal areas are comfortable and provide a range of areas where people can relax. Individual bedrooms are personalised they are comfortable and well maintained. People using the service are supported in maintaining their rooms to a high standard of cleanliness and safety. There is regular maintenance with many rooms being redecorated since the last inspection. The AQAA identifies that management have an open dialogue with the landlord to ensure that delays in repairs are kept to a minimum. The garden at 155 is to be improved so that it is easier to maintain. One person using the service is involved in maintaining the garden. Care Homes for Adults (18-65 years) Page 25 of 33 Evidence: People spoken with during the inspection said that We like our own rooms and have chosen how it has been decorated. Bedrooms seen showed individuality and contained items to suit their lifestyles. Standards of cleanliness and odour control in all areas of the home were good. Care Homes for Adults (18-65 years) Page 26 of 33 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
. Staff skills and recruitment practices ensure that the needs of people who use the service are supported and that they are protected. Evidence: Mencap has a thorough recruitment procedure and files seen confirmed that required employment checks, application form, two references, criminal records bureau disclosures and interviews that involve people who use the service had been undertaken. The support worker team have a sound knowledge base about the needs of people that use the service. Through observation during the inspection they showed that they had a range of skills to support individuals and were proactive in developing everyday living skills. Support workers are offered a range of opportunities to train. Of the staff team of eight only two people have National Vocational Qualification at level two. This is below the 50 set within the national minimum standards and requires to be addressed. Support workers spoken to had a good knowledge of the needs of people using the service and were committed to providing a good service. They have regular supervision, which is very well recorded. Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: Support workers have access to a wide range of topics that include Person Centred Planning, a system that identifies the individual needs, of people using the service Lifestyle Planning, Epilepsy, Communication, Health Action Planning, Risk Assessment, Report Writing, Fire, Food Hygiene, etc. Training records are kept within individual staff files. New staff have to go through a detailed induction programme, based on the Skills for Care professional model. Care Homes for Adults (18-65 years) Page 28 of 33 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 service is person centred and effectively managed in the best interest of people who use it. Evidence: The Registered Manager effectively manages the home in the best interests of people who use the service and the support workers. There was good feedback from people who use the service and support staff about the role of the manager. There are several internal meetings within the service that focus on person centred care and enable people to voice their views and choices. All meeting have clear and comprehensive records. The registered manager reviews the service through the continuous improvement plan with their manager on a monthly basis. In addition monitoring forms are completed to ensure that the service develops and maintains a quality assurance system. All meetings at the home are recorded and demonstrate how the views of people using are fed into the ongoing review. The AQAA was reflective about the future
Care Homes for Adults (18-65 years) Page 29 of 33 Evidence: development needs of the service and shows that the management team are proactive. Over the next 12 months their aim is to make support plans a live document by continual review and monitoring. This will include goals and achievements of people using the service and working more with families and including their views. The provider has undertaken all health and safety checks required. Clear records of all checks are well maintained. The AQAA also confirms the checks undertaken. Mencap has robust financial checks of personal monies that require records of receipts, running balances and two signatures. Monies are checked daily to ensure they are correct. Health and Safety Policies and Procedures are in place support workers are aware of these. Induction training ensures staffs knowledge and understanding of these. Care Homes for Adults (18-65 years) Page 30 of 33 Are there any outstanding requirements from the last inspection? Yes ï£ No ï 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 31 of 33 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 Description 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 Description Timescale for action 1 20 13 The provider must review 31/03/2009 storage facilities at the home to ensure that controlled drugs can be safely stored. If controlled drugs were to be prescribed the provider must ensure that they meet the requlations that came tinto force in 2007 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 35 That the number of staff employed at the home holding National Vocational Qualifications at level two or above meets the recommended national minimum standards. Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website.
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