Inspection on 05/08/08 for 2 Kettlewell Way

This inspection was carried out on 5th August 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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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Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

CARE HOME ADULTS 18-65 2 Kettlewell Way 2 Kettlewell Way Chelmsley Wood Birmingham West Midlands B37 5JG Lead Inspector Kevin Ward Unannounced Inspection 5th August 2008 08:10 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 2 Kettlewell Way Address 2 Kettlewell Way Chelmsley Wood Birmingham West Midlands B37 5JG 0121 770 4513 0121 770 4513 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Solihull Care Trust Manager post vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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. The maximum number of service users who can be accommodated is: 3. 4th September 2007 2. Date of last inspection Brief Description of the Service: 2 Kettlewell Way is a small home providing permanent accommodation for three adults with a learning disability. The service is part of a scheme linked to other similar services in the Chelmsley Wood area. The Registered Provider is Solihull Care Trust. The service is located in a residential neighbourhood within a bus ride from Chelmsley Wood shopping centre and is in reasonable distance to local amenities. 2 Kettlewell Way provides a full range of residential care service to individuals that minimises institutionalisation and combines this with an integrated day service to enable people to be engaged in meaningful activities, education and personal development. There are two bedrooms one of which is located on the ground floor as part of a garage conversion. None of the bedrooms have wash hand basins and bathing facilities include a bathroom with bath and overhead shower unit and wash hand basin. There is also a toilet in the bathroom and one is located on the ground floor. Communal space, include a separate lounge and there is a kitchen/dining area. There is a separate laundry facility with washing machine and tumble dryer. There is a garden at the ear of the premises. There is roadside parking. In the Statement of Purpose the current fees range from £1181 to £1251 per week. People are required to pay personal items and extras, such as clothing and the use of Health Trust transport (in the event that this is required). 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means that people who use the service experience adequate outcomes. This is the first inspection of 2 Kettlewell Way since the home was registered with Solihull Care Trust, 24th July 08. Previously it had been registered with Bromford Carinthia Housing Association, with care staff employed by Solihull Care Trust. This was a key unannounced inspection, which addresses all essential aspects of operating a care home. This type of inspection seeks to establish evidence showing continued safety and positive outcomes for residents. The inspection focused on assessing the main key Standards. As part of the inspection process the inspector reviewed information about the home that is held on file by us, such as notifications of accidents, allegations and incidents. A person who lives at the home returned a questionnaire and an autism trainer also returned a survey giving their views of the service. The inspection included seeing the three people who live at the home. Two of them provided the inspector with some helpful insights about life in the home. Two people at the home at the home do not easily communicate verbally so it was not possible to gain their views of the service. One person was able to provide good feedback of their experiences of living at the home. The inspection also included case tracking the needs of two people that live at the home. This involves looking at people’s care plan and health records and checking how their needs are met in practice. Discussions took place with three staff on duty at the home as well as the home leader. A number of records, such as care plans, complaints records, and fire safety records were also sampled for information as part of this inspection. An annual quality assurance assessment (AQAA) was completed and returned by the provider in time for this inspection, providing the manager’s views of the home’s performance during the last year. An expert by experience also attended the inspection site visit to give their views on the home, in particular social activities, food and the general environment. An expert by experience is the term used to describe people whose knowledge about social care services comes directly from using social care services. 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 6 What the service does well: Satisfactory care plans are in place, containing information to help staff to support people in a safe manner and in the way they like. People are supported to get out and about during the week so that they are part of the community and get to do the things they enjoy doing. Meetings are held so that people can plan what they want to do and what they want to eat during the coming week. Encouragement and opportunities are given to people to get involved in the life of the home and to act independently where they can do so. This includes shopping to choose food and clothing, clearing tables and other day-to-day jobs in the house. In his summary of the service, the expert by experience commented, “It seems a nice place to live and the staff seem friendly. The home was nice and tidy. Staff are encouraging people’s family to be involved in their lives by organising family events, which is good. Staff seem to have good values and seem to be supporting people to be as independent as possible as staff told me that one man has started to withdraw his own money from the bank and this man confirmed this. Staff had taken time to work towards this and said that it is working well”. When speaking about staff, a person at the home said, “they are all good and they are all nice”. Support is given for people to access help from health professionals and relatives are included in the arrangements for planning people’s care, where appropriate. Suitable procedures are in place for dealing with complaints and for reporting any suspicions of abuse. Staff are provided with training and procedures so that they are able to raise any concerns they have about the running of the home. The home is clean and well maintained and provides a comfortable place for people to live in. People have been supported to make their bedrooms look as they want them to look and to reflect their personalities and interests. Staff are provided with training to help them to support people in a safe manner and so that they are properly equipped to carry out their work well. There are a number of checks and audits in place to make sure the home is running well and to pick up any shortfalls that need to be addressed. This includes seeking the views of the people at the home and their relatives. 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Information and contracts need to be provided so that people’s rights to suitable information are properly upheld. EVIDENCE: Solihull Care Trust has become the new registered provider for the home (24th July 08). The Statement of Purpose and the service user guide have yet to be updated to take account of changes in the responsibilities of the landlord (Bromford Carinthia, housing association) and the care provider (Solihull Care Trust). Currently people have licensee agreements on their files that will also need to be reviewed in the light of the new arrangements. Contracts have still to be issued by Solihull Care Trust to advise people of their rights and responsibilities whilst living at the home. The manager said that he had received documentation detailing the necessary contractual changes that would need to be considered when revising the home’s documentation and that he would proceed promptly to ensure that people have the correct information and contracts. 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 10 The three people living at the home have lived together for several years and no one new has moved to the home recently. The manager explained that any new people considering a move to the home would be properly assessed and enabled to visit beforehand to ensure their needs can be met properly before they move in. This is in keeping with good practice. 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are being reviewed and care plans are being amended so that staff have suitable guidance in place by which to meet needs sensitively and safely. EVIDENCE: Two people’s care plans were checked. Care plans are formatted in a way that makes them easy to read and clearly records essential needs and how to meet them. The care plans cover a good range of needs, such as communication needs; health, diet, mobility and skin care as well as social and religious needs. People’s needs are also being risk assessed to provide staff with guidance to support people in a safe manner, such as, kitchen safety, community access, swimming and moving and other activities. Care plans also include a section detailing people’s preferred routines. This is a good way of helping people who have difficulties communicating, to express their choices, so that staff can fit in around their routines. 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 12 Information on people’s records indicates that the home are responding appropriately to changes in their needs and making use of other professionals, such as psychologist and psychiatrist to provide intervention, advice and guidance where necessary. Detailed psychology guidelines were seen on a the files, advising staff how to best respond to individual needs, to reduce anxieties and associated behaviours. Three staff spoken to confirmed that they had also been provided with challenging behaviour and autism training to help them to support people in an appropriate manner. Notes of care review meetings indicate that the home involves relatives and professionals in significant meetings to address people’s changing needs. During the site visit a relative and advocate attended a care plan review meeting at the home. A person at the home confirmed they are involved in review meetings to make plans for the coming months. Whiteboards in the kitchen are used to provide people with reminders about who is on duty and what meals are planned for the day. A person at the home confirmed that everyone is included in meetings to plan activities and menus. This was verified in discussions with staff and entries in house meeting records. 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are provided with access to a varied range of community activities, in keeping with their choices interests and are consulted about what they like to eat, so that they are provided with meals they enjoy. EVIDENCE: One person has a white board in his bedroom containing his planned activities for the week. Another person uses picture cards to help him to choose his activities and make other choices. An activities timetable is in place on the kitchen wall summarising everyone’s activities planned for the current week. This is devised with the involvement of the people at the home and based on knowledge of the activities they are known to enjoy. One person explained how he has enjoyed attending a variety of courses at the local college, including computer training and cooking. He said he is looking forward to college starting again in September so that he can 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 14 take more courses. He also enjoys gardening and has a green house as well as a vegetable plot in the garden, which he keeps very well tended. Activities timetables and records show that the other two people at the home are supported to venture out with staff to enjoy their preferred activities. The home is making purposeful use of health trust resources, such as the hydrotherapy pool and sensory room as well as the local community. The expert by experience asked a man at the home about activities and was told, “I like going in my room to use the computer, staff help me to use it. I have lots of DVD’s; I like to come into my room to watch them. My favourite film is Pirates of the Caribbean. I see my Mom once a month on a weekend. I do the garden”. The expert by experience comments, “I think that this man does quite a lot and seems happy with the activities that he does. The activities planner and entries in people’s activity records provide evidence of other recent activities including, walks, Birmingham parks, shopping, coffee and cakes out, baking, canal boat ride and cinema. One person also enjoys going swimming. A risk assessment was seen to keep the person concerned safe during this activity. Activities are evaluated on a regular basis (records seen) to ensure that they are still being enjoyed and so that alternatives can be provided where necessary. This is good practice, particularly where people have difficulties in communicating their wishes verbally so that dissatisfaction with activities can be addressed more promptly. Staff explained that two people were supported to go on holiday to Devon in June. A person living at the home verified this. Another person had recently been on a day trip to the seaside with a member of staff (photographs were seen as evidence of this fact) and has plans for a holiday, with a relative, later in the year. Staff explained, people at the home are encouraged to take part in domestic tasks to support their independence, such as cleaning their bedrooms and bringing down their laundry to be washed. One person said that he enjoys doing all his own laundry and ironing. People were seen to take their crocks back to be washed, after eating. One person also made his own breakfast and lunchtime rolls. The expert by experience spoke to this person and comments, “I asked this man if he helps cook the meals and he said he doesn’t. He told me earlier that he does cooking at college so why isn’t he being encouraged to cook at home? Since the site visit, the manager has agreed to talk with the person concerned to check if he would he would like to do more cooking, with a view to providing him with more opportunities to do so. Two people also went shopping for the house groceries on the day of the site visit and another person was seen to enjoy baking a sponge cake with assistance from staff. 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 15 Entries in people’s records indicate that they are supported to maintain contact with their relatives. Two people visit their relatives at weekends and another person has recently been supported to regain contact with family members. One person takes his diary record home at weekends to help to keep his relative informed of events and to aid two-way communication with the home. Information in care review records indicate that relatives are encouraged to remain involved in the process of reviewing each person’s care plans. Recent menu records and records of food eaten show that people are provided with a variety of balanced meals. As previously noted, regular meetings are held each Friday to plan the weeks menu with people and they are involved in shopping for groceries. The menu includes some African Caribbean meals, which are a particular favourite of a person at the home. The expert by experience comments, “It is good that staff are considering his cultural needs by cooking Caribbean food for this man”. Fruit was on display in a bowl in the kitchen for people to help themselves to. The manager confirmed that none of the people at the home have any special requirements. 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people living at the home are provided with the support they need to meet their personal care and health needs. Shortfalls in the medication administration procedures could lead to errors. EVIDENCE: Everyone at the home was well groomed and dressed in age appropriate, welllaundered clothing, indicating that they are supported to take a pride in their appearance and to maintain a good self-image. Comments by staff indicated a good awareness of the people’s needs and of the information contained in care plans and guidelines, such as ways to best respond to people’s anxieties and concerns. Staff were seen to talk to the people at the home in a friendly manner, to be responsive to requests for care and support and be sensitive to their communication needs. In one instance a member of staff was seen to consult with a person at the home using picture cards to help express his preferences. 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 17 People’s health records show that they are being supported to access the assistance of health professionals where necessary. For example, two people’s records show that a consultant psychiatrist is reviewing their medication and a psychologist has recently devised guidelines for staff to follow when supporting a person with autism. One person’s records show evidence that the home has used the services of the speech and language therapist to create information in the form of a “communication passport”, containing the details of a person’s communication needs to assist people to communicate with home effectively. Weight records are being maintained by the home so that any changes in weight can be monitored at an early stage and any associated health issues may be investigated. Records of significant incidents are being logged appropriately, along with recording forms provided by the psychologist, designed to assist in monitoring the reasons for behavioural incidents. Entries in health records show that individuals are being supported to attend routine check up, such as eye tests and dental checks. Overall the appointments are well recorded with details of advice provided by health professionals. However in two instances, the outcomes of the appointments had not been recorded. The manager said that he would arrange for health notes to be closely monitored to address this matter. A lockable cabinet is in place for the safe storage of medication. The cabinet was well ordered and tidy making it easy to identity people’s medication. Three staff were spoken to and confirmed that they had been provided with medication training and had been assessed prior to being allowed to give out medication. One member of staff, giving out medication was unclear and thought that medication should be signed for as it is set up rather than after it had been given, The house leader corrected this mistake with the staff member concerned. The manager said that he would take action to reinforce correct medication recording procedures with staff. Where non-prescription medications are used, such as vitamin supplements are given there is recorded evidence in the records to show that this has been agreed with the GP to ensure they are safe to give. The medication is recorded into the home and accounted for on the medication sheets and a running total of PRN (as required) medications is being kept so that the medication is properly accounted for at all times. One person’s PRN medication was set up in a date ordered blister pack rather than in a box. Only one tablet had been taken and the rest of the pack had been retained for future use. This is not good practice, as the blister pack should be returned when the dates dictate. The manager said that he would approach the pharmacist to arrange for the medication to be provided in a boxed format in future. The running total was found to tally correctly with the number of tablets in the pack. 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Suitable arrangements are in place for dealing with complaints and reporting allegations of abuse in order that people can raise concerns and be protected from harm. EVIDENCE: A summary of the home’s complaints policy and procedure is contained in the Statement of Purpose and an accessible version of the complaints procedure is included in the service user guide. The manager has previously sent both documents to people’s relatives so that they know how to complain. A copy of the procedure is also on display on the kitchen wall where it can as a reminder for people. There has been one complaint about staff approach since the last inspection and one allegation of abuse, during the same time period. Comments by the manager and entries in records confirm that these matters have been referred for proper investigation. As a result of an allegation of physical abuse the manager has taken appropriate action to suspend a member of staff (as a neutral act) whilst proper investigations are ongoing. Three staff at the home confirmed that they had received adult protection training. A staff member explained that the training included information about different types of abuse to look out for and demonstrated a satisfactory understanding of the reporting procedures, including whom to see if she had 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 19 any concerns about the way in which the home was run. A copy of the home’s adult abuse procedure and multi agency guidelines are in available in the office for staff to refer to. Two people’s expenditure records were checked. The records contain a clear record of people’s expenditure. Two staff sign each item of expenditure. The records are also signed and checked by the home leader on a regular basis, as evidence that people’s money is being monitored. Lockable cupboards are in place for people to keep any personal valuables safe. One person looks after his own savings book and receives staff support to withdraw money, which is recorded on the expenditure sheet. The home leader said that she would introduce more frequent monitoring checks of the person’s savings book to further safeguard his money. 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 2 Kettlewell Way provides clean and comfortable accommodation so that people benefit from a pleasant, homely living environment. EVIDENCE: During the last two years the kitchen and bathroom have been refurbished and the bedrooms have been decorated to each individual’s liking, and are comfortable and personalised. One person has a freeze painted on the wall that he likes. Another person has had sensory lights fitted in keeping with his needs. The carpets are in a satisfactory condition, though some were stained in parts, most notably on the stairs. The manager said that he would ensure that the cleanliness of carpets takes a higher priority when carrying regular monitoring checks of the environment (records seen). 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 21 The dining table in the kitchen is modern and in good condition and has sufficient seating to enable people space to sit down together for meals. The house leader explained that plans are in place to replace the dining chairs as some are becoming squeaky. The lounge is comfortably furnished and the décor is in good condition, making it a pleasant place for people to sit and relax or watch TV. The toilets and shower room were clean and in good condition and the home was fresh and well aired and did not contain any unpleasant odours. Everyone living at the home is ambulant and no one requires specialist moving and handling equipment to use the bath / shower facilities at the home. An expert by experience, present on the site visit comments, “It seems a nice place to live and the staff seem friendly. The home was nice and tidy”. The house leader and a member of staff confirmed that there is not currently a requirement to manage any continence laundry. A washing machine and dryer are available for washing clothes. A staff member explained that everyone’s clothes are washed separately so they don’t get mixed up. Staff on duty confirmed that they had received infection control training to support good hygiene practices in the home. 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Shortfalls in vetting information about agency staff could compromise people’s care. Permanent staff are being appropriately trained to provided care and support to people in as safe manner. EVIDENCE: The home leader explained that due to staff transferring to other homes and vice versa and due to long-term sickness, most of the staff are different from those at the home last year. This has meant that the people at the home have had to get used to new staff supporting them. This is thought to have been unsettling time for a person at the home. The house leader explained that the use of agency staff has significantly reduced since earlier in the year and only a small number of hours are now filled in this way. Evidence to show that agency staff have been properly vetted was not available at the home. The manager said that he would arrange for the agency to send him written verification of vetting checks and qualifications. This is 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 23 necessary to ensure that agency staff are suitable to work with the people at the home. There are currently 6 staff at the home. The rotas show that during the week, there are typically two staff on duty in the morning and sometimes three and there is one member of staff during the evenings. This enables people to get out and about during the day but offers no scope for evening activities. The manager said that in the event that people request to venture out during the evening he is able to arrange for extra staffing to be provided. As people are not being routinely asked if they want to go anywhere they may assume that this is not an option. The manager agreed to consult with people at the home to check if they would like to go out anywhere during the evenings and to arrange staff where necessary. The manager said that new staff have been recruited from outside the organisation to work at the home since the last inspection. The file of a member of staff who has transferred from another home within the Care Trust was sampled and found to contain evidence to confirm that relevant vetting checks, including Criminal Record Bureau checks have are carried out when staff are newly recruited. Three staff on duty confirmed that they are being supported to access regular training courses and updates to help them to provide safe support to people at the home, such as first aid, food hygiene, fire safety, moving and handling and Safeguarding Vulnerable Adults training. Staff also confirmed that other courses are provided such as, autism and challenging behaviour training, to help them respond sensitively to people’s needs. The manager explained that Solihull Care Trust has ceased providing certificates for courses attended. In order to provide future evidence of courses attended the manager said he would arrange for the training department to provide confirmation of the list of course attendees and for course details to be appended to the list. The manager sent us an updated record of courses attended, which verified that staff are being provided with the courses noted above. In the AQAA the manager reports that approximately 75 of staff now hold National Vocational Qualifications and the remaining staff are enrolled on these courses. This demonstrates a commitment to ensuring that staff are equipped to carry out their roles effectively. The manager stated that Solihull Care Trust is working with a local college to provide accredited induction training for new staff joining the organisation. The home also has an induction checklist that is completed with new staff to familiarise them of relevant polices, procedures and paperwork in the home when they first start at the home. 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 24 There has been no equality and diversity training for staff at the home. The manager said that managers have received this training and this would be provided to staff in due course. 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Positive progress is being made in the management and development of the home. There is scope for increasing the security of the home, to ensure a safer living and working environment. EVIDENCE: The manager covering the home holds the National Vocational level 3 and has many years experience of working with people with learning difficulties. The manager said that he intends to start training for the Registered Managers Award in September. This training is designed to equip managers to carry out their role effectively. The manager said that his post is due to be advertised shortly and he would be applying to register with us, assuming he is successful in his application for the job on a permanent basis. 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 26 There are a number of quality assurance arrangements in place to support the home to run satisfactorily. Last year the manager sent out questionnaires to the people at the home and their relatives to seek their views on the home and explained that he would be repeating the exercise again shortly. The manager said he would also be sending questionnaires to professionals involved at the home so that they can give their views of the service. As previously noted regular meetings are held with the people at the home to plan activities and menus. Staff complete and sign a record as part of the shift handover process, which includes confirmation that money and medication has been checked and accounted for properly and that appointments have been attended. Weekly and monthly checks of the environment also take place in order that maintenance issues in the home are monitored and reported. Staff confirmed that they are provided with regular planned supervision to support them in their work role. This was verified by viewing a staff members supervision notes. The notes indicate that supervision is used purposefully to support staff in their work, including practice and training considerations. Monthly monitoring visits have started to take place at the home by managers of Solihull Care Trust, since it was registered with them in July 08. The visits are carried out by senior managers to monitor the work of the home. The manager explained that he was waiting for the reports of two visits to be sent to him. Shortly after the site visit the manager gained access to the reports and copies were sent to us. The manager explained that Solihull Care Trust is recruiting a new officer to take on this role to speed up the writing and reporting process, so that managers have access to the findings of these reports in a more timely fashion. Six monthly home audits were also seen, which senior managers of the organisation have carried out. Earlier in the year a staff member fell down the stairs and seriously injured herself, requiring hospitalisation. No other staff were on duty at the time. A person at the home took prompt action to alert neighbours to send for the emergency services. Since then amendments have been made to the lone working policy, whereby staff alone on duty make calls to another home, several times during the evening, to confirm that they are safe. In the event that they fail to call staff from the other home call back and alert emergency support if necessary. The expert by experience visiting the home, raised concerns about security at the home. He says, “I must raise concerns about the safety of the people that live there when opening the front door. I am all for, and it is only right that the people that live there open their own front door but there should be staff around to make sure people are safe. One of the men who do not use words to communicate opened the front door to me and I was left standing there for 10 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 27 minutes. I rang the doorbell twice after that and still no staff came, the front door was wide open so I shouted through the house and still no one came. This man was becoming quite agitated by us standing at the door so we moved back a little and waited. Eventually after 10 minutes a staff member came through the lounge and noticed the door open and said to this man “Why didn’t you tell us that someone was at the door”? This man has no verbal communication. Maybe he uses signs to let them know? I could have been anyone knocking the door. I fully appreciate that the staff members were busy in the garden but there should be some bell or other indication that the door has been opened or the bell had rung”. This was reported to the manager on the same day. He agreed this was not acceptable and said he would take action and provide the necessary guidance, to ensure that this situation does not reoccur again. This is necessary to ensure that people are kept safe from harm and belongings are kept secure. Health and Safety records were sampled to check that people are living in a safe environment. A landlord gas safety certificate shows that the gas appliances have been recently checked to ensure they are safe for use. Similarly a qualified contractor has checked electrical equipment in the home and the hard wiring has been inspected this year. A record of hot water temperature checks, carried out by a contractor was seen, indicating that the hot water is routinely checked to make sure it runs at a safe, comfortable temperature. The house leader explained that a new thermostatic valve has been fitted to the boiler to control the hot water temperatures in the home. The fire log contains entries to demonstrate that fire alarms and lights are being tested and maintained in good working order and that fire drills take place at the home. The house leader explained that the fire officer has visited and recommended that a turn lock is fitted to the back door so that it easier to exit the building in the event of a fire. New fire door seals have also been recommended. The manager said that this work is being addressed with the landlord. The cupboard containing cleaning fluids was appropriately kept locked and risk assessment fact sheets were seen containing information to advise staff on their safe usage. 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 34 35 36 3 3 X 3 X LIFESTYLES Standard No Score 11 12 13 14 15 16 17 X 3 3 X 3 3 3 2 2 3 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000072294.V369458.R01.S.doc Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 2 Kettlewell Way Score 3 3 2 X 2 X 3 X X 2 X Version 5.2 Page 29 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA1 Good Practice Recommendations Proceed with plans to revise the Statement of Purpose and service user guide to recognise the change of Registered Provider so that people have access to correct information about the home. Proceed with plans to issue contracts of terms and conditions so that people at the home are clear about the terms and conditions of their residency so that their rights may be upheld. Proceed with plans to reinforce correct medication recording procedures with staff to ensure that the medication sheet is signed only after the medication has being given, to reduce the possibility of medication errors occurring. Proceed with plans for PRN medication to be provided in boxed form so that it can be more effectively accounted for. The people at the home should be asked regularly if they wish to go out any evenings and staffing arranged as DS0000072294.V369458.R01.S.doc Version 5.2 Page 30 2 YA5 3 YA20 4 5 YA20 YA33 2 Kettlewell Way necessary. 6 YA34 Proceed with plans to ensure that written verification of vetting checks and training is provided from agencies employing staff at the home, to ensure that people are only supported by suitable staff. Proceed promptly with plans to address the recommendations made by the fire officer following his recent inspection, 30/7/08, most notably replace fire door seals and fit a turn lock to the back door. This is necessary to ensure that people are kept safe in the event of a fire at the home. Provide guidance to staff to ensure that they are available when the front door is opened to visitors, to ensure security in the home. The guidance should be considered in the context of the lone working arrangements and individual’s risk assessments. 7 YA42 8 YA42 2 Kettlewell Way DS0000072294.V369458.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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