Inspection on 22/01/09 for 222 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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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: 222 Bills Lane 222 Bills Lane Shirley Solihull West Midlands B90 2PP     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: 222 Bills Lane 222 Bills Lane Shirley Solihull West Midlands B90 2PP 01217442624 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Solihull Care Trust care home 4 Number of places (if applicable): Under 65 Over 65 4 learning disability Additional conditions: 0 The maximum number of service users to be accommodated is 4. The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disability (LD) 4 Date of last inspection Brief description of the care home 222 Bills Lane provides care, support and accommodation to up to four people with a learning disability. Each person has their own bedroom. There are two bedrooms on the ground floor and two on the first floor of the home. Shared space consists of a lounge and dining room, kitchen and bathrooms. There are adapted bathing facilities in the ground floor bathroom which meet the needs of the people who live there. The home has a spacious rear garden and car parking spaces at the front of the premises. Fees are 1637.67 a week, of which people pay a contribution from their welfare benefit. 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 (these tell us about any events that have happened which affect the well being of people) they had sent to us. 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 assistant house leader and two members of staff as well as all of the people who live at Bills Lane. We looked around the building to make sure that it was clean, warm and comfortable. There were no immediate requirements made as a result of our visit. This means that there was nothing urgent that needed to be done to promote peoples health and well being. 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. People are given information about the home before they move in and their individual needs are assessed so that they can be confident their needs can be met there. Evidence: There have been no new people admitted to the home since we last visited in 2007. During our last visit, we saw that there was a procedure in place for assessing the needs of people so that they could be confident that the home would be suitable for them. The Annual Quality Assurance Assessment that we received confirmed that this procedure encouraged people to visit the home on as many occasions as they needed to before deciding to move in. The home has a statement of purpose and service user guide that are made available to people who live there and a copy given to their families. The service user guide has pictures and photographs that give information about the services and facilities provided in the home. Staff members told us that using pictures and photographs makes the information Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: easier to understand for the people who live at Bills Lane. 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 care plans and risk assessments for two people who live in the home. These records give information about the type of support that people need to carry on with their day to day lives. The records were clearly written and explained how the person should be supported with regard to personal and health care, spiritual and cultural needs, communication, mobility, social and leisure needs and day to day living. There was evidence that the records had been reviewed on a regular basis so that they Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: remained relevant to peoples current needs. The three members of staff that we spoke to demonstrated knowledge of each persons individual needs, which indicates that care records had been read and understood. We looked at daily records, which described the choices that people had made as part of their day to day routines, such as getting a haircut, choosing DVDs to watch and preparing their breakfast. Some people attend a tenants meeting, that is run outside of the home by the registered provider. We were told that the meetings give people an opportunity to comment on the service they receive at Bills Lane. People told us that they were well looked after and that the staff group were very good. 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. Planning meetings take place each week so that people can decide what they would like to do. Peoples choices had been recorded and each activity evaluated to determine that the person had enjoyed the activity. One person showed us his activity planner, which he kept in his bedroom. The planner contained photographs so that the person could see exactly what he had planned to do each day. We were told that people made good use of their local community and took part in a range of activities such as food shopping, trips to cafes and pubs, bowling, Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: church services and relaxation sessions. One person said that he went to an evening social club each week and really enjoyed the experience. This person went on to say that he had booked a singer for his birthday party and that the staff team had helped him arrange the party. The home supports people to keep in touch with their friends. Care plans that we looked at described how people should be supported to maintain this contact. One person said that they enjoyed meting their friends at the local Gateway Club (a social club which provides leisure opportunities for people with learning disabilities). 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. People told us that they had a choice of meal and that they went shopping for food each week. Menus were presented by use of photographs so that people could see what was available each day. The home offers traditional English meals, which is in keeping with the cultural needs of the people who live there. We were told that the food is very good and that the staff are excellent cooks. 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 had been recently reviewed to make sure that they were accurate and up to date. There was some person centred information in the personal care plans that we looked at, such as ensuring that staff left bedroom lamps on for people and ensuring a person took a cup of tea to their bedroom last thing at night. This indicates that peoples preferred routines have been considered and understood. 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. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: The health records we looked at showed that people had regular appointments with healthcare staff and that the outcome of the contact had been recorded so that staff had up to date information about peoples well being. Moving and handling risk assessments were in place for those people who need support to move around. From looking at the environment that people live in, it was evident that care had been taken to remove any hazards and keep each room clutter free so that people could move around their home freely. We looked at the way medicines are managed in the home to check that this was being done safely. Medicines had been securely stored and we were told that all medicines were checked by staff at the end of each shift. This should ensure that errors are spotted quickly and investigated promptly. A senior member of staff told us that there had been no mistakes in handling medicines within the last twelve months. Staff have had accredited training in the safe handling of medicines and their competence is assessed by a registered nurse every six months. This should ensure that people receive their medication by a trained and knowledgeable team of staff. From looking at the medication records of two people it was evident that medicines had been given as prescribed. In one case a persons supply of paracetamol tablets had been carried over from one month to the next. The amount carried over had not been entered onto the medication record, which meant that when we looked at the amount of tablets in stock compared to the records that stated how many should be in stock, the two did not match. This does not ensure that an accurate system of auditing medicines is in place. 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 has been one complaint, made directly to the home since our last visit. The records that we looked at showed that this had been responded to promptly and resolved to the complainants satisfaction. The home has a complaints procedure which is made available to the people who live there. The procedure (devised by a Speech and Language Therapist) consists of plain language and symbols so that it is accessible to people in a format they can understand. People told us that the staff team listen to them and that they could raise any concerns with them. One person said that he had no complaints and was very happy with everything at the home. There have been no safeguarding issues raised within the home since our last visit. The home has a procedure for safeguarding vulnerable adults, which is available to staff and also covered during the induction procedure for new staff. Some staff have not completed training in safeguarding vulnerable people, however the staff that we spoke to were able to describe their role within the safeguarding process. Care Homes for Adults (18-65 years) Page 17 of 27 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. People live in a clean, warm and well furnished home which meets their individual needs and promotes their independence. Evidence: Bills Lane is situated in the Shirley area of Solihull and is close to shops, pubs, cafes and public transport routes. This is important to the people who live there as they make regular use of these facilities. Each person has their own bedroom, two of which are on the ground floor with the remaining two on the first floor. The bedrooms that we looked at had been furnished and decorated to peoples individual tastes. People told us that they were happy with their bedrooms. There is a lounge and dining room which leads onto the kitchen. The rooms are spacious and present no hazards to people moving around freely. The home was clean and warm, with no evidence of odours that may indicate poor cleansing routines. There are assisted bathing facilities in the ground floor bathroom, which meet the specific needs of people who live in the home. We noticed that the bath surround in Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: this bathroom was chipped and damaged, which does not look pleasant. There is a laundry room that has suitable equipment to meet the needs of the people who live in the home and staff have access to a range of personal protective equipment, such as disposble gloves and aprons, to reduce the risk of the spread of infection. 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: We asked people about the qualities of the staff who work with and were told that the team are very good and very friendly. One person said that he wouldnt want to live anywhere else. During our visit staff interacted well with people and were respectful of their home and routines. For example, a person who came in from an appointment was immediately offered a hot drink as they were clearly cold and the staff team spent time with her asking questions about her day. It was obvious that the person enjoyed this interaction. The staff that we spoke to at this visit were knowledgeable about peoples needs and clearly know them well. From observation of the homes rota it was evident that there are enough staff on duty Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: each day to meet peoples needs. The home employs waking night staff. The rota showed that this person is always female, so that women who live there have access to a member of staff of the same gender to assist with their personal care at night. 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 Annual Quality Assurance Assessment stated that six of the eight staff employed at the home have completed National Vocational Training at level 2. This should make sure that people are supported by a competent and trained team of staff. The home has a rolling programme of staff training that is provided by Solihull Care Trust. This should ensure that staff have access to regular training to assist them to meet peoples needs more effectively. One area of training that had not been provided was that of meeting the needs of older adults. The current resident group are all over seventy years old, so training in this area would be desirable to fully meet peoples needs. 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 well managed and peoples health and safety is promoted and protected. There are systems in place to listen to the views of people who live in the home and to develop and improve the standards of care provided. Evidence: The home has a registered manager who is a learning disability nurse with over forty years social care experience. In the managers absence (this person manages another home in Bills Lane) the day to day running is undertaken by an assistant house leader. This person has sixteen years experience in social care and has completed National Vocational Training at level three. The assistant house leader frequently works as part of the staff team, leaving her little time to manage her leadership responsibilities, which could impact on the smooth running of the home. There are systems in place to review the quality of care and service provided within the home. A representative of the registered provider visits the home on a regular basis and writes a report about the standard of care provided. We saw, in a recent Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: report, that some care plans needed to be reviewed. This had been done. The staff team had completed a quality assurance questionnaire, which had been requested by Solihull Care Trust. The document asked for evidence that the home were meeting national minimum standards in care so that they could draw up a plan for development and improvement. At the time of our visit the home had not received feedback about their performance, however the staff team were able to provide examples of how minimum standards were met such as ongoing staff training and making information accessible to people who live there. 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. One person showed us a certificate of attendance at a fire lecture that he had taken part in with the staff team. We saw evidence that regular 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 20 Stocks of medicines carried over from one month to the next should be entered onto the medication record so that accurate auditing take place for peoples ongoing protection. A review of staff training in the area of safeguarding vulnerable people should take place so that all staff are aware of their role in the safeguarding process for the ongoing protection of people who live in the home. The bath surround in the ground floor bathroom should be repaired so that it looks more pleasant for the people who live in the home. Training in meeting the needs of older people should be considered so that staff have the skills and knowledge they require to meet the needs of the people who live in the home more effectively. Consideration should be given to providing sufficient time for the assistant house leader to work in a manner that gives her scope to complete her leadership duties to ensure the day to day running of the home. 2 23 3 24 4 35 5 37 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. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!