Inspection on 31/12/05 for 66 Rectory Road

This inspection was carried out on 31st December 2005.

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

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 07/08/2009.

Key inspection report CARE HOME ADULTS 18-65 66 Rectory Road 66 Rectory Road Redditch Worcestershire B97 4LL Lead Inspector Sally Seel Unannounced Inspection 7th May 2009 09:30 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 66 Rectory Road Address 66 Rectory Road Redditch Worcestershire B97 4LL 01527 403813 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) Dawn.Chapman@new-dimensions.org.uk www.dimensions-uk.org Dimensions (UK) Ltd Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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: 2. Learning disability (LD) 4 The maximum number of service users who can be accommodated is: 4 5th April 2007 Date of last inspection Brief Description of the Service: Rectory Road is an older style detached house in the residential suburbs of Redditch, providing a home for up to four people with learning disabilities. The home is within easy access to local shops, public transport and the town centre. Rectory Road provides services within a homely environment and also aims to promote independence and dignity. People who use the service receive care and support to live as ordinary a life as possible in the community. This involves staff teaching skills and creating opportunities for individuals living at Rectory Road. People who use the service are encouraged to participate in the running of the home and share in the general household activities within their capabilities. Dimensions (UK) Ltd is now the care provider for the service, having registered with the Commission for Social Care Inspection on 1st April 2006. Interested parties should make contact with the home direct to gain up to date fees charged for living at this home. 66 Rectory Road DS0000066851.V375270.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 2 star. This means the people who use this service experience good quality outcomes. The focus of our inspections is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. One inspector undertook this fieldwork visit to the home, over one day. The support manager and staff members assisted us throughout. The home did not know that we were visiting on that day. There were four people living at the home on the day of the visit and the inspector arrived before people living in the home had left for the day. Information was gathered from speaking to and observing people who lived at the home. Two people were “case tracked” and this involved discovering their experiences of living at the home. This was achieved by meeting people or observing them, looking at medication and care records and reviewing areas of the home relevant to these people, in order to focus upon outcomes. Case tracking helps us to understand the experiences of people who use the service. Staff files, training records, health and safety documentation and Regulation 37 reports about accidents and incidents in the home were reviewed in the planning of this visit. Also seven staff surveys were completed and returned to the Care Quality Commission, (CQC). Information from these sources was used when forming judgements on the quality of service provided at the home. The people who live at this home have a variety of needs. We took this into consideration when case tracking two individuals care provided at the home. For example, the people chosen have differing communication and care needs. The people who live at this home have communication needs that meant discussions with them could not take place and/or some people chose not to speak with the inspector. In view of this we spoke to staff on duty in order to find out about the support people receive. The atmosphere within the home is inviting and warm and we would like to thank everyone for their assistance and co-operation. 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: A detailed record of food eaten by people living in the home needs to be maintained. This should include the daily portions of fruit and vegetables offered to people this will enable staff to effectively monitor that each individual is having a varied and balanced diet. The recording of individual’s weights should be completed on a regular basis so that any losses and or gains are identified to ensure that any underlying medical conditions are detected at an early stage. 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 7 Consideration should be given to developing photographic activity and menu boards so that people know what activities and meals are on offer. Ensure that the repairs and redecoration to the premises that are needed continue to be done so that people live in a homely and well maintained environment. An assessment of the dependency levels of people who live in this home should be completed to ensure staffing ratios on all shifts enable individuals needs to be met and people have the opportunity of activities that are meaningful to them. This assessment should be maintained at the home as documentary evidence for inspection purposes. One comment from staff survey confirmed that being able to spend one to one time with people who live in the home, ‘it helps them so their not as anxious and you can spend the time with them that they require’. The recruitment of a permanent manager to the home would ensure that commitment and consistency to achieving good outcomes for the people living there were maintained in the longer term and provide staff with a sense of stability. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. 66 Rectory Road DS0000066851.V375270.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 66 Rectory Road DS0000066851.V375270.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 2. People using the service experience good quality outcomes in this area. The statement of purpose and service user guide provide relevant information about the home to enable people to make a choice about if they want to live there. Individual’s needs are assessed before they move in so they know whether their needs can be met there. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Copies of the home’s statement of purpose and service user guide were readily available in the home. The statement of purpose gives the reader information about the home, such as, what the home is like inside, management and staff, facilities and services to meet individuals assessed needs together with how individuals are able to make complaints. It also confirms, The home can offer personal care to people with a learning disability. 24 hour care is provided to adults (male/female) 18-65 years. The staff team can also support people with any practical, emotional, social, financial and spiritual needs. People are encouraged to visit the home and the statement of purpose states that overnight visits can be arranged so that individuals are able to meet the other 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 10 people who live in the home together with gain an insight into whether they would like to live there. This is important to ensure new people coming to live at the home are able to ‘fit in’ with individuals who already live there. One staff survey commented on what the service could do better, ‘Look more closely into the needs of the people we support. By looking at housing needs and who they share their home with. The people I support have no or little interaction with each other’. The service user guide is in an easy read format that includes pictures making it easier to understand for people who live at the home. Information within both documents was observed to be up to date but it would be useful to the reader if the statement of purpose confirmed the name of the home the information is referring to, as 66 Rectory Road. This is because in some sections of the statement of purpose another home is mentioned which could cause some confusion. Discussion with the acting manager and information recorded on the Annual Assurance Assessment, (AQAA), indicates the admission procedures are satisfactory, and remain unchanged from previous inspections. Care files that we sampled showed that assessments had been carried out before the current people moved into the home. There are two males who currently live at the home with one vacancy. Staff told us:‘Cares for individual well, staff very caring’. ‘We have a good staff team’. 66 Rectory Road DS0000066851.V375270.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9. People using the service experience good quality outcomes in this area. Staff have most of the information they need in care plans and risk assessments so they know how to support people safely to meet their needs and achieve their goals. The people living there are supported to make choices about their day-to-day lives. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The care provided to the two people who live at the home was case tracked. Each individual had their own person centred care plan. Care plans had recent reviews to ensure people’s needs are being met. This is done in a review meeting where relatives are invited to attend. The plans generally contained satisfactory information to enable staff to meet people’s needs, areas included, 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 12 routines, personal care, communication, family contact, finances, making choices, meals, behaviour, health, activities and cultural needs. Positively pictures and symbols are used in the plans we looked so that people living at the home can be supported to take part in care planning and how their needs are met. In one of the care files that we sampled we found the plans for meeting the person’s mobility and dressing and undressing to be blank. We pointed this out to the acting manager as it will need to be completed to ensure individual’s needs are met consistently and in the way they prefer by all staff. Staff surveys confirm what the home does well, ‘Communicate important information’ and another one stated, ‘try our hardest to work towards achieving all the needs of the guys we support’. Behaviour management strategies were in place for individuals. These provided staff with guidance about possible triggers to behaviour, and guidance on how to prevent some behaviours occurring as well as what to do in the event of some behaviours occurring. Guidelines sampled were up to date and where needed advice was taken from doctors. People’s ability to exercise choice and to make informed decisions is variable, according to their individual needs. Records showed that where an individual has made a decision this has been listened to and action taken to make sure their wishes are followed through where practicable and safe. Records sampled and observation of practice indicates that choice is offered to include activities, meals, times of going to bed and getting up. Staff told us that they use different methods of communication with people who live in the home. For example, pointing to objects and or showing them to individuals so that choices are given and people are able to express their wants. We also found communication guide sheets which tell staff how individuals communicate and what it means so that staff can follow peoples different styles of communication. This is important in this home where the two people living here have limited verbal communication. In the AQAA it is confirmed, ‘Involvement with speech therapist and completion of communication passports and new communication aids’. This shows that the acting manager is looking at ways to improve communication between people who live in the home and staff. People are involved in the running of the home where possible, for example, individuals are supported to go to the shops and to take part in checking their own monies with staff on a daily basis. This ensures a sense of independence is maintained for people living in this home. People’s risk assessments were sampled. There is evidence that people are supported to take manageable risks, and individuals are encouraged to have an independent lifestyle. Assessments were up to date and included epilepsy, roads, getting up and down steps, swimming and getting in and out of the bath. These stated how staff are to support individuals to minimise the risks involved. 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 13 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 14 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): This is what people staying in this care home experience: 12, 13, 15, 16 & 17 People using the service experience good quality outcomes in this area. Arrangements are sufficient to ensure that the people living in the home experience a range of activities but this could be further enhanced to ensure they are individually meaningful and encourage independence. Generally people are offered a healthy diet and are encouraged to choose what they want to eat and drink. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Staff provide people at the home with some opportunities for personal development but this is being developed further and the AQAA informs of plans for improvement, ‘To increase access to structured activities and increase independent living skills’. This will be facilitated in part by key 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 15 worker meetings where staff meet regularly to work on developing opportunities for people who live at the home. The two people who live in the home have key workers who develop close relationships with the person and gain knowledge of the individual needs, aspirations and goals. In the plans that we looked at it was noted what type of key worker people would like to be supported by, such as, staff who are kind, patient and have a good sense of humour. For people living at this home this means that through their key workers they are provided with opportunities to participate in a range of activities, some of these are designed to promote personal development. These include personal grooming, making choices and housework tasks. One staff member told us that one person who lives in the home is able to put the kettle on but is then supported to make a drink. Also in one care file it confirms that the person likes to set the table and help in making a sandwich. Personal development is also incorporated into people’s person centred plans. The home has the facilities of an activity room where we are told art and craft sessions take place. On the day we visited people were going to have their hair cut and then went to the shops. People were spoken to with respect and encouragement. Sampled daily records showed that people take part in activities such as shopping, swimming, meals out, trips to the cinema, tea dances and discos. One of the main issues raised by staff in their surveys were in relation to low staffing levels having an impact upon the activities that people living in the home were able to take part in. Some of the comments were, ‘employ more staff to meet individual specific needs such as having one to one daily in house or two to one when out on activities’ and ‘These people need at least one to one support to enable them to live individual and independent lives’. The previous inspection report also made a requirement that staffing levels should be appropriate to ensure that quality day activities are provided from people who live in the home. There were only two people living at the home at the time of our visit. However, if this should increase the requirement made at the previous inspection together with staff perceptions need to be considered. This is to ensure that people living at the home are able to take part in their chosen activities with sufficient staff on duty to enable this to happen. In the AQAA the acting manager states, ‘With a reduction of individuals living in the house, we have enabled them to have increased activities and more one to one staffing’. Daily records and care files sampled show contact with family and friends are supported. Relatives are invited to review meetings where appropriate. The acting manager has stated in the AQAA, ‘To put action plans in place to increase contact with friends’. This shows that the acting manager is working to ensure that people living in the home are being supported and encouraged to maintain relationships that are important to them. We were told that menus are planned on a weekly basis and include the choices of people who live in the home. Some examples of food on menus are 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 16 sausage, mash and beans, beef casserole, chicken curry and rice and pizza and wedges. Food offered looked well balanced and varied to meet individual’s cultural and dietary needs. We looked at care files which showed the daily recordings of meals individuals have eaten each day, although there were gaps in the records we looked at. This was pointed out to the acting manager. We also discussed the practice of staff recording the daily portions of fruit and vegetables that people are offered to maintain the recommended ‘five a day’ to ensure nutritious and healthy diets are promoted. 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. People using the service experience good quality outcomes in this area. People living at this home receive care and support to ensure that their personal care and health needs of are met. The management of medication protects people and ensures their well-being. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Care plans sampled apart from one which as discussed earlier in this report was left blank in relation to dressing and undressing tasks included information for staff on how to support individual’s to meet their personal care and health needs. Staff confirmed with us that people living in the home would need assistance to wash, shower and or take a bath. We could not find any recordings that told us how often people were being assisted to wash, shower and or take a bath. Therefore we recommend that daily recordings reflect any personal care that staff assist people with so that these can be reviewed 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 18 together with care plans to ensure individuals are receiving help with personal care tasks in the way they prefer, by whom and at times to suit them. On the day we visited we observed people living at the home to be well dressed in good quality clothes that were appropriate to their age, gender and the activities they were doing. Discussion with staff and observation of finance records shows that people have their own personal toiletries and are supported to go to the barbers or hairdressers if they want to. Those people who were at home at the time of the visit had limited communication abilities but they appeared to be comfortable, moved around freely as they chose and at home in their environment. Records sampled showed that other health professionals are involved in the care of individual’s where this is appropriate and we were told best interest meetings take place where medical decisions need to be made on behalf of the people who live in the home. This shows that staff are following good practice in line with the guiding principles in the Mental Capacity Act and the Deprivation of Liberty Safeguards so that decisions are made where people lack capacity in a forum of varying professionals in the individual’s best interests. Health action plans were sampled for the two people that live in the home. This is a personal plan about what a person needs to stay healthy and what healthcare services they need to use. The AQAA tells us that these are continually updated at key worker meetings so that any changes in people’s health and or medication are acted upon. These show that people’s health needs are well planned for and annual health appointments undertaken as needed. The weight records we examined showed that staff are not regularly checking people’s weights to ensure they are not losing or gaining a significant amount of weight that could be an indicator of an underlying health need. Clear guidelines were in place regarding a person who has epilepsy in relation to the recording and monitoring of seizures together with a management plan for staff to follow. Staff who administer medication have received training to do so and the AQAA informs us that all staff receive 6 monthly updates to ensure staff remain competent to administer medication. Sampled medication administration records and found that these were satisfactorily completed to ensure people living in the home receive their correct prescribed medication at the right time. Where people are prescribed PRN (as required) medication a protocol is in place stating when, why and how this should be given. At the time of our visit people’s medication was stored in an appropriate secured cabinet but each person will have their own secure medication cabinet in their rooms for staff to continue to administer medication to individuals. There is also appropriate storage for controlled drugs but we were told that none are prescribed to people living in the home at this time. 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 19 We found funeral plans in the care files that we examined which ensure that people’s wishes, choices and cultural needs are respected at this important time of their lives. 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 20 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. People using the service experience good quality outcomes in this area. Arrangements are in place to ensure that the views of the people living at the home are listened to and acted on. Staff have the knowledge to generally ensure that the people living there are protected from abuse, neglect and selfharm. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The Care Quality Commission, (CQC), has not received any complaints regarding this service in the last twelve months. A satisfactory complaints procedure is in place. An easy to understand version included pictures and symbols is available in the care files that we examined. The organisations complaints procedure is also in the statement of purpose and service user guide which means that people living in the home and visitors have easy access to this. We examined the organisations complaints log and looked at one complaint that has been received. This was responded to appropriately by the management of the home. In the AQAA the acting manager confirms that one of the areas of improvement is to make staff aware at team meetings of the policies and procedures in relation to complaints. This is important as the 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 21 people living in this home would need a lot of help to voice any concerns and or complaints that they had. Surveys from staff inform us that staff do know what to do if concerns and or complaints are made known to them. The home has satisfactory policies and procedures for safeguarding adults. Staff have received prevention of abuse training. Staff were spoken with about what they would do if an allegation of abuse was reported to them; their answer showed they know what to do to keep people safe. Two people’s finance records were looked at. Receipts of each purchase were available. Staff sign monies in and out of the home and this means that people’s monies are safeguarded. Each person has an up to date inventory of their possessions to ensure that staff know what possessions each person has and it is easier to track if things should go missing. The systems in place for the recruitment of new staff are generally satisfactory. 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 22 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26 & 30 People using the service experience good quality outcomes in this area. Redecoration work has made 66 Rectory Road a more pleasant environment in which to live and work but some areas need attention to ensure people live in a homely environment that is meaningful to them. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home is a large Victorian detached property situated in the residential area known as Headless Cross within the town of Redditch. The home is within walking distance of Redditch Town Centre and the shopping centre. There are also bus tops close by and a small area of local shops. 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 23 We were shown around the home by the acting manager and found that the kitchen area has been refurbished and redecorated. Within the kitchen area there are plenty of work surfaces and essential appliances to prepare and cook meals. There is a table and chairs so that people living in the home can sit together to have their meals if they choose. Just off the kitchen area is a utility room that has also been refurbished but this is waiting to be completed. In this area there is a washing machine and dryer for the laundering of clothes. At the previous inspection soiled linen would need to be carried through the kitchen to the laundry room due to the close proximity of this room to the kitchen area. However, we did not see examples of this being done on the day we visited but it does remain an issue for the management of the home to consider and manage it in relation to promoting good practices in infection control procedures. We looked at the lounge area which has comfy settees and chairs for people to relax and watch television as they choose. There are views of the garden area from this room and in one corner a small table and chairs which the acting manager told us is now going to be removed. The acting manager also informed us that some further work is needed in the lounge area which will make it more homely and meaningful to the people who live in the home. There is a downstairs toilet which has the necessary hand washing facilities, liquid soap and towels to promote good infection control measures. The rear garden is large and appropriately enclosed to ensure the safety of people who live in the home. There are some spaces at the front of the house to enable visitors to park their vehicles. On the first floor there are three bedrooms, a small activity room, office area and bathroom with shower facilities. We were shown the bedrooms and these have no ensuite facilities’ but do have hand wash basins for people to use as they choose. The wardrobes are not secured to the walls and we pointed this out to the acting manager who will ensure that work is undertaken to rectify this. Bedrooms now require some further decoration and personalised touches that will be meaningful to individuals. This has been acknowledged in the AQAA, ‘Further decoration to 2 bedrooms and other communal areas’. This shows that the home is continually being well maintained for the people who live there so that they are able to live in environment that meets their individual needs. On the day we visited the home looked clean and there were no offensive smells. 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 24 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36. People using the service experience good quality outcomes in this area. Generally the arrangements in place ensure that people living at the home benefit from a staff team that is competent and qualified to meet their individual needs. Staffing levels need to remain consistent and where needed increased to ensure peoples individuals needs are met, practically, socially and emotionally. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Staff were observed to give support with warmth, friendliness, patience and treat people respectfully. Information from the AQAA shows that over 50 have staff have achieved a National Vocational Qualification, (NVQ), Level 2, which exceeds the standard of 50 . This ensures that staff have the skills and knowledge to meet the needs of the people living there. 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 25 As discussed earlier in this report staff surveys recorded that staffing levels should meet the individual needs of the people who live in the home. We recommend that a dependency assessment is undertaken in relation to the people who live at the home and staff ratios reflect the outcome of this. Documentary evidence of this assessment should be maintained at the home for inspection purposes. This is to ensure that support and assistance is provided to individuals in relation to participating in their individualised activities. Staff rotas were sampled and these showed that the home maintains two staff on all shifts with one staff member who remain awake through the night to offer any assistance that may be needed at this time. There is currently one vacancy at the home and as stated previously in this report the management of this home should consider staff perceptions of having enough staff on duty to meet peoples individual needs so good outcomes are maintained for people on a daily basis. This will be particularly important when a third person comes to live at 66 Rectory Road. We looked at three staff records, one of which was a new member of staff. These included most of the required recruitment records including evidence that a Criminal Records Bureau (CRB) check had been done before the person started working there to ensure they are ‘suitable’ to work with the people living there. Evidence was also available to show that satisfactory references had been obtained before people started work in the home. Sampling of the records reflect that application forms are obtained for all new staff to ensure there is enough information about the person to make a decision about their suitability to work with vulnerable people. We were shown staff training records which indicate that a variety of training has been undertaken by staff. Staff had done mandatory training together with more specific training to include first aid, manual handling, health and safety, food hygiene, abuse, autism, communication and epilepsy. A programme of cyclical fire training is in place and training for staff that needed refresher fire training is scheduled. Staff surveys show that staff are satisfied with the availability and quality of training on offer. 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 26 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 42. People using the service experience good quality outcomes in this area. People benefit from a home where the management recognise where changes and improvements need to be made to continue to develop areas of practice to ensure people living there are provided with good outcomes. The health, safety and welfare of the people living at this home are promoted and protected. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The style of management in the home is relaxed, open and inclusive, and the acting manager, Helen Smith, is making clear efforts to develop the service for the benefit of the people living there. In the AQAA the acting manager has 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 27 identified practices that they would like to improve and an example of two are, ‘We are looking at trying more structured activities especially in the form of self help and everyday living skills to promote independence’ and another one is, ‘We are looking at improving our communication system and having such things as pictorial time tables’. However, it is recommended that the organisation gives some consideration to recruiting a permanent manager at this home so that consistency and stability can be achieved for both people who live at the home and staff alike. Helen Smith is a registered nurse (RMNH) and has recently moved to 66 Rectory Road. Prior to moving to this home, Helen Smith was in the role of deputy manager at one of the organisations other homes for people with learning disabilities. The acting manager informed us that they have commenced a leadership qualification and works full time at the home completing three shifts and has the other two days designated for administration duties. It is the responsibility of the organisation to ensure that their representative visits the home on a monthly basis to ensure it is being well managed. Reports of these visits were available in the home and they covered any improvements that need to be made to the homes environment, care practices, any complaints received, finances, health and safety issues and speaking with staff to gain their views about the services that are being offered to the people who live in the home. As at the previous inspection these reports are also part of the home’s quality assurance and monitoring system. The outcomes from the reports form an annual development plan for the service. This report will include views on the service from people who use it, stakeholders and interested parties. This should ensure that good outcomes for people living at this home are achieved and any improvements made in a timely manner to benefit the people who live there. Staff surveys told us:‘Support interest/hobbies by planning activities and giving varied choice’. ‘Provides a very good service for the people living there’. ‘We often don’t have enough staff to carry out two to one activities which means P.W.S, (people who live in the home), lose out on activities, holidays etc’. Fire records showed that an engineer regularly services the fire equipment. Staff test the fire alarms and emergency lights regularly to make sure they are working. Regular fire drills are held with people who live at the home and staff so that they all know what to do if there is a fire. The fire procedure was produced using pictures making it easier to understand and in each care file we found personalised fire evacuation plans so that people can be assured they will be safe in the event of a fire occurring. A Corgi registered engineer has completed the annual test of gas equipment to make sure it is safe. 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 28 Staff test the fridge and freezer temperatures daily to ensure food is stored safely and reduce the risk of people having food poisoning. A specialist water company has a contract to regularly monitor the water to ensure it is safe. Records showed that water temperatures were safe and protect people from the risk of scalding. 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 29 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 X 2 3 3 X 4 X 5 X 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 2 25 X 26 2 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 2 3 X LIFESTYLES Standard No Score 11 2 12 2 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 3 X 3 2 3 X X 3 X Version 5.2 Page 30 66 Rectory Road DS0000066851.V375270.R01.S.doc Are there any outstanding requirements from the last inspection? No. 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. 2. Refer to Standard YA1 YA6 Good Practice Recommendations Statement of purpose should have up to date information to enable people to consider whether they would like to live there. Care plans should be completed to ensure residents receive care in they way they prefer and times to suit them so that staff practices remain consistent in delivering care to meet individual’s needs and goals. The daily records of what food residents are eating needs to be consistently completed together with ensuring this includes daily fruit and vegetable portions to promote nutritious and healthy diets. The daily recordings of when and how staff assist residents with their personal care tasks should be completed so that residents needs and independence can be monitored and reviewed as per their care plans. The recording of resident’s weights should be completed on a regular basis to ensure that any losses and or gains are identified in order that any underlying medical DS0000066851.V375270.R01.S.doc Version 5.2 Page 31 3. YA17 4. YA18 5. YA19 66 Rectory Road 6. YA24 7. YA37 conditions don’t go undetected. The redecoration and any outstanding repairs in relation to the refurbishment of the home should continue to ensure that it is a well maintained and homely environment for people to live in. Consideration should be made to recruiting a permanent manager to provide consistency to managing the outcomes for residents and stability for staff group. 66 Rectory Road DS0000066851.V375270.R01.S.doc Version 5.2 Page 32 Care Quality Commission West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway, Birmingham B1 2DT National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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. 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