Inspection on 26/02/07 for 7 Silverbirch Road

This inspection was carried out on 26th February 2007.

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 found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

7 Silverbirch Road 10/10/05

7 Silverbirch Road 11/05/05

7 Silverbirch Road 18/01/05

7 Silverbirch Road 25/08/04

7 Silverbirch Road 11/03/04

7 Silverbirch Road 04/02/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

Ravenhurst

Polesworth Group 64 Long Street

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Silverbirch Road (7) Erdington Birmingham West Midlands B24 0AR Lead Inspector Monica Heaselgrave Key Unannounced Inspection 26th February 2007 10:30 Silverbirch Road (7) DS0000016990.V326988.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 Silverbirch Road (7) DS0000016990.V326988.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. Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Silverbirch Road (7) Address Erdington Birmingham West Midlands B24 0AR 0121 382 1899 F/P 0121 382 1899 elcavanagh@aol.com 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) Birmingham Multi-Care Miss Emma Louise Cavanagh Care Home 4 Category(ies) of Learning disability (4), Physical disability (4) registration, with number of places Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents must be aged under 65 years. Date of last inspection 10th October 2005 Brief Description of the Service: 7 Silverbirch Road is located in the Erdington area of Birmingham. It is close to the main Sutton Road, which has public transport links to Birmingham and Sutton Coldfield. The house is a traditional semi-detached property with space for off road parking. Limited off road parking is available. The facilities include entrance porch and foyer area, which houses the shaft passenger lift leading to the first floor. There is a spacious bathroom on the ground floor that is well equipped with aids and adaptations and a Jacuzzi bath. Laundry equipment is located in the ground floor bathroom. To the front of the premises there is a spacious lounge and to the rear is a dining room with patio doors leading via a ramp to a patio and large rear garden. There are four single bedrooms on the first floor all with individual colour schemes and matching bedding. One of the rooms has a double bed for service users who prefer more sleeping space. A shower room is located on the first floor with a toilet on the same landing. The service offers a respite care service for adults with a learning and physical disability. The current charge for respite care is £991.57 per week. Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The fieldwork took place over one day lasting about six and a half hours, enabling the afternoon and evening routine to be observed. Prior to the inspection the inspector received a pre inspection questionnaire completed by the manager, which gave information about the service, which is included in this report. Three service users were present at the time of the visit. The inspector collected information in a number of ways; she spoke to the people who lived there, three families, the manager, and care staff. Service users and staff records were looked at, along with records relating to the management of the home, recruitment, training, and work patterns of staff. Medication records and stocks were sampled. The inspection focused on the last requirements and recommendations and what progress had been made towards these since the last inspection. A tour of the building was undertaken to ensure facilities met with service users needs. Examination of the procedures in place to protect the health and safety of service users was undertaken. What the service does well: What has improved since the last inspection? Care plans and health care plans have been redesigned and now show in better detail the type of support a service user requires, this means staff can meet the needs of service users in a consistent manner. Service users decision Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 6 making, is given a higher profile in their care plan, this ensures that opportunities in line with their level of ability are not overlooked when planning. A number of staff recruited last year have had a full induction and received updated training to support them in their role and responsibilities. Service users have better access to homely remedies since written agreements have been put in place, which means they can access medication you can buy over the counter without delay. Some new activities have been introduced to include music sessions which the service users enjoy. A redecoration programme has ensured that the environment is a nice, pleasant and comfortable one for the service users. 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. Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 7 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 Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 8 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&4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective respite service users have had information in a format suited to their needs, which helped them and their family to make an informed decision about using the service. Service users can be confident that the staff will support their individual needs and aspirations. EVIDENCE: The Statement Of Purpose and Service User Guide were seen to be generally comprehensive documents. The format was suited to the needs of the service users this included a larger size type and pictures. Each service user and their family is given a copy of this at the point of assessment. Many service users would have difficulty in comprehending this information in written or pictorial form; the manager explained that a verbal account could also be given to service users to assist them in their understanding. Copies of complaints information and details about the Commission are also given to service users and their families. Conversations with service users was limited, due to their specialist communication needs and level of comprehension. However one service user did share information with the inspector, which showed that an informed choice was made about using the service. This was based on what was important to this person. Comments included; “ I like coming here, the staff Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 9 are very nice”. “ I have a key to my bedroom”. “I do lots of things I enjoy, like watching T.V. cooking, shopping and seeing my mates”. Service users are initially assessed by a social worker prior to receiving respite care at Silverbirch Road. The assessment information was not always comprehensive making it difficult for the service to plan the care. In response to this the manager carries out a pre assessment visit. A recent one was looked at and showed that lots of good information about individual needs, preferences likes and interests, is gathered and utilised to develop a care plan. The care plan shows the needs the service user presents and the manner in which staff will support this. This has meant that the service users expectations and aspirations can be met by the home. It was positive to see that the service user is central to this process so ensuring everyone knows what to expect. There is a good admissions procedure, which ensures that prospective service users have the opportunity to visit and meet staff and other service users, enjoy a meal, and be consulted about their needs and how the home intends to meet these needs, prior to the service user making a final decision. There was good information to show a planned admission and how this was managed. This included a trial period, a review, and the persons’ compatibility with existing service users. There is a good emphasis on trying to mirror the care the individual receives in their own home, this ensures that during their stay, service users are not distressed or subjected to routines they are unaccustomed to. This is important, as Silverbirch Road is a respite service whose aim is to support the service user and their family for short periods of time, and therefore they are temporary carers. It was positive to see that cultural and religious needs are assessed and that the service supports people to attend the Temple and follow a religious diet. At the time of the visit the inspector noted that food items appropriate to a religious diet, had been purchased for two service users. Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 10 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&9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs are set out in detailed care plans, ensuring staff know how to support them. Service users are supported in taking some risks as part of an independent lifestyle. EVIDENCE: Silverbirch Road provides a respite care service and as such the staff are not the permanent carers for the service users. Their role is to provide a care to service users that as far as possible, reflects the care they would otherwise receive in their own home. Staff try to be consistent in providing service users with their usual routines and activities so that their stay is an enjoyable one and does not disrupt their usual daily life experiences. Two service users’ care plans were examined and showed that all aspects of the service users daily living activities are covered, looking at each need the service user presents, and how this will be supported. Risk assessments were cross-referenced, as were daily records. It was positive to see that the involvement of the service user is reflected, for instance; ‘I like a double bed’ I like to sleep in the blue room’. ‘I need constant supervision as my awareness of danger is limited.’ ‘I don’t like walking’. Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 11 Service users are supported to make decisions about their lives, this includes activities they take part in, how they celebrate festive events and birthdays. The contributions of service users’ parents was evident in supporting this process, written information regarding personal care routines was evident and another set out how staff should communicate with the service user such as the use of short sentences, or Makaton. The care plans detailed specific care needs such as the type and size of continence supplies required, this is important so as to avoid any potential health care difficulties due to ill-fitting pads. Risk assessments were seen to be in place for manual handling ensuring that service users who have difficulties with mobility are supported in a safe manner. Risk assessments for the use of bedrails were seen ensuring that staff know how to ensure the safety needs of service users at night. It was positive to see that service users are supported to engage in preparing snacks, cooking and other domestic tasks within a risk assessment framework, which ensures that any known risks are known, recorded and action taken to minimise these. Silverbirch Road does not aim to focus on skills development due to the respite nature of the service, however it was positive to note from the care records that some skills are supported such as independent eating which staff are able to support in a safe manner. Service users may not always have had the opportunity to do this as they require constant supervision, Silverbirch can provide the necessary staff support to undertake this safely. One service user confirmed that she exercises decisions about the food she eats, the activities she engages in, and her personal care routine, she said ’I love coming here I get to choose lots of things to do, when I go to bed and how I spend my time, I really like being able to talk to the staff, they are really good to me.’ Other positive examples about enabling service users to make decisions were recorded on individual care plans, this ensures that service users are supported to exercise their choices and that staff are have access to this information, which is important to document given that the clients change on a weekly basis. Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 12 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): 12,13,14,15,16&17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Opportunities to undertake interesting activities are evident ensuring service users can enjoy a meaningful lifestyle. Service users are supported to stay in touch with people who are important to them. Service users have a varied and nutritious diet, and a review of risk factors associated with food ensures nutritional needs are met. EVIDENCE: Service users are supported to have a varied social life and are encouraged to take part in activities of their choice. Service users continue to attend their usual daytime activity either day care or college, during their respite care period. Personal records and conversations with staff and service and users showed that people are able to engage in activities of their choosing. A range of community amenities are also utilised, these included social clubs, shopping, theatres, church, restaurants, cinema, and planned trips. The staff at Silverbirch ensure that the social, educational and recreational interests and Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 13 commitments that respite service users have are continued during their respite stay, and that options not otherwise available to them are also considered. Relatives spoken with confirmed that they are happy with the opportunities available. On the day of the fieldwork visit it was positive to see that the service users were engaged in their different daytime activity. On return to the home they were greeted by staff, made comfortable and shared a drink and snack. Some then engaged in a game of bingo, whilst others engaged in conversation with staff through the use of verbal and sign language, it was positive to see that the service users means of communication was known and practiced by staff, and they were clearly happy in the company of the staff on duty. The inspector interacted with the three service users and spoke with one service user at length. The care plans for a further two service users were looked at. From this it was evident that social and recreational pursuits take place on a regular basis. One service user described that she has support to manage her money, and chooses her daily activities, such as shopping or going to the cinema. The care plans showed that good attempts had been made to establish an activities programme suited to the needs of the service users. Daily records sampled, generally reflected what had been offered to service users, and what had been declined. Most service users had utilised community based amenities to include church, shopping, panto, and meals out. Essentially service users said they enjoy the DVD, video and music centres available. Care plans also showed that where an individual, due to specific needs does not enjoy group activities, their individual interests are supported, such as listening to Asian music, watching Asian videos, or cricket. There was a good description of likes and interests in all the care plans seen, which is particularly important where service users cannot easily communicate this, and where the service users accommodated, change on a weekly basis. This ensures staff have the information necessary to supporting the interests of the service users. The information available suggests there are usually enough activities for service users to undertake. Due to the respite nature of the service, service users continue to maintain contact with their friends and relatives. Relatives confirmed that they have good relations with the staff, and that there is a good system of communication. The inspector saw that diaries are used to keep open communication between the family and the service. This is a good system to support the communication needs of the service users who would otherwise have difficulty in sharing their activity with their family. Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 14 There are no rigid rules or routines those service users observed all had their own individual plan for the day, which specified their preferred routine. Service users are provided with a varied nutritious diet. A record of meals eaten by service users is kept. Service user care plans specified dietary requirements such as a Halal diet. A vegetarian option of quorn chicken style pieces was available for the evening meal. Risk factors associated with diet were specified in the care plan, this provided important information to prevent harm to service users, such as choking risks, health care risks such as diabetes, and weight monitoring to ensure service users eat sufficient amounts. Service users were observed to have a choice, which they indicated with the use of gestures. The cupboards, refrigerator and freezer compartment were well stocked with a variety of food choices and the manager explained that weekly shopping is undertaken, and that meals are prepared once the choice of the service user is established. This allows a good deal of flexibility for service users. One service user indicated that issues of privacy and independence are addressed. Service users have been offered their own bedroom door keys, but do not utilise these. Service users have appropriately equipped toilet and shower facilities to ensure a degree of privacy and independence. A telephone is available; staff said service users could be offered a mobile phone to make calls. Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 15 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&20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have personal support in the way they prefer and require. Health care is well planned, which ensures service users needs are consistently well met. Medication is generally well managed, which ensures service users get the right medication at the right time. EVIDENCE: Silverbirch Road accommodates service users who have a range of different personal and health care needs. Service users have a learning disability and or physical disability. Some service users have associated needs including; autism, speech and specialist communication needs, and Epilepsy. Routines are flexible and seen to meet the needs of service users, each has a plan showing their particular routine and level of support needed, this ensures that those who require it have the structure they need and that personal care is met in a manner that is appropriate to their individual preferences, particularly where service users cannot easily communicate this. A service user confirmed that personal care arrangements including make-up and appearance were to her liking and that staff supported her in this area. This means service users are supported in having the choices about their appearance that are similar to their peers and reflective of their age, personality and gender. Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 16 Service users care plans showed that service users’ healthcare requirements are known. A District Nurse visits to undertake blood tests as part of a service users’ needs relating to diabetes. There is a protocol in place for the management of Epilepsy, and staff have had specialist training from the community nurse to administer this. A medical consent form is on file for all service users to ensure that any treatment that might be required during their stay can be administered. The inspector was informed that named staff administer suppositories as part of a service users’ health care needs. This practice could be considered as invasive and the manager must review this with the relevant health care professionals, and ensure that procedures are in place to address the assessed need. A communication record is maintained whenever the service user comes into the service for respite. This includes information given by relatives of any medication changes and whether the service user has to attend a medical appointment during their stay. The daily recording of service users referred to where service users had assistance with their personal care such as having a shower, bath or with shaving. Since the last visit the manager has addressed a requirement from the previous inspection for service users to have assessments for nutrition and the prevention of pressure sores. All service users records examined contained these assessments. Manual handling assessments were in place and these had been reviewed since the last inspection. Observation of the care practice confirmed that staff supported service users appropriately, when transferring them from wheelchair to chair. The management of medication was found to be good and included a list of staff trained to administer medication. An examination of the Medicine Administration Records found these to be well maintained. It was noted in the care file that one service user has an allergy to Penicillin. This must be noted on the MAR (medication administration record), to minimise any risk. The manager has addressed a previous requirement for individual service users’ homely remedies agreements to be updated. Some had been returned and signed by their respective GP. Sampling of the accident records and regulation 37 reports showed that accidents are followed up and recorded ensuring the wellbeing of the service user. Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 17 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&23. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The Complaints procedure has been given a good profile ensuring service users and family know how to raise concerns. Service users finances are managed well, ensuring they are protected and have access to their money. There are arrangements to protect service users from abuse, neglect and self-harm EVIDENCE: The Commission has not received any complaints with regards to this service. One service user spoken with said they were aware of how to make a complaint. Copies of the complaints procedure are made available to service users, in a format suited to the specific needs of the service user. It was not possible to ascertain service users views about accessing this procedure. However the complaints records did show that where complaints had been made on behalf of service users, a record was maintained to show what action had been taken to resolve this, and a letter of the outcome sent to the complainant. The complaint looked at showed that the complainant was satisfied with the outcome. It was positive to see that concerns are acted upon. The service has policy and procedure for adult protection, which follows the multi agency guidelines published by Birmingham Social Care & Health. Staff training records showed that staff has received training in this area and discussion with them established that they know their responsibilities in protecting vulnerable service users. A procedure is in place for the use of physical intervention. Strategies for the management of behaviour that challenges are in place, and appropriate levels Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 18 of supervision are known and practiced to minimise the risk of self-harm. The Commission has been notified via Regulation 37 of incidents and accidents within the home. The arrangements for safeguarding service users finances are mainly managed by their carers. Where small amounts of money are brought in for the duration of the respite period, appropriate records are maintained. Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 19 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): 24,25,26,27,29&30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises are maintained to a high standard providing a clean, tidy and homely environment for service users. Appropriate aids and adaptations promote service users independence and safety. EVIDENCE: Silverbirch Road provides facilities suited to the needs of people with a disability. There is a spacious bathroom area on the ground floor, which allows room for those who may require assistance this is fitted with equipment that enables service users to be more independent in their personal care, which means their dignity is further promoted. There is a jaccuzzi bath with a wash hand basin and toilet. Toilet facilities are also available on the first floor. There is a level access shower that is also the first floor. Service users have access to a range of equipment to assist with moving and handling such as grab rails in the bathrooms and toilet with track ceiling hoists throughout the building. There is a passenger lift available that can accommodate wheelchair users. The four bedrooms were furnished to a good standard, spacious and well decorated. One service user confirmed that the bedroom met with her needs in terms of comfort and space. Suitable locks were fitted to the bedroom doors Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 20 that would guarantee service users’ privacy but could be opened by staff in an emergency. The lounge is comfortable with good standard furnishings, spacious, and bright with a TV, Video and DVD player. The dining room is located separately and provides sufficient room for service users to sit to the table and have staff support throughout their meal. All areas of the home are nicely presented with pictures, ornaments and plants. There is a large well-maintained garden that is accessible via a ramp and rails from the dining room. The dining room also provides a space where service users can engage in quieter pursuits such as bingo, which was observed at the time of the visit. A programme of redecoration continues to enhance the already good accommodation for the benefit of service users. Service users who use the service for respite care said that the accommodation was adequate for their needs as they generally only brought in a small amount of personal possessions. Maintenance and repairs are acted upon ensuring that the environment is kept safe and comfortable for service users. The kitchen was viewed. Cleanliness standards were good. Food supplies were appropriately stored and labelled. Care staff undertake the domestic tasks, and meal preparation. Food hygiene and infection control measures are practiced and staff had good knowledge of these. The laundry is located in the bathroom but is not used when service users are having a bath. Appropriate arrangements are in place for the disposal of clinical waste. Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 21 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): 32, 34&35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An effective staff team who are skilled and experienced ensure that the needs of service users are met. Service users are protected by the service’s recruitment practices. EVIDENCE: The staff team had a good knowledge of service users’ support needs. There is currently one vacancy, for which interviews are being held in March. The use of bank or agency staff has ensured appropriate staffing levels. Staff rotas show clear information as to who is on duty, their designation and the actual hours worked by staff and the manager. The manager explained that due to the nature of the service, planning is essential, and if a week of respite is known to be a higher dependency group of service users, staffing levels or service user numbers are adjusted accordingly. This means that the needs of service users can be planned for ensuring adequate staffing levels. Relatives describe staff as approachable, supportive, and helpful to them. The staff on duty actively engaged with service users, supporting them to Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 22 undertake their daily tasks. The interactions between staff and service users was good, with good use of communication skills. The pre inspection questionnaire completed by the manager prior to the fieldwork shows that future training has been planned in First Aid, Fire safety, infection control, food hygiene, adult abuse, medication, NVQ 2 and manual handling. Staff have also had Induction training based on the Skills For Care standards designed for staff in the social care setting. This covers all aspects and principles of care for those working with service users who have a learning disability. It includes all the statutory training staff require to do their job effectively. It was positive to see that some service user specific training in Epilepsy, and Health and Nutrition has been planned to meet with the specific needs of the service user group. The pre-inspection questionnaire stated that 25 of staff had achieved NVQ level 2 and above, the service recruited a number of staff last year. The Manager will need to ensure that this number is increased to meet the target of 50 of staff achieving an NVQ. Discussions with staff identified that they had a good understanding of the specific needs of service users, to include their methods of communication, and understanding and anticipating behaviours, this ensured they had the skills necessary to support the individual in a positive manner. Staff recruitment procedures are robust and ensure the safety of vulnerable service users. The pre inspection questionnaire showed that all of the staff had a Criminal Records Bureau Check. Staff had been robustly screened prior to them commencing work in the home. Key pieces of documentation including ID, photo; health declaration and confirmation of CRB clearance, completed application form and two references, were seen. There was documentation available to confirm that staff had undertaken an induction programme. The system in place for recruiting staff ensures that service users are protected by the home’s practice. Staff records have been updated to include a current job description and statement of terms and conditions. Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 23 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&42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well-managed service providing positive care and opportunities. Service user views underpin the development of the home with the service users interests being foremost. Health and safety practices ensure the safety and wellbeing of the service users is promoted EVIDENCE: The manager is experienced and has achieved the Registered Managers Award, (RMNA). The style of management is open and inclusive, service users staff and relatives confirmed this. Service users opinions are heard and acted upon, with good examples of them being at the forefront of daily consultation, diaries are maintained between the carer and the service, which enables improved communication. Staff advocate on behalf of service users in staff meetings and key worker meetings, which ensures their views are taken on board when planning the service. Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 24 Staff spoken with were well informed as to their role and responsibilities, and had a good understanding of service users needs. Files and records were well ordered and were easily available. Monthly Regulation 26 visits are carried out, this ensures that there is effective monitoring of the service and it’s standards. Some progress has been made in developing a quality assurance system that takes on board all the service users’, relatives’/carers’, and staff’ view points about the service offered. This has proved difficult. The majority of health care services are utilised in the community and at the service users own home address. Therefore these services do not know the service in an intimate way to pass comment. Feedback on the outcome of the surveys has been done through the annual general meeting, which is not always fully attended. It may be useful to consider a newsletter to keep people updated on the service achievements. There are good arrangements to ensure the health and safety of service users and staff. The pre inspection questionnaire returned prior to the fieldwork stated that servicing and maintenance of equipment had been undertaken as required. Certificates for these were seen and confirmed this to be the case. Records were looked at during the fieldwork and found to be in a good order. Water temperatures are checked and recorded weekly, this minimises the risk of scolds to service users. Legionella checks were completed annually. There was a Gas Landlord Certificate in place, ensuring the gas supply was safe. Fire safety procedures are consistently carried out; emergency lighting is checked monthly, fire drills and weekly tests are undertaken. It is required that the outcome of the fire risk assessment, currently in draft, is developed into a suitable emergency action plan showing control measures to ensure fire safety. Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 25 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 3 2 3 3 x 4 3 5 N/A 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 3 26 3 27 3 28 x 29 3 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 x N/A LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 x 3 x 3 x x 2 x Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 26 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. 1. YA19 Standard Regulation 13.(1)(b) Requirement The Registered Person must ensure that the use of suppositories is reviewed and procedures put in place to address the health care needs of the service user. The Registered Person must ensure the Medicines Administration Records, (MAR) charts clearly state any known allergy to medication. The Registered Person must ensure that the number of staff trained to NVQ level 2, is increased to meet the target of 50 of staff achieving an NVQ level 2. A proposed plan to achieve this should be forwarded to the Commission. The Registered Person must ensure staff records provide clear evidence to confirm the frequency of staff supervision. Not assessed on this fieldwork visit. Requirement brought forward. The Registered Person must ensure that a suitable emergency action plan showing the fire control measures is DS0000016990.V326988.R01.S.doc Timescale for action 10/04/07 2. YA20 13. (2) 10/04/07 3. YA35 18 (1) (c) 10/04/07 4. YA36 18(2) 10/04/07 5. YA39 23.(4)(a) 10/04/07 Silverbirch Road (7) Version 5.2 Page 27 completed to ensure fire safety. 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 YA39 Good Practice Recommendations The manager should consider a means of feeding back the outcome of service user surveys via the use of a newsletter. Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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. Extracts may not be used or reproduced without the express permission of CSCI Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 29 Silverbirch Road (7) DS0000016990.V326988.R01.S.doc Version 5.2 Page 30 - 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. 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