Inspection on 25/11/08 for 75 Ludford Road

This inspection was carried out on 25th November 2008.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

75 Ludford Road 10/01/07

75 Ludford Road 07/03/06

75 Ludford Road 20/06/05

75 Ludford Road 07/12/04

75 Ludford Road 22/06/04

Similar services:

The Lodge Nursing Home

Bracken House

Sunnycroft

Field Farm House

Edgeview Nursing Home

Church Terrace Nursing & Residential Home

The Forbury

The Maples

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 75 Ludford Road 75 Ludford Road Bartley Green Birmingham West Midlands B32 3PQ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Brenda ONeill     Date: 2 5 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: 75 Ludford Road 75 Ludford Road Bartley Green Birmingham West Midlands B32 3PQ 6080800 01216838855 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Shelagh Munro Type of registration: Number of places registered: Mind in Birmingham care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 8 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: Mental disorder, excluding learning disability or dementia (MD) 8 Date of last inspection Brief description of the care home 75 Ludford Road is a home that provides care and support for 8 people with mental health issues who are aged between 18 and 65 years. The unit is managed by MIND and the accommodation owned by Focus Housing who take responsibility for the maintenance and upkeep of the building. The accommodation provided consists of eight single bedrooms. The home in the main is decorated to a high standard. The communal space consists of one large lounge and a dining room. There is also a large Care Homes for Adults (18-65 years) Page 4 of 32 Over 65 0 8 Brief description of the care home kitchen. The rear garden is very pleasant, having a sheltered seating area, lawn and bedding plants. Within a close distance to the home there are a range of community facilities including, shops, pubs, churches, leisure facilities and a medical centre. The immediate area has a good public transport system. The service user guide for the home detailed the fees as being £765.00 per week. Care Homes for Adults (18-65 years) Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The last key inspection at the home was carried out on January 10th 2007. Following this an Annual Service Review was was done on December 10th 2007 when we sent some satisfaction surveys to the people living in the home and the home sent us some information in the Annual Quality Assurance Assessment. From the information we received we decided the home had continued to provide a good service to the people living there and that we did not need to bring forward the next inspection. This key inspection was carried out by one inspector over one day in November 2008. During the course of the inspection we spoke with four of the people living in the home, the registered manager, acting manager and one staff member. We looked at the support being offered to two of the people living in the home which involved Care Homes for Adults (18-65 years) Page 6 of 32 looking at care plans, daily records, health care records and medication management. We also looked at documents in relation to staff recruitment and training and toured the communal areas of the home. Prior to this inspection we sent satisfaction surveys to the six people living in the home all of which were returned to us. The manager completed and returned to us the Annual Quality Assurance Assessment (AQAA) for the home which gave us some additional information. There had been no complaints or adult protection issues raised with us about the home since the last inspection and none had been logged at the home. What the care home does well: What has improved since the last inspection? There were only three requirements made following the last inspection. These had been addressed at the time of this visit. Care Homes for Adults (18-65 years) Page 8 of 32 The risk management plans for the people living in the home needed to be accessible to staff at all times. This would ensure staff have all the information they need to ensure the people living in the home are safeguarded. Risk assessments had been drawn up for all the risks the people living in the home were exposed to ensuring they were safeguarded. Written protocols had been put in place for the administration of PRN (as and when necessary) medication ensuring staff knew when this should be administered. The shortfalls noted in the staff training at the last inspection had been addressed ensuring the staff had all the necessary skills and knowledge to support the people living in the home. Further training had been offered to staff to further improve their skills in topics such as diversity and computers. There had been some improvements to the environment including, new flooring on the downstairs hall way and up the stairs, the lounge and two bedrooms been repainted and new flooring had been fitted in two bedrooms. We were also told that the office and dining room were due to have new flooring. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 9 of 32 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 10 of 32 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 11 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People wanting to move into the home were fully involved in the pre admission assessment process where they agreed to this. The pre admission procedures ensured the needs of the people being admitted could be met by the staff at the home. Evidence: There was a service user guide for the home and this included all the necessary information to help people decide if the home could meet their needs. One of the surveys returned to us indicated that the individual had not received enough information about the home before they moved in and also that they were not asked if they wanted to move into the home. The manager told us that that she went to assess the individual at the residential home where she lived before moving to Ludford Road. The individual refused to be involved in the assessment and would not go and visit Ludford Road. It was not possible to try and reassess the individual as the home closed suddenly and the individual had to be admitted to the home quickly. Care Homes for Adults (18-65 years) Page 12 of 32 Evidence: The file for this individual was seen. There was documentation that indicated the individual had refused to take part in an assessment on the day of admission. The manager had completed the information as best she could from the information known to her from the previous home and social workers. She also confirmed that the individual had been given a copy of the service user guide. The individual concerned had been living at Ludford Road for five months at the time of the inspection and this had clearly been a huge change for them. We spoke to the person briefly and they seemed fairly settled. The manager stated there had been a noticeable change in the individual and some of the behaviours they had encountered when the individual had been admitted to the home had subsided. The individual had in some small ways started to take part in the every day life in the home, for example, going to the local shops and spending a little time with the other people living in the home. Care Homes for Adults (18-65 years) Page 13 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home were fully involved in drawing up their care plans. They made decisions about their lives on an ongoing basis and were supported to take risks. Where this may indicate a risk to their physical and or mental health strategies were in place to help reduce the level of risk. Evidence: Two files were sampled during the inspection. Both included lifestyle plans which the individuals concerned had been involved in drawing up. The lifestyle plans indicated what was positive about the individual, what was essential to them, who and what was important to them, their preferences and what they enjoyed. The plans also included a section entitled unresolved issues and these detailed such things as cleanliness of room, personal hygiene, improving social skills and so on. There were also action plans that detailed how staff were to successfully support the individuals. The action plans linked to the needs identified in the lifestyle plans and any risk that had been identified. Areas covered in one of the action plans detailed the support to be given by Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: staff for such things as isolation, diet, appropriate dress and personal hygiene. Monthly evaluations of the lifestyle plans and action plans were undertaken with the people living in the home, where they agreed to this. The evaluations detailed any progress made on the action plans, any issues that had arisen, activities, health care appointments and general overview of the individuals well being. Where any issues had been identified an interim action plan was put in place that was then reviewed the next month. For example, one evaluation identified that one of the individuals had missed some medication and that staff were to knock on the bedroom by 10am if they had not been to the office for their medication by this time. There were numerous risk assessments in place for the people living in the home. General risk assessments detailed the general hazards that may be encountered in the home, for example, use of laundry and kitchen equipment and bedroom hazards. These detailed the extent of the supervision people needed in each area. For example, for one persons bedroom it stated needs constant reminders to dispose of cigarettes safely ensure she has ashtrays and metal bin. Other risk assessments in place linked to peoples mental health and they were involved in drawing these up wherever possible. These covered issues such as exploitation, violence and aggression, self neglect and intoxication. These were very well detailed and included triggers, early warning signs and the actions to be taken by staff to minimise the risks. It was noted that there were no specific management plans in place for the relapse of the individuals mental health. These had been in place at the time of the last inspection. Speaking to staff they were aware of how to recognise when individuals mental health was relapsing. The day after the inspection the manager contacted us and stated she had found the crisis plans which detailed how staff would recognise any relapses and the actions to be taken. The manager stated she was going to review these and put them with the daily records. The manager needed to ensure that these and all other risk assessments were accessible to staff at all times. This is of particular importance for the newer staff in the home who would not know the people living there so well. The people living in the home made decisions about their lives on an ongoing basis and were involved in running their lives as they wanted. They were involved in drawing up their lifestyle plans and saying how they wanted staff to support them. Where they agreed they were involved in drawing up their risk assessments which could include some limitations on their movements outside the home. Throughout the course of the inspection it was apparent that the people were able to spend their time as they chose whilst also having to take some responsibility for small household tasks such as cleaning their bedrooms. Care Homes for Adults (18-65 years) Page 15 of 32 Care Homes for Adults (18-65 years) Page 16 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home were supported to have an independent lifestyle as far as possible, which the home encouraged and supported them to achieve. Their rights and responsibilities were recognised in their every day lives. The people living in the home were satisfied with the meals at the home. Evidence: The people living in the home determined their own lifestyles within the bounds of any risk assessments that were in place and they were all very different. The people living in the home accessed all the local community facilities either independently or with staff support. These included local shops, health care facilities and pubs. During the day of the inspection one person was seen to go and collect her own medicines and another went to the local shops for bread and milk for the home. Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: This was a task that each of the people living in the home took turns to do. All the people living in the home were encouraged and enabled to do tasks around the home including their own laundry, keeping their bedrooms clean, clearing away after meals, putting out the bins and sweeping up the leaves in the garden. During the inspection They were seen to come and go from the home as they pleased and all had keys for the front door. The people living in the home appeared quite content. One spoke to us about going to a centre and meeting her friends. On the day of the inspection she had been on a work placement at a charity shop that she very much enjoyed. Another individual spent much of his time practising playing musical instruments. He was heard doing this on the day of the inspection. He attended a centre for music sessions and had recently played at the annual general meeting for the oragnisation. A work placement and college course had been arranged for another of the people living in the home but due to an ongoing health concern this had been delayed. One of the people living in the home spent much of her time there but had only been in the home for a short time. She was being encouraged by staff to go out and would go out with staff shopping and so on but there had been some behaviour issues that they had to address. The manager stated these were slow small steps for this person to improve their lifestyle. Another individual was the representative for MINDs residential homes and attended committee meetings. We were told that three of the people living in the home had arranged a night out at the cinema which they enjoyed, they also went out bowling, for meals and some went swimming. Two of the people living in the home had been on holiday. The others chose not to have a holiday and wanted to have trips out instead this had been arranged and they had been to such places as Blackpool. There were some in house activities such as DVD nights, take away meals and listening to music but these tended not to be pre arranged. The manager stated they had tried a variety of activities but the people living there were not always willing to participate. Staff had suggested further activities but were trying to encourage the people living in the home to say what they would like to do. Activities were an ongoing topic in the meetings held with the people living in the home. It was suggested that it may be a good idea to look at arranging more in house activities with the people living in the home to enable them to socialise more in the home. The people living in the home appeared generally quite content with their lifestyles. Comments from them included: Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: I love it here this is my home. I like living here. I like to go to my two centres. Contact with families and friends was encouraged where this was what the people living in the home wanted. One person regularly stayed with family and he was away at the time of the inspection. Another had family living locally and spent much of her time with them. Friends and families were able to visit the home where there were no risks incurred. One of the people living in the home had had a visit from a family member and had made it clear she did not wish to see them. This had been respected by staff. There was a three week rolling menu at the home which was agreed with the people living in the home. The menu was varied and nutritious and there were alternative foods available in the home if people did not want what was on the menu. Most of the people living in the home prepared their own breakfasts, some with staff support. Lunch and the main meal in the evening was prepared by staff with some help from the people living in the home. During the course of the inspection people were seen to prepare snacks and drinks for themselves. Staff encouraged the people living in the home to eat healthily and this was discussed with them but this could be difficult as they would go out and buy food such as take aways. The people living in the home were satisfied with the meals being served. There was plenty of food available in the home at the time of the inspection. It was noted that one of the fridges was locked. This was discussed with the manager who stated this was for reasons of good food hygiene. There was another fridge that the people living in the home always had access to that was stocked with provisions for making snacks and drinks. Care Homes for Adults (18-65 years) Page 19 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home received individual support to maintain their personal care needs and were able to access and receive support from community health care services as needed. The practices and policies of the home generally ensured that medicines for the people living in the home were managed safely and in accordance with the prescriptions. Evidence: The assistance with personal care needed by the people living in the home was minimal. It was usually only prompting by staff that was needed. Any issues were identified in care plans with details for staff, for example, encourage to bathe or shower at least once a week, change her bed and clean her room. Ensure she has adequate toiletries and clean towels offer assistance if needed. Staff were seen to quietly remind individuals about their hygiene and the need for them to have a shower. There was very good documented evidence that both the physical and mental health care needs of the people living in the home were being met. It was evident that staff Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: were quick to identify any health care issues and address them appropriately. One of the people living in the home had commented to the staff that some days she felt like taking all of the medicine she had collected from the G.P. This had been discussed with her and she was now escorted by staff when she collected this particular medicine. The manager stated that they received good support from the local mental health team. Any relapses were generally managed by the home with support from the appropriate health care workers but if necessary hospital admission was arranged. Records showed that the people living in the home had contact with G.Ps, psychiatrists and community psychiatric nurses and attended hospital appointments as necessary. Some of the people living in the home attended appointments on their own and others preferred staff to go with them. One of the people living in the home had an ongoing health concern and had been having quite intensive treatment that had required frequent visits to the G.P. and the hospital. Medication management in the home was generally good. The AQAA indicated that all staff had received training in medication administration. The majority of the medication was delivered to the home on a weekly basis in monitored dosage cassettes. All was booked in at the home and any balances remaining from the previous week were carried forward. There was some boxed medication in the home. One minor discrepancy was found when auditing this however this would not have put the individual concerned at any risk. Since the last inspection protocols for the administration of PRN (as and when necessary medication) had been put in place. Some controlled medication was being administered in the home. The records for this were being kept appropriately. One of the people living in the home self administered all their medication and the appropriate risk assessments had been undertaken for this. Others went to the office to get their medication at the appropriate times. Care Homes for Adults (18-65 years) Page 21 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints made by the people living in the home were listened to and acted on. Individuals needs in respect of being protected from abuse were met including safe management of their money. Evidence: No complaints or adult protection issues had been lodged with us since the last inspection and none had been raised directly with the home. The surveys returned to us were generally positive about staff listening to the people living in the home and treating them well. One person stated they did not know how to make a complaint but would know who to speak to if they were unhappy. The minutes of the meetings held with the people living in the home showed that discussions had taken place, on more than one occasion, on how to raise concerns and make complaints. Comments received included: When I am unhappy I talk to my key worker. All the staff are there. If I dont feel too well or if I am depressed they are there all the time. Daily records showed that there had been an occasion where there had been a dispute Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: between two of the people living in the home. One had stated that the other was a bully. This had been followed up by the manager very quickly and the individual had said she did not want to lodge a formal complaint. The manager did have a dispute folder and all the details of the incident were entered in here. The records included the discussions with both individuals and the resolutions that had been agreed. The policies and procedures for adult protection were not viewed at this inspection. They had met the required standard at the previous inspections and no changes had been made. The training matrix indicated that two staff had not had training in adult protection issues however these staff had only been employed at the home for a relatively short time. All the people living in the home had their own bank accounts and drew their own money. There was a system in the home for the safekeeping of individuals money if they wanted to put money in or required assistance with budgeting. The records for this were sampled and were appropriate. All deposits were recorded and when people had money back they signed to say they had received it. All the balances checked were correct. Care Homes for Adults (18-65 years) Page 23 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable, generally safe and homely environment that meets their individual and collective needs. Evidence: Only the communal areas of the home were toured. These were found to be generally safe, well maintained and comfortable. It was noted that some of the people living in the home would leave the front door open when they went out to the local shops meaning anyone could enter the home. Clearly from the records of the meetings held with them people had been advised of how dangerous this was and that they must shut the door and take their key with them. The manager should explore the possibility of having a different type of door or lock that would not allow this to happen to manage this situation. There had been some improvements made to the home since the last inspection including, new flooring on the downstairs hall way and up the stairs, the lounge and two bedrooms been repainted and new flooring had been fitted in two bedrooms. We were told that the office and dining room were due to have new flooring also. Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: The communal areas comprised of a large lounge and a dining room. These were comfortably furnished. However it was noted that the carpet in the lounge area and on the upstairs landing was wearing and needed to be replaced. We were told that the people living in the home were allowed to smoke in the lounge between the hours of 6 and 10pm. The manager was advised to ensure this did not breach the no smoking regulations. There was a large well equipped kitchen that the people living in the home had access to at all times. We were told that one of the fridges was due to be replaced. As stated earlier one of the fridges was locked but this was to ensure good food hygiene. There was ample outdoor space for the residents in the rear garden which was well maintained and had seating for the residents to use in the better weather. Bedrooms were all of single occupancy and the people living in the home appeared satisfied with their rooms. The home had one bathroom and a shower room on the first floor and a shower room on the ground floor. These appeared to meet the needs of the people living in the home at the time. The home had a laundry room for the people living in the home and the staff to use which was equipped with washing machine and tumble drier. The home was clean and hygienic at the time of the visit. Care Homes for Adults (18-65 years) Page 25 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home are provided with support from a team of staff who are knowledgeable, well supported and who have an awareness of their changing needs. Recruitment procedures were robust and protected the people living in the home. Evidence: Throughout the course of the inspection it was evident there were good relationships between the people living in the home. The surveys returned to us indicated that staff treated the people living in the home well and that they listened to them and acted on what they said. One person stated: The staff at Ludford Road care for me and I love being here. There had been some staff turnover at the home since the last inspection. Some new staff had started work at the home and there was still one part time vacancy. Rotas indicated that there were two staff on duty throughout the waking day and one staff member slept in each night. The home also employed a domestic assistant who worked five days a week. The recruitment files for two new staff were sampled. The records are sent to the Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: home by the organisation in a sealed envelope to be opened by inspectors only ensuring they are kept confidential. The records showed that the recruitment procedures were robust and safeguarded the people living in the home. POVA first and CRB checks were undertaken prior to employment and two references obtained. There was a comprehensive induction pack for new employees which appeared to meet the specifications laid down by Skills for Care. We were told that MIND were reviewing the induction training pack as it was mainly tick boxes and a very large document. The training matrix for the home indicated that staff had undertaken a good range of training including manual handling, food hygiene, COSHH, adult protection and fire safety. Also included on the training matrix were a range of training courses specifically related to mental health such as voices, self harm and valuing the journey to recovery. It was recommended that all training entered on the matrix was dated so that it was easy to identify when staff needed refresher training. The information on the AQAA indicated that there have been further training opportunities for staff in topics such as diversity and using the computer. The AQAA also indicated that six of the seven staff employed had NVQ training. Care Homes for Adults (18-65 years) Page 27 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was very well managed and run in the best interests of the people living there. The health and safety of the people living in the home and staff were well managed. Evidence: The registered manager was spending only two days a week at the home as she had been seconded to another home three days a week. While she was not at the home another staff member had been made acting manager to cover. Both the manager and acting manager were very experienced in caring for people with with mental health needs. Both attended the home during the inspection and throughout they demonstrated a very good knowledge of the people living in the home. Clearly both were very committed to helping the people who live in the home to have the best quality of life possible without putting any undue pressure on them. They were very aware of how long it could take some people to achieve even the smallest of improvements. Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: Both managers had very good relationships with the people living in the home. The organisation had a new quality monitoring system which involved assessing the service against the quality standards set by the organisation which are linked to the National Minimum Standards. Two of the people living in the home were involved in the process and group meetings were being held. The manager has to produce evidence for senior managers that the service is meeting the set standards and if any short falls are found an action plan has to be put in place to address them. At the time of the inspection the most recent information had been sent into the organisation for them to audit. The manager had devised some new satisfaction surveys for the people living in the home. There were regular meetings for the people living in the home, topics discussed included such things as activities, holidays, security of the home and how to raise concerns. It was evident throughout the course of the inspection that the people living in the home were involved in the day to day processes in the home as much as possible. Their views were listened to and taken into account and on an ongoing basis the manager was looking for ways to involve individuals further. Health and safety in the home were well managed. Staff received training in safe working practices. The information received on the AQAA indicated that the equipment in the home is serviced as required. The home continued to notify us of any incidents or accidents in the home as required. Care Homes for Adults (18-65 years) Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 30 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 The risk management plans for the people living in the home must be accessible to staff at all times. This will ensure staff have all the information they need to ensure the people living in the home are safeguarded. It was suggested that it may be a good idea to look at arranging more in house activities with the people living in the home to enable them to socialise more in the home. The manager should explore the possibility of having a different type of front door or lock that would not allow the door to be left open by the people living in the home. The carpet in the lounge and on the upstairs landing should be replaced. This will ensure the home is kept to an acceptable standard for the people living there. The manager should ensure that the arrangements for smoking in the home are not in breach of the no smoking regulations. It is recommended that the training matrix indicates when staff have undertaken training courses to make it easier to identify when they are due for refresher training. 2 14 3 24 4 28 5 28 6 35 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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