Inspection on 01/12/05 for 8 Coriander Close

This inspection was carried out on 1st 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 17 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

8 Coriander Close 24/09/09

8 Coriander Close 03/07/07

8 Coriander Close 12/07/06

8 Coriander Close 06/07/05

8 Coriander Close 03/02/05

8 Coriander Close 22/09/04

8 Coriander Close 14/01/04

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 08/07/2008.

CARE HOME ADULTS 18-65 Coriander Close, 8 Northfield Birmingham West Midlands B45 0PD Lead Inspector Sarah Bennett Unannounced Inspection 1st December 2005 02:40 Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 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 Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 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. Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Coriander Close, 8 Address Northfield Birmingham West Midlands B45 0PD 0121 453 7292 0121 453 0831 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) Trident Housing Association Mrs Patricia Podmore Care Home 5 Category(ies) of Learning disability (5), Physical disability (5) registration, with number of places Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents must be aged under 65 years Date of last inspection 6th July 2005 Brief Description of the Service: 8 Coriander Close is registered and offers long-term residential care to five people who have learning and physical disabilities. All of the current residents have complex health needs and all are wheelchair users. The home was purpose built in 1995 and is owned and managed by Trident Housing Association. The house is designed on two levels. There is a spacious open plan lounge and dining room and a sensory room. There are two well-equipped bathrooms with mechanical baths, shower trolleys and hoisting facilities to aid lifting. The kitchen is accessed from the lounge. The first floor is accessed via a stairway. Located on this floor is the office, the laundry and staff facility including a bathroom and bedroom. This floor is not accessible to residents. Currently all communal areas are open plan and there are no private areas for residents to receive visitors apart from their own bedrooms. Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted by, one Inspector over four hours. This was the second of the statutory inspections for this home for 2005/2006 and not all of the National Minimum Standards were assessed. To get a full picture of the home it is advised to read this report in conjunction with the report from 6th July 2005. At this inspection time was spent observing care practices, interactions and support from staff. The residents do not have verbal communication and their ability to communicate to the inspector their views of the home was limited. A tour of the home was made. Residents care plans, risk assessments and some Health and Safety records were inspected. The Inspector had the opportunity to talk with members of staff and the Deputy Manager. The Inspector did not have an opportunity to speak with relatives. What the service does well: What has improved since the last inspection? All bedroom and the hall carpets have been cleaned which makes the home more comfortable for the people who live there. There has been a fire drill and staff have had training in fire safety. So, staff and the people who live there are aware of what to do if there is a fire in the home. Staff have had training in first aid so they will be more able to help the people who live there if there is an accident. Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 Page 6 A new member of staff has started working at the home. This provides the people who live there with more staff who know them well to support them. 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. Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 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 Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 5 Prospective residents do not have all the information they need to make an informed choice about where to live. Prospective residents needs and goals are assessed before they move in to see whether it is a suitable place for them to live. Each resident has an individual contract that states the terms and conditions of their stay at the home. EVIDENCE: A requirement was made at the last inspection for the statement of purpose to be updated with the changes within the organisation and the management of the home. The Deputy Manager said that she is in the process of completing this. A requirement was made at the last inspection for the service users guide to be produced in a way that would be accessible to the residents. The deputy Manager said that this is being done but has not yet been completed. Since the last inspection one resident has moved into the home. Before they moved in an assessment of their needs was completed. Reviews have taken place with all the relevant professionals involved to make sure that their needs can be met at the home. Resident’s records included a Licence Agreement that included the terms and conditions of the residents stay at the home. Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Staff do not have the information they need to know how to support each individual resident to meet their needs, goals and aspirations. Residents are supported to make choices about their day-to-day lives and their individual wishes are taken into account in all aspects of life in the home. Residents are not adequately supported to take risks within a risk assessment framework. EVIDENCE: The resident who has been admitted to the home since the last inspection did not have a care plan. There was a sheet of one side of A4 paper that stated what the resident likes and dislikes, how they communicate and some information about their past. This is not enough information for staff to be able to support them appropriately and knows their needs, goals and aspirations. Staff were observed talking to residents asking them what they would like to eat and drink, what they would like to do and where they wanted to spend their time. Staff were observing residents non-verbal communication to see if they like or disliked something. One resident’s records showed that they have an advocate who has taken part in the residents review meetings. Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 Page 10 A tenant participation officer has recently been employed by Trident. They recently attended a staff meeting and gave staff some advice on person centred planning. Because most of the residents do not have verbal communication it is difficult to have residents meetings where their views are sought. The Deputy Manager said that one of the residents used to be involved in the Trident tenants meetings, which are to be re -established in 2006. This resident will be given the opportunity to take part in these. The Deputy Manager said that through observations and talking to resident’s relatives, staff get to know what residents like and dislike and ensure that these wishes are granted. There were no risk assessments in place for the resident who has been admitted to the home since the last inspection. The report from the occupational therapist dated September 2005 stated that the resident needed a risk assessment for the bedsides that they need to have on their bed to keep them safe. A risk assessment was not in place for this. Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 Arrangements are in place so that people living at the home experience a meaningful lifestyle. EVIDENCE: Residents go to day centres from Monday to Friday. Residents records showed that they go out to restaurants, shopping, pubs and out for drives. Inside the home residents watch television, videos, listen to music, use the sensory room and sensory equipment provided in other rooms and have hydrotherapy baths. Staff were observed talking to residents and engaging them in sensory activities. Resident’s records seen at the last inspection showed that residents participate in a range of activities within the local community. Staff said residents continue to take part in these activities. Staff said that all residents went on holiday to Butlins, Bognor Regis in September. Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Residents generally receive personal support in the way they prefer and require. Resident’s health needs are generally met. The arrangements for the management of medication are not adequate to protect residents. EVIDENCE: Residents were well dressed appropriately to their age and the weather. Residents use wheelchairs, these are made specifically for each individual and it was evident that staff ensure that these are well maintained and kept clean. Staff said that one of the residents would be getting a new wheelchair the following week. There was not a manual handling risk assessment in place for the resident who has been admitted to the home since the last inspection. This needs to state how staff are to support the resident with their mobility and what equipment, if any, is to be used. Health professionals are involved in the care of residents where appropriate including the community nurse, epilepsy nurse, district nurse, speech and language therapist, dietician, occupational therapist, chiropodist, physiotherapist and psychiatrist. Resident’s records included details of health care appointments that they attended and the outcome of these. Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 Page 13 Some residents are fed through a PEG tube following a decision by the multidisciplinary team. Individual guidelines are in place stating how much food residents are to have and whether or not they can have liquids or food orally. The multi-disciplinary team develop the guidelines. All staff have received training in PEG feeds. Staff said that when they notice that one of the residents is not well they take them to the GP immediately. One of the residents had been to the GP earlier in the day and was prescribed antibiotics. The Deputy Manager said that one of the residents health needs had changed so they brought forward an appointment with the consultant. Health Action Plans are not available for each resident. The Government White Paper ‘Valuing People’ stated that everyone who has a learning disability should have a health action plan by June 2005. It is a personal plan about what support a person needs to stay healthy and what health care services they need to access. At the last inspection a requirement was made for each resident to have their own medication cabinet in their bedroom. The medication cabinet in the office upstairs is too small to store all the resident’s medication. Two staff administer medication to residents and at some times of the day this means that residents are left on their own downstairs whilst medication is being checked. The Deputy Manager said that quotes obtained had been very expensive. Advice was given that they need to be lockable, metal cabinets that are secured to the wall and only store the individual’s medication but not necessarily from a medical supplier. Staff had signed the Medication Administration Records (MAR), indicating that medication had been given as prescribed. For as required (PRN) medication there were protocols in place. When PRN medication had been given to resident’s, staff had entered on the back of the MARS the reason why it had been given. Staff observed giving medication to residents spoke to the residents as they were giving it and ensured that residents took it. One resident is prescribed Midazolam (‘rescue’ medication for epilepsy). The Deputy Manager said that most of the staff had received training in giving Midazolam and the other staff have been booked to do this training. One member of staff has successfully completed the accredited ‘Safe Handling of Medicines’ training and the other staff are undertaking this training. Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 The arrangements for complaints are adequate to ensure that resident’s views are listened to and acted on. Adequate arrangements are not in place to ensure that residents are protected from abuse, neglect and self-harm. EVIDENCE: The Deputy Manager said there have been no complaints since the last inspection. The complaints procedure is printed using symbols to make it easier to understand. A copy of the complaints procedure is available in each resident’s bedroom. A copy of the Birmingham Multi-Agency Guidelines on the Protection of Vulnerable Adults was available. Staff have not received training in adult protection and protecting residents from abuse. This remains outstanding from the last inspection. Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 28, 29, 30 Residents live in a clean, safe, comfortable and homely environment that generally meets their individual needs. EVIDENCE: The home was warm, clean and well decorated. Resident’s bedrooms were well decorated according to individual tastes and contained many personal possessions. One resident has an en suite shower room. However, the room needs a new ceiling track hoist for the resident to be able to use it. This remains outstanding from previous inspections. The Deputy Manager said that quotes for this work have been obtained and the funding now needs to be agreed. This must be completed so that the resident can benefit from having their own shower room and the privacy that this gives. Some residents had some sensory lighting in their bedrooms. There is a sensory room, which is also used to store equipment such as fans and hoists when not being used. Staff said that some of the equipment in the sensory room was not working. A new washing machine and tumble dryer had been provided recently, as the others had broken down. Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35 The arrangements for staffing the home, their support and development was variable. EVIDENCE: The Deputy Manager said that another member of staff has just started doing NVQ level 2 in Care. The Deputy Manager said that they have one part-time staff vacancy of 24 hours. There has been one member of staff start working at the home since the last inspection. Two members of staff were on annual leave. One permanent member of staff and two agency staff were covering the late shift. One of the agency staff was late arriving. The Deputy Manager rang the agency a few times and told them that this was unacceptable and did not wish the member of staff to work at the home in the future. Both agency staff had worked at the home before and so knew the residents. Staff said that they are well supported by the Deputy Manager and Service Manager. Since the last inspection staff have received training in pressure area management, fire safety and first aid. The Deputy Manager has completed the three- day first aid course. The Deputy Manager said that some staff have received training in manual handling and others are booked to do this. Staff have not received training in adult protection and protecting residents from abuse. This remains outstanding from the last inspection. Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 42 The management arrangements are not adequate to ensure that residents benefit from a well run home. The arrangements for promoting and protecting the health, safety and welfare of residents are generally adequate. EVIDENCE: The home has been without a manager since the previous manager left in July 2005. The Deputy Manager said that the Managers post had recently been advertised. The Deputy Manager said that she receives regular support from the Service Manager. There are some requirements outstanding from the previous inspection, which would probably have been met if a manager had been in post. Fire records showed that staff regularly test the fire alarm and emergency lighting to make sure they are working. A fire drill took place in July 2005 and these must take place at least every six months to make sure that staff and residents know what to do if there was a fire. Staff have regular training in fire Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 Page 18 safety to make sure they are aware of what they can do to prevent a fire and action to take if there is a fire. Staff test the water temperatures each week to make sure that the water is not too hot or cold for the residents. Records showed that these are generally between 41 - 43 degrees centigrade, which is within safe limits. There were no risk assessments in place for the resident who has been admitted to the home since the last inspection. The report from the occupational therapist dated September 2005 stated that the resident needed a risk assessment for the bedsides that they need to have on their bed to keep them safe. A risk assessment was not in place for this. Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 Page 19 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 Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 Page 20 CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 X X 3 Standard No 22 23 Score 3 1 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 1 3 3 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X 3 2 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 3 X 2 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 2 X Standard No 37 38 39 40 41 42 43 Score 1 X X X X 2 X Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 Standard YA1 Regulation 4(1)(b, c) Requirement Timescale for action 31/01/06 2 3 YA1 YA6 4 5 6 YA6 YA18 YA19 7 YA42YA20 8 YA35YA23 The statement of purpose must be updated with the management and organisational changes. (Previous timescale not met). 5(1)(2) The service users guide must be produced in an accessible format. 15(1)(2) All care plans must be restructured and reviewed. (Previous timescales of 30/04/05 and 31/08/05 not met). 15 (1) (2) A care plan must be in place for all residents. 13(4)(a-c) Manual handling risk assessments must be in place for all residents. 12(1)(a) Each resident must have a Health Action Plan in,ine with ‘Valuing People’. (Previous timescale not met). 13(2) A medication cabinet must be 13(4)(c) available in each residents bedroom to store their individual medication. (Previous timescale not met). 13(6) All staff must receive training in adult protection. (Previous timescale of 31/05/05 and 31/10/05 not met). DS0000016935.V270821.R01.S.doc 28/02/06 31/12/05 31/12/05 15/12/05 31/01/06 31/01/06 31/01/06 Coriander Close, 8 Version 5.0 Page 22 9 10 YA24 YA27 11 12 YA42YA35 YA37 13 YA9YA42 All the equipment in the sensory room must be in working order. 23(2)(b,n) The en suite bathroom requires refurbishment. (previous timescale of 31/05/05 and 31/08/05 not met). 13(5) All staff must receive updated 18(1)(a,c) training in moving and handling. (Previous timescale not met). 8 (1)(a) A manager must be recruited to work at the home. (Previous timescale of 31/08/05 not met). 13(4)(a-c) A risk assessment must be in place for all residents that have a bedside fitted to their bed. 23 (2)(c) 31/01/06 31/12/05 31/01/06 31/01/06 06/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Coriander Close, 8 DS0000016935.V270821.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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