Inspection on 22/02/08 for Albert Road (8b) (Hightrees)

This inspection was carried out on 22nd February 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Albert Road (8b) (Hightrees) 27/11/06

Albert Road (8b) (Hightrees) 02/02/06

Albert Road (8b) (Hightrees) 05/07/05

Albert Road (8b) (Hightrees) 22/02/05

Albert Road (8b) (Hightrees) 18/05/04

Albert Road (8b) (Hightrees) 24/06/03

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Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

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Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Albert Road (8b) (Hightrees) Harborne Birmingham West Midlands B17 0AN Lead Inspector Sarah Bennett Unannounced Inspection 22nd February 2008 09:50 Albert Road (8b) (Hightrees) DS0000016966.V360433.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 Albert Road (8b) (Hightrees) DS0000016966.V360433.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. Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Albert Road (8b) (Hightrees) Address Harborne Birmingham West Midlands B17 0AN 0121 428 3423 F/P 0121 428 3423 ruth.gavin@sbpct.nhs.uk 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) Accord Housing Association Ltd Ms Ruth Gavin Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Albert Road (8b) (Hightrees) DS0000016966.V360433.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 27th November 2006 Brief Description of the Service: 8B Albert Road, Hightrees, is a purpose built care home, which accommodates five men, who require care and support as they have a learning disability and some behaviour that challenge the service. The home is situated within a residential area of Harborne, and is close to local amenities, and transport links. The home offers off road parking for approximately four cars. The home has three ground floor bedrooms, a communal lounge, dining room, kitchen, and shower room. On the first floor are a further two bedrooms, a staff sleep in room/office, and a bathroom. The first impression of the home is very positive. Accommodation is spacious, bright and homely. The home has a stable staff team who understand and can meet the needs of the people accommodated and provide individualised plans of activity to positively engage people inside and outside the home. The service users guide stated that each person living there pays £135.49 per week to Accord as a contribution to their fees. The information included in this report applied at the time of inspection and the reader may want to obtain more up to date information from the care service. The reports of previous inspections are available in the home. Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The visit was carried out over one day; the home did not know the inspector was going to visit. This was the homes key inspection for the inspection year 2007 to 2008. The focus of inspections that we, the commission undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home and the manager completed a questionnaire about the home – Annual Quality Assurance Assessment (AQAA). Two people who live in the home were case tracked this involves establishing individuals experience of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking people’s care helps us understand the experiences of people who use the service. The people who live at the home, the manager and the staff on duty were spoken to. A tour of the premises took place. Care, staff and health and safety records were looked at. The people living there and four of the staff who work there completed the ‘Have your say’ questionnaires about the home and their views are included in this report. What the service does well: The people living there were seen making choices about their daily lives, what they wanted to do and what they wanted to eat and drink. The people living there said that they were happy. Staff are well trained and have the skills and experience to provide a service to people with complex needs. Staff have the information they need in people’s care plans and risk assessments so they know how to help each person. Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 6 The people living there can at times behave in a way that could put them, the other people living there and staff at risk of being hurt. Staff know how to support people so these risks are reduced. All the people living there go on holiday each year, supported by staff. Cruises and holidays to Malta have been chosen and enjoyed by some people living there. The environment is homely and comfortable. The atmosphere was relaxed and people were doing the things they liked doing. People have a healthy diet to help keep them well. Some people need to lose weight and others need to stay at the weight they have gained. Separate menus show staff how to help people to do this so they can be healthy. What has improved since the last inspection? 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. Albert Road (8b) (Hightrees) DS0000016966.V360433.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 Albert Road (8b) (Hightrees) DS0000016966.V360433.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users have the information they need so they can make a choice as to whether or not they want to live there. EVIDENCE: The statement of purpose included the relevant and required information so that prospective service users would have the information they need to make a choice as to whether or not they want to live there. Each person had a copy of the service users guide to the home in their bedroom. This is produced using pictures making it easier to understand. It included the information that the people living there need so they know what the home provides and their rights and responsibilities whilst living there. Since the last inspection there had been no people admitted to the home and there are no vacancies. Admission and assessment records for one person were looked at during previous visits. These were assessed as meeting the required standards. The standard relating to assessment was not looked at during this visit. Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have the information they need in individual’s care plans and risk assessments so they can support them to meet their needs and be safe. The people living there are supported to make choices about their lives. EVIDENCE: The records of two of the people living there were looked at. These included an individual care plan. This detailed how staff are to support the person to meet their needs and achieve their goals. Care plans had been reviewed regularly and updated where the person’s needs had changed so staff knew how to support them appropriately. Some people living there have autism. Their care plan detailed how this affects their daily life and what staff can do to ensure they are supported in a consistent way so reducing their anxieties. Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 10 Records sampled included regular individual meetings with the person’s key worker/s. These showed that they talked about their health, personal care, family contact, the activities they want to do, care plans and risk assessments. One person living there said, “ I like my key workers.” Accord plan to become the sole provider of the home, as South Birmingham Primary Care Trust (PCT) are withdrawing from being the care provider. Records sampled showed that staff had explained this change to individual’s and how this may affect them and the staff working with them. People were observed during the day being offered choices about what they wanted to do, where they wanted to go, what they wanted to wear and what they wanted to eat or drink. Records included individual risk assessments. These detailed how staff are to support the person to minimise the risks to their health and safety. They included when having their medication, using the kitchen, bathing/showering, personal care, eating and drinking, their behaviours, travelling, going on holiday, during the night, mobility, locking the front door, activities and going out in the community. Risk assessments had been regularly reviewed and updated where necessary to ensure that action was still appropriate to minimise the risks. The people living there had received fire safety training. This was through an easy read questionnaire using pictures making it easier to understand. Questions were about what the person would do if the fire alarm sounded and this was asked depending on what room they were in at the time. It also asked where the fire exit signs are. They had been completed and signed by the individual. An individual procedure was in place for each person stating the support they would need if they had to evacuate the home because of a fire. Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 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. 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. The people living there experience a meaningful lifestyle and are supported to keep in touch with the people important to them. The people living there are offered a varied diet that ensures their individual health needs are met. EVIDENCE: Staff said that two of the people living there go to college twice a week where they do life skills, art and cookery. Another person works at a gardening project. During the day two people went out with a staff to a park and for lunch. They later went shopping and one person went to visit their relative. Another person went to a GP appointment with staff and then went to a park for a walk. Another person went out shopping with a member of staff to buy a card and present as they were going to visit their mum at the weekend. One person was away at Disneyland, Paris with their family. Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 12 Records sampled showed that people go for walks, out to cafés and restaurants, go shopping, listen to music, watch TV and DVD’s, go to the cinema and go out on day trips. Exercise equipment and games are provided in the home if people want to use them. Where people had been offered the opportunity to do activities but refused this was recorded to show that people are offered regular opportunities and choices. One person said, “At the weekend I go to a disco.” Another person said, “ I enjoy my activities.” The home has a vehicle, which can be used to enable the people living there to access the community. Staff said and records sampled showed that people also use public transport and walk to local places. Staff said that all the people living there went on holiday last year supported by staff. People do not go away in groups but go on holidays that they choose. One person went to Malta last year and is planning to go to Greece this year. One person went to Wales and another person went to Jersey. One person does not like flying so they go on cruises. Last year they went with staff on a cruise to Scandinavia. There were photographs around the home of this person very smartly dressed on cruise ships. Records sampled showed and the people living there said they are supported to keep in contact with their family and friends. Records showed that staff had maintained contact with relatives on individual’s behalf if they wanted this. Contact is made by phone calls, letters, visits to relatives and visits from relatives to the home. One person was away on holiday with their family at the time of this visit. The people living there were observed making their breakfast and their own drinks if they could do this. Records showed that people are encouraged to take part in household tasks so increasing their independence. One person said, “I like cooking.” There is a keypad lock on the front door. At the last inspection it was recommended that this be reviewed to ensure it is needed and does not restrict the people living there. The manager said that this had been reviewed and remained a risk particularly for one person living there. There are always staff on duty and the people living there need support from staff to go out. Therefore, this should be reviewed regularly and documented to show that the risks outweigh the benefits of having the door unlocked. Records sampled included a healthy eating plan that had been developed with advice from the dietician. Menus had been developed to ensure people have the food they like and it follows their healthy eating plan. Due to individuals different needs there was one menu to ensure that people lost weight and another for people who need to maintain their weight to be healthy. These were varied and included portion sizes. Staff said that they are developing a Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 13 picture menu using photographs so it is easier for the people living there to know what is on the menu that day. Food records sampled showed that people have a varied diet that includes at least the recommended five portions of fruit and vegetables each day for a healthy diet. Records showed that the food offered is appropriate to the cultural background of the people living there. Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 14 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. Arrangements are in place to ensure that the personal care and health needs of the people living there are met so ensuring their well being. Arrangements for the medicine management systems ensure that people receive their medication as prescribed so ensuring their health needs are met. EVIDENCE: Care plans sampled detailed how individuals are to be supported to meet their personal care and health needs. The people living there were well dressed in clothes that were appropriate to their age, gender, the weather, what activities they were doing and their cultural background. Records sampled showed that health professionals are involved in the care of individuals where needed. Staff follow the advice given by the health professionals to ensure that individual’s health needs are met. Records showed that people have regular check ups with the dentist, optician and chiropodist where needed to ensure their health and well being. Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 15 Records included an individual health action plan. This is a personal plan about what support a person needs to stay healthy and what healthcare services they use. When people attended health appointments the health professional had written in their health action plan the advice given and any follow up care needed. Staff were observed feeding this information back to the other staff after supporting a person to a GP appointment so that all staff knew how to support the individual. Records sampled showed that health professionals were pleased with the support given to individuals and the progress that had been made in meeting their health needs. Care plans sampled included details of the medication that the person is regularly prescribed and what medication they are prescribed ‘as required’ (PRN). A protocol was in place for each PRN medication stating when, why and how much of the medication should be given to the person to ensure it is used appropriately. Care plans stated what each medication was for and the possible side effects so that staff are aware of these. Medication is stored in a locked cabinet. Two staff sign the Medication Administration Record (MAR) when giving medication to the person to double check that it is being given as prescribed. A daily medication audit is completed to check that all medication is given as prescribed. The pharmacist supplies the medication in blister packs using the monitored dosage system. This makes it easier for staff to know what medication is to be given to the person and at what time. The morning blister packs were sampled and these cross - referenced with the MAR indicating that medication had been given as prescribed. Some medication is not suitable to be stored in blister packs as this affects its effectiveness. These are stored in boxes in the cabinet. One of these boxes was looked at and cross-referenced with the person’s MAR indicating that they had received their medication as prescribed. Most of the staff had completed training in giving medication. The manager said that three staff still have to complete this but one of these staff is currently doing this training. Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 16 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 judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that the views of the people living there are listened to and acted on. The people living there are protected from abuse, neglect and self-harm. EVIDENCE: Records sampled included the complaints procedure of South Birmingham PCT and Accord so that the people living there knew how to make a complaint if they are unhappy with the service provided. The home had not received any complaints and the commission had not received any complaints about this home since the last inspection. The AQAA stated that the people living there are encouraged during meetings and informal chats to disclose any concerns or complaints they may have. The people living there can sometimes display behaviour that is ‘challenging’. Records included an individual reactive strategy that detailed the person’s target behaviours, what can trigger these, are there any early warning signs, what proactive steps staff should take so the behaviours may not occur, how to distract the person from behaving in that way and how staff should intervene if the person displays the behaviour. It also stated the support that staff should have in managing the behaviours and how to monitor behaviours so if there are any concerns referrals can be made to health professionals for support and advice. Staff training records showed that staff receive training in managing behaviour and minimising confrontation. Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 17 Records included an inventory of the person’s belongings. These had been regularly updated when the person had bought new things or thrown something away. This makes it easier to track what belongs to each person so if something should go missing there is a record of what it was and when the person last had it. Individual’s finance records sampled cross-referenced with the amount of money they had in their individual tin. This indicates that people’s money is being spent appropriately. Receipts are kept of all purchases and these cross-referenced with what the record stated that the person’s money had been spent on. An incident took place between two of the people living there where staff reported that one person might have been at risk of being abused by the other person. This was reported appropriately as a safeguarding referral to the relevant authorities. A meeting of professionals was arranged and staff had taken appropriate action to ensure that all the people living there are safe. A risk assessment is also in place that detailed the action that staff need to take to prevent the people living here from harm, as they pose a risk to each other both verbally and physically. Staff training records showed that staff had received training in adult protection and the prevention of abuse so they know how to keep people safe. Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 18 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, 26, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Arrangements generally ensure that people live in a safe, clean, homely and comfortable environment that meets their individual needs. EVIDENCE: The home was generally well decorated and furnished in a contemporary style that reflected the age of the people living there. Staff had painted the walls of the shower room and bathroom with lighthouses and sea creatures so these rooms were less clinical and more homely. Bedrooms were personalised and decorated according to individual tastes. One person’s bedroom is to be redecorated and the manager was talking to them about choosing the colour for this. As stated in the last inspection report the flooring in one person’s bedroom needed replacing but this had not yet been replaced. The manager said they are looking to do this in the new financial Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 19 year. They also plan to replace the flooring in another person’s bedroom. Where people are able to use a key they have their own key for their bedroom so they can lock it if they want to. The stair carpet was very stained and should be replaced with more appropriate floor covering that would withstand the wear and tear that the stairs get. Heating engineers visited during the day. Staff said that there has always been a problem with the heating not being efficient, particularly in the lounge. Staff said that the radiator covers had been removed to try to resolve this but it had not helped. Some areas of the home felt cool and ongoing work is taking place to try to resolve this. The AQAA stated they could do better by improving the time it takes for repairs and improvements to be undertaken. They hope to improve communication links with Accord in respect to planned improvements and time scales. They plan to provide sensory equipment in bedrooms. One person had purchased this equipment for their bedroom and was waiting for it to be installed. The ground floor shower room was clean however, the toilet roll holder was rusty and the toilet seat was starting to show signs of wear and tear. These should be replaced to minimise the risks of cross-infection. The home was clean and free from offensive odours throughout. One person living there said, “The home is always tidy.” Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 20 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, 33, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for staffing, their support and development ensure they have the skills and knowledge to meet the needs of the people living there. The recruitment practices protect the people living there from harm. EVIDENCE: The AQAA stated that eleven of the fifteen staff have National Vocational Qualification (NVQ) level 2 or above in Care. This exceeds the standard that at least 50 of staff have achieved this and ensures they have the skills and knowledge to work with the people living there. The manager said that the other staff are planning to achieve this qualification. There was a picture rota in the hall so the people living there knew which staff were on duty during that day and when. People living in care homes can often be anxious about which staff are going to support them and this helps to alleviate that anxiety. Staff said we have four staff per shift to ensure the people living there can do what they wish to do. Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 21 The AQAA stated that one full-time member of staff had left in the last 12 months. The manager said there is one staff vacancy, which they plan to recruit to. They also plan to involve one of the people living there in the recruitment process. Rotas showed that bank staff cover the vacancy, often this is permanent staff doing bank shifts so that they know the people living there well. The manager said that agency staff are rarely used to work there. Rotas showed that there are three staff on early shifts plus one staff who provides day care from 9am – 3pm, four staff on a late shift and one waking night and one sleep-in staff at night. The manager said that they used to have permanent waking night staff but this caused particular difficulties with one person who lives there who does not find it easy to work with staff from different cultural backgrounds. It was agreed that it was not in this person’s best interests to have permanent waking night staff. This means that one member of staff works three nights and one day each week and other staff work a combination of nights and days. Minutes of staff meetings showed that these are held regularly. This helps staff to know how to support the people living there and to keep updated with ‘best practice’ in social care. Three records of the staff that work there were looked at. These included the required recruitment records including evidence that a Criminal Records Bureau (CRB) check had been completed. This helps to ensure that ‘suitable’ people are employed to work with the people living there. A member of staff said, “My CRB was completed before my appointment and has since been renewed”. Staff said, “I had a full induction when I first started my job.” Staff training records sampled showed that staff had the necessary training to meet the needs of the people living there and keep them safe from harm. When staff first started working at the home they had an induction so they knew how to support individuals and the homes and organisations policies and procedures. As part of their induction staff complete the Learning Disability Award Framework (LDAF) training. This provides them with the skills and knowledge to work with people who have a learning disability. Staff records sampled showed that staff had formal, recorded supervision with their manager each month. This ensures that they are supported and receive the appropriate training and development to meet the needs of the people living there. Records showed that individual targets were set for the member of staff with them and the manager so that they knew what they needed to achieve to improve the service offered to the people living there. Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 22 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, 38, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management arrangements ensure that the people living there benefit from a well run home. The people living there cannot always be confident that their views underpin all self-monitoring, review and development by the home. Arrangements are in place to ensure that the health, safety and welfare of the people living there is promoted and protected. EVIDENCE: The manager was off duty but came in when staff phoned her about the inspection, as she wanted to be there and co-operated throughout. The manager is a learning disability nurse and demonstrated that she is knowledgeable about the people living there and the service provided. Good Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 23 interactions were observed between the manager, staff and the people living there. There was a relaxed atmosphere in the home yet the manager demonstrated a clear sense of direction to the staff to ensure that the home is well run for the people living there. Currently, Accord are the registered provider and South Birmingham PCT provide the care. This is due to change with Accord taking over as the sole provider from 1st April 2008. The manager said that she had attended a meeting with Accord and was positive about the plans for the future. A representative from the PCT had not completed an audit of the home since December 2006. A representative from Accord had visited the home four times a year to complete an audit. The reports of their visits showed that a detailed audit took place that included asking the views of the people living there. However, these visits should be monthly visits to ensure the home is well run and improving the lives of the people living there. The manager had completed an improvement plan for the first six months of 2008. This included how improvements would be made to the environment, staffing and recruitment, care plans, risk assessments, meeting individual’s health needs, person centred planning, menus, opportunities for the development of the people living there and social activities, ensuring that the move to Accord was an improvement, providing user friendly information and Equality & Diversity. The AQAA stated and records showed that an electrician completed the five yearly electrical wiring test in 2006 and stated that it was in a satisfactory condition. The annual test of the portable electrician appliances was completed in 2007 and this stated that these were safe to use. The AQAA stated and records showed that a Corgi registered engineer completed the annual test of the gas equipment in July 2007. They stated that it was in a satisfactory condition and safe to use. An Environmental Health Officer visited in November 2007. Their report stated that there were ‘very good practices in place’ in relation to food hygiene and safety. This helps to ensure that the people living there are not at risk of having food poisoning. Staff test the water temperatures weekly. Records showed that these were within the recommended safe limits so that people are not at risk of being scalded. Fire records showed that staff test the fire equipment weekly to make sure it is working. An engineer regularly services the fire equipment to ensure it is well maintained and works well. Staff have regular fire safety training so they know how to prevent fires from starting. Regular fire drills are held so that staff and the people living there would know what to do if there was a fire. Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 24 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 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 2 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 4 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 2 X X 3 X Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 25 Yes, one Are there any outstanding requirements from the last inspection? 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 YA39 Regulation 26 Requirement Regulation 26 visits must be undertaken monthly and record maintained in the home. This will ensure that the people living there can be confident that their views underpin the development by the home and the home continues to be well run. Outstanding from the last inspection. Timescale for action 30/04/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA24 YA24 Good Practice Recommendations The heating system should be efficient to ensure that the people living there are comfortable at all times. The stair carpet should be replaced with more suitable flooring that can withstand the wear and tear that this area gets so that it is clean and comfortable for the people living there. The flooring in two bedrooms should be replaced with suitable flooring that meets the individual needs of the DS0000016966.V360433.R01.S.doc Version 5.2 Page 26 3. YA26 Albert Road (8b) (Hightrees) 4. YA30 person living there. The toilet roll holder and toilet seat in the ground floor shower room should be replaced to minimise the risks of cross-infection. Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Albert Road (8b) (Hightrees) DS0000016966.V360433.R01.S.doc Version 5.2 Page 28 - 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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