Inspection on 05/03/09 for George Leonard Rest Home

This inspection was carried out on 5th March 2009.

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

George Leonard Rest Home 16/03/10

George Leonard Rest Home 02/08/06

George Leonard Rest Home 28/11/05

George Leonard Rest Home 11/04/05

George Leonard Rest Home 04/10/04

George Leonard Rest Home 27/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: George Leonard Rest Home 237 - 239 Oldbury Road Rowley Regis West Midlands B65 0PP     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: Christine Lancashire     Date: 0 5 0 3 2 0 0 9 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. that people have said are important to them: They reflect the things 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 Older People 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 Older People Page 2 of 27 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 Older People Page 3 of 27 Information about the care home Name of care home: Address: George Leonard Rest Home 237 - 239 Oldbury Road Rowley Regis West Midlands B65 0PP 01215614984 01215611783 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr R S Odedra,Mr S B Odedra care home 23 Number of places (if applicable): Under 65 Over 65 3 23 dementia old age, not falling within any other category Additional conditions: 0 0 Service users to include up to 23 OP and up to 3 DE(E) at any one time not exceeding the total number registered for. Date of last inspection Brief description of the care home George Leonard Care Home is located on a main road between Blackheath and Whiteheath. A number of local shops and other facilities are available within easy reach of the home including a main bus route. The home was originally two houses and they have been linked together, converted and extended to provide the 23 bedded care home. There is a small garden and car parking space for approximately five cars to the front of the property and a patio and lawned area to the rear. There are two storeys. The ground floor houses the office, lounge, dining room, conservatory, kitchen, laundry, one of the assisted bathrooms and toilets. The first floor houses bedrooms, toilets and the second assisted bathroom. The home provides 19 single and 2 double bedrooms. 10 single and both double bedrooms are provided with en-suite facilities. The fees are available on application to the home. Care Homes for Older People Page 4 of 27 Care Homes for Older People Page 5 of 27 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We visited this home on a weekday without telling anyone that we would be arriving. The purpose of the visit was to see how the home is meeting key National Minimum Standards. Before the visit we had received information from the manager about the running of the home and the plans for development. At the inspection we spoke to the manager, staff and some people who live at the home. We looked round the building and into several bedrooms. We looked at the records which the home is required to keep and these include records about peoples needs and preferences, safety, menus, staff rotas, medication, staff recruitment and training, complaints and minutes of meetings. We looked at the systems which the home has for monitoring its performance and at the Care Homes for Older People Page 6 of 27 results of questionnaires completed by people who live there. We used this information to write this report. What the care home does well: What has improved since the last inspection? What they could do better: The manager has identified areas she intends to develop further in coming year. These include developing a powerpoint display to show people information about the home, continuing to develop a wider range of activities and pictorial menus. She also intends Care Homes for Older People Page 8 of 27 to work to try to reduce the turnover of staff. 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. 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 Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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 who are considering moving into this home are provided with the necessary information to make an informed choice. Assessments and visits to the home ensure that people know, before they move in, that their needs can be met by the home. Evidence: We saw that the Home has a detailed Statement of Purpose and service user guide which are updated at least annually and displayed in the entrance area. The manager told us that she and her deputy make assessment visits to the homes of people thinking of moving into the home. They also obtain the social services care plan where available and seek the views of other relevant professionals and family members. We saw letters on file informing people that the home could meet their needs. The manager told us that people are invited to visit the home and sample the atmosphere before moving in on a trial basis. Following the trial period a review is carried out with the person concerned, the manager or deputy and any other people, such as a social Care Homes for Older People Page 11 of 27 Evidence: worker, who can provide relevant information. We sampled care files and found the necessary paperwork. All people in the home are are issued with a statement of terms and conditions (local authority funded) or contract (privately funded) which include information regarding fees and any extra charges. The manager told us that the staff realise that moving into a care home is a stressful and demanding time for people and their families and they try to provide appropriate support. People are welcome to bring personal items, including furniture from their previous home, so that they can feel more at home in their room. Care Homes for Older People Page 12 of 27 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health, personal and social needs are set out in a care plan so that they can be met by staff. People are treated with respect and their privacy and dignity are maintained. They are protected by the homes practices in relation to the storage and administration of medication. Evidence: The manager told us that she uses the information in the assessments and the social services care plan to form the basis of a care plan which provides staff with detailed informaiton about the care which each person needs and prefers. We sampled peoples files and found that the care plan templates are easy to follow and include various risk assessments including preferred daily routines, activities, tissue viability, mobility, pressure sores and manual handling. We saw records of peoples preferred times for getting up and going to bed and the time when they prefer to take a bath or shower. Each plan is updated at least monthly or when changes take place. Wherever possible the person concerned and their family are involved in the development and update of Care Homes for Older People Page 13 of 27 Evidence: the care plan, which is agreed and signed. We found that the care plans are detailed and easy to read. The daily records show that care staff support people with personal care where this is needed, but they encourage people to be as independent as possible. They monitor people on an ongoing basis and when necessary, involve other professionals such as the district nurse. There are risk assessments which cover activities and indicate the measures which are taken to help people to undertake tasks and activities in as safe a way as possible. People are monitored by care staff and, where necessary, assessed by the District Nurse if there is a risk of developing pressure sores so the appropriate action can be taken and where necessary equipment obtained to promote tissue viability. This is all recorded in the care plan. The home seeks professional advice to promote continence where necessary and regular assessments are maintained to ensure appropriate equipment is supplied. Food and fluid intake is monitored on a daily basis and recorded. People are weighed monthly or as and when if there is reason for concern and recorded. All people at the home are registered with a GP, dentist, chiropodist and optician of their choice and, where applicable, on referral from their GP to hearing tests, speech therapists, dieticians and physiotherapists. The Home has policies and procedures for handling dying and death. All people at the home have their final wishes in their care plans. These are discussed with the relevant people and held on file until the information is required. The majority of care staff have received bereavement training. The manager told us that family and friends of people with a terminal illness are able to stay with them, unless the person makes it clear that he or she does not want them to. Should someone die at the home, their body is handled with dignity at all times and time is allowed for family and friends to pay their respects. The Home has a detailed medication policy and procedure. All staff responsible for medication are trained to do so, and a signature list is kept in the drug trolley at all times. The manager carries out regular weekly drug audits to ensure compliance and safety. The contracted pharmacist also carries out three monthly audits. Records are kept of all medication received in the home or disposed of and two trained staff signatures are obtained. There are suitable arrangements for the storage and administration of controlled drugs. The manager told us that the home has a good working relationship with the contracted pharmacist and seeks advice when ever needed. We saw that risk assessments are completed for those people who wish to self administer medication. Staff monitor the condition of people on medication for any adverse effects and any concerns are reported immediately to the GP. Care Homes for Older People Page 14 of 27 Evidence: We saw staff treating people with respect. The manager told us that people are asked how they prefer to be addressed. Personal care is carried out in peoples own rooms. Bathrooms and WCs are large enough for staff to provide assistance with the door closed. The manager asked people for their permission to enter their rooms on the day of the inspection. People may entertain their visitors in their rooms. There is screening in shared rooms. We saw the telephone which is available for people in the home. This is in a fairly private location. The manager told us that people may use the portable office telephone in their own rooms shoud they need to be assured of privacy. Care Homes for Older People Page 15 of 27 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. 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. Peoples lifestyles in the home match their preferences and suitable activities are arranged. They are encouraged to maintain significant relationships with people in the community and they receive a choice of nutritious meals which meet their needs and take account of their preferences. Evidence: The manager told us that people are involved in a range of activities in and out of the home. They are consulted about their preferences in this area at service user meetings. The information on the notice boards shows that there is a daily programme of activities as well as monthly events and other peroidic outings and parties. On the day of the inspection, some people were playing play your cards right with staff. Others were chatting or watching television. Some people had chosen to stay in their rooms, where one person was watching television. Events in the home include coffee mornings, singers and keyboard players. We saw photographs of people enjoying parties at times such as Christmas, Halloween and in the Summer. Staff told us that friends and relatives of people in the home also come to the parties. There are regular visits from representatives of local churches and services are held in the home for people who wish to attend. There are daily activity recording sheets which are Care Homes for Older People Page 16 of 27 Evidence: completed by staffand questionnaires are used to find peoples opinions on what is provided. People are actively encouraged to maintain personal and social relationships. Family and friends are welcome to visit at any time although discouraged at meal times. People can choose to take visitors to their own rooms or any communal area in the home. The Home will refuse entry to any visitor if the person does not wish to see them and any actions taken are recorded in the care plan. We saw the minutes of the service user meetings which are held every two months. These meetings follow a set agenda including cleaning, laundry, menus and personal care, activities, entertainment and staff. The manager forms an action plan following these meetings. Questionnaires are issued twice yearly to people in the home, stakeholders and staff. Further views are found through comments sheets, thank you letters and cards. Peoples legal rights are protected and upheld. All people in the home are registered to vote. There is an access to information policy. The manager is up to date with the latest training in relation to the Deprivation of Liberty Safeguards and is undertaking appropriate assessments in the home. The four weekly menus show that people are offered four meals a day, with hot and cold drinks available throughout the day and night on request. Peoples medical needs and preferences in terms of food are recorded and there is choice at each meal, with people being asked for their preference on the day. We saw the daily menu on display in the dining room. This is printed in a large font so that it is easy to read. Meals are well presented. Meal times are not rushed. If necessary, staff are ready to offer assistance to people, but independent eating is encouraged. Care Homes for Older People Page 17 of 27 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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. There are good arrangements to ensure that people are protected, including the arrangements for handling complaints. Evidence: The Home has a detailed complaints policy and procedure. This is in the Statement of Purpose and service user guide and is on display on the notice board with advocacy leaflets. The manager promotes a open door policy to people who live there, their visitors and visiting professionals. The home record of complaints made includes details of investigation, action taken and any external agencies informed. Complaints are dealt with within a stated timescale. Staff are made aware of the procedures to be followed should anyone wish to make a complaint. People in the home told us that they would tell a member of staff or the manager if they were not happy. The home has an adult protection policy and staff are trained in recognising the possible signs of abuse. They are also made aware of the action to take should they suspect that someone has been abused. This means that people are well protected. People told us that they feel safe in the home and are treated well by the staff. One said, there is nothing to grumble about. Care Homes for Older People Page 18 of 27 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, 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. 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 live in a homely, clean and safe environment which meets their needs. Evidence: The home is set back from the road with parking space at the front. There are two lounges and a dining room on the ground floor. The garden is accessible from the lounge and provides a patio area with furniture, as well as a grassed area which is accessible up a ramp. The home is non smoking within the building, but there is a smoking shelter outside. The bedrooms are of varying size and shape. The bedrooms which we saw are personalised and individual in style. There are two shared rooms which are occupied by people who agreed to share. These rooms have screens for privacy. All bedrooms are well ventilated, centrally heated with radiator covers and all exposed pipework covered. Lighting is domestic in appearance and there is over bed lighting. Some rooms have en-suite faciltiies and those which do not are close to WCs. There are two assisted bathrooms and one assisted shower room. All hot taps on hand basins are thermostatically controlled so that people do not scald themselves. People have access to all parts of the home either by ramps or passenger lift and there Care Homes for Older People Page 19 of 27 Evidence: are grab rails and bath/mobile hoists. We found all areas clean, well furnished and free from unpleasant odours. There are suitable procedures for handling laundry. An industrial washing machine is provided with sluicing facilities. Staff have access to protective gloves and aprons and there are procedures for infection control. Care Homes for Older People Page 20 of 27 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. 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 people who live in this home are cared for by sufficient numbers of staff who are well trained and competent to do their jobs. They are protected by the homes recruitment practices. Evidence: The staff rotas show a good level of cover. The staff team is diverse in terms of age and ethnic background and there is a male carer. We sampled staff files and found that staff are recruited through a standard process, which includes taking up references and checks through the Criminal Records Bureau. The manager showed us the system which is used for equal opportunites monitoring of the recruitment process. Monitoring takes place at the application, interview and appointment stage. The manager told us that newly appointed staff receive Skills for Care induction training and this is followed by more mandatory training. Other relevant training is provided so that staff are competent to meet the needs of the people in the home. There are detailed training records which show that all staff, including the cook and the cleaner are trained to at least NVQ level 2, 8 members of the team have achieved level 3 and one has achieved level 4. Staff employed to undertake domestic duties told us that they are provided with the opportunity to obtain training in care related areas. Care Homes for Older People Page 21 of 27 Evidence: We saw the minutes of regular meetings of kitchen staff, domestic staff and the complete team. These make sure that staff know about recent changes in legislation and plans for the home and are provided with an opportunity to discuss relevant issues. Staff are also supported through two monthly supervision and regular opportunities for discussion. There are handover periods between shifts so that there is continuity of care. Care Homes for Older People Page 22 of 27 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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. People live in a well managed home which is run in their best interests and where there are good systems for maintaining the quality of care. Their financial interests are safeguarded and their health, safety and welfare is promoted and protected. Evidence: The manager is well qualified and experienced with nineteen years experience in care, of which ten years have been in management. She has NVQ Registered Managers Award level 4, NVQ 4 Management and NVQ 4 Care and other qualifications relevent to the job role. She continues to update her training. She shows enthusiasm for continual improvement in the service which is offered to the people who live in the home. All records in the home are well organised and accessible. The home has a comprehensive and robust Quality Assurance monitoring system which allows people in the home, stakeholders and staff the opportunity to view opinions and put suggestions forward through twice yearly questionaires. The manager Care Homes for Older People Page 23 of 27 Evidence: carries out audits on a monthly basis on different areas of the home. She monitors all records and systems and analyses information such as the records of accidents. The annual report of the Quality Assurance is made available to people in the home, stakeholders and staff. Visits are made to the home by an indpendent person who prepares reports for the manager so that she can make improvements where needed. The manager makes sure that, where possible, people are able to take control of their own finances. The home will look after money for people when requested to do so. We looked at the system and found that receipts are provided and there is a detailed record of all transactions. Two signatures are required by management, supervising care assistants or people in the home when transactions are made. All reciepts are kept in individual envelopes with peoples forms. The manager audits the records on a regular basis. We checked the money and records for two people in the home and found that the records were accurate. The manager provided us with the dates of checks and servicing of equipment in the home. We sampled the records and found them them to be up to date. At the last visits from the environmental health officer and the fire officer, there were no concerns. There are regular checks on the fire alarms and fire detection system. We saw that there are regular checks on the wheelchairs and other aids and adaptations. There are good systems to make sure that the high standards of safety are maintained for people in the home, staff and visitors. Care Homes for Older People Page 24 of 27 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 Older People Page 25 of 27 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 Care Homes for Older People Page 26 of 27 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). 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. Care Homes for Older People Page 27 of 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!