Inspection on 13/10/08 for Hamstead Hall Road, 43

This inspection was carried out on 13th October 2008.

CSCI found this care home to be providing an Adequate 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

Hamstead Hall Road, 43 24/03/06

Hamstead Hall Road, 43 21/10/05

Hamstead Hall Road, 43 05/01/05

Hamstead Hall Road, 43 12/08/04

Hamstead Hall Road, 43 26/01/04

Hamstead Hall Road, 43 27/10/03

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

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 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hamstead Hall Road, 43 Hamstead Hall Road, 43 Handsworth Wood Birmingham West Midlands B20 1HT     The quality rating for this care home is:   one star adequate 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: Lesley Webb     Date: 1 3 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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 Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Hamstead Hall Road, 43 Hamstead Hall Road, 43 Handsworth Wood Birmingham West Midlands B20 1HT 01215235472 F/P01215235472 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Milbury Care Services Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 4 43 Hamstead Hall Road is registered to provide accommodation, care and support for three people who have learning disabilities. The Home is run by Voyage Care Services. The house is a domestic scale detached property, located in a quiet, well-established residential neighbourhood in the Handsworth Wood area of Birmingham. There are good public transport links for this locality. Downstairs there is a comfortable lounge to the front of the house. There is a separate dining room at the back of the house, and this gives access to the garden through patio doors. There is also a kitchen, separate laundry and toilet on this floor. All of the bedrooms are situated on the first floor, accessed by the staircase leading from the front hallway. A small box room serves as an office. The domestic scale bathroom includes toilet facilities. There is a paved driveway at the front of the house offering limited parking. To the rear of the property is a private enclosed garden. Fees charged for living at the home vary and the Care Homes for Adults (18-65 years) Page 4 of 31 Brief description of the care home Statement of Purpose was not up to date on the day of our visit. Interested parties should contact the home directly for this information. Care Homes for Adults (18-65 years) Page 5 of 31 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: One inspector carried out this visit over a day. The home was not informed that we would be visiting. Time was spent examining records, talking to residents and staff and observing care practices, before giving feedback on our findings to the deputy manager. Prior to our visit the home supplied information to us in the form of its Annual Quality Assurance Assessment (AQAA). Information from this was also used when forming judgements on the quality of service provided at the home. The people who live at this home have a variety of needs. We took this inot consideration when case tracking 2 individuals care provided at the home. For example the people chosen consisted of both male and female and have differing communication and care needs. The atmosphere within the home was inviting and we would like to thank everyone for Care Homes for Adults (18-65 years) Page 6 of 31 his or her assistance and co-operation. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In the main people who may consider moving into this home have the information needed to decide if it will meet their needs. Assessment processes ensure individuals needs are identified and met by the home. Evidence: The home has a Statement of Purpose and Service User Guide available for people to view in the home. It was pleasing to see copies maintained in resident bedrooms so that they have ready access to information. When examining these documents we noted that some information is out of date and should be reviewed. For example information about the commission refers to a previous address and management arrangements both within the home and operationally does not reflect the current arrangements in place. There have been no new admissions to the home for over 12 months however evidence contained within residents files demonstrates needs are reviewed on a regular basis. This helps identify changes needed to care plans and support that Care Homes for Adults (18-65 years) Page 10 of 31 Evidence: individuals require. Needs assessments are comprehensive and cover areas including personal hygiene, behaviours, mobility and communication. Care Homes for Adults (18-65 years) Page 11 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In the main individuals who live at the home are involved in decisions about their lives. Care and risk management processes ensure residents needs are met safely. Evidence: There are good systems in place for ensuring the care and support needs of individuals are met. For example all the residents files we examined contained comprehensive care plans that have been generated from the initial needs assessments. Plans contain information regarding the specific need identified, short and long term goals and how these are to be achieved. All plans viewed have been reviewed on a regular basis. We noted that none of the care plans have been signed by residents and/or their representatives. We discussed this with the deputy explaining that this should take place to ensure people agree with the support they are receiving. This will also evidence peoples involvement in the compilation and reviewing of their plans. In addition to care plans each person has a person centred communication plan to aid communication. Photographs and pictures have been used to support residents in Care Homes for Adults (18-65 years) Page 12 of 31 Evidence: understanding the contents of these. All 3 people who live at this have have varying communication levels. However efforts are made to involve them in decision making. For example each person is allocated a key worker, regular residents meetings take place and annual reviews are arranged by the home where relatives and other interested parties are invited. We spoke to a member of staff about the needs of a resident they support and they demonstrated good knowledge and understanding. They explained, X likes to build own relationships, so you need to spend quality time with X, its important to stick to the contents of the care plans due to autism. When looking at decision making processes we found that each resident has a decision making care plan. These give good information to staff on how to offer choices in order to support residents. We did note that none make reference to the Mental Capacity Act and what actions should be taken if a resident lacks capacity to make a decision. We discussed this with the deputy advising that these be reviewed to ensure individuals legal rights are upheld. As with care planning risk management processes in the main ensure individuals are not exposed to undue risks whilst promoting their rights to freedom. The majority of care plans we looked at also had risk assessments completed that complimented to contents of the care plans. This promotes an holistic approach to care management. We did note that the contents of a risk assessment for one resident contained information relating to other residents living at the home. We discussed this with the deputy advising that a review of all risk assessments is undertaken to ensure the contents are based on each individuals needs. Care Homes for Adults (18-65 years) Page 13 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to make choices about their life style and supported to develop their life skills. Activities meet individuals expectations. Residents rights to an annual holiday have not been maintained. In the main meals meet residents expectations. Further work should be undertaken to ensure choices are promoted. Evidence: By observing practices, talking to people and examining records we found that people living at the home undertake a range of activities that meet their individual needs. For example 2 of the 3 residents attend different day placements for further education, all 3 residents undertake a range of living skills activities within the home and community activities include accessing local shops, public houses, cinema, restaurants and leisure facilities. On the day of our inspection one resident was at college, another out in the community shopping and another at home. The resident who was at home confirmed Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: (using gestures) their enjoyment of swimming, walking and dancing. We viewed care plans that support individuals and reflect their preferences with regards to activities and social stimulation. As with other care plans these contain both short and long term goals and methods of achievement. In previous years residents have been on holiday to places including Skegness and Nottingham Forest. None of the residents have been on holiday this year. When asking the deputy about this he stated, no holiday this year because of situation. When asked what he meant by this he stated, suspension of staff and manager leaving. The minutes of residents meetings evidence that holidays have been discussed from February to September and residents were asked their preferences and arrangements made including a holiday being booked. The deputy confirmed this had been cancelled. Another member of staff informed us some staff employed at the home could not escort residents on holiday due to family commitments. As we explained, residents are entitled to an annual holiday paid for by the home (as detailed in the Service User Guide) and the organization that owns the home has a responsibility to ensure staff are available to support residents on a holiday of their choosing. Action should be taken urgently to ensure residents rights to an annual holiday are met. All 3 residents are supported to maintain contact with family members as per their individual needs. Discussions with staff and examination of records confirm this includes one resident staying overnight with their relative every month, another who is supported to send birthday cards and a third who maintains contact by telephone. Efforts are made to involve residents in choosing meals of their liking. For example a picture board is on display in the dining room that shows meals on offer for each day. On the day of our inspection we observed staff get 2 tins of soup and explain the flavours to a resident in order that they could choose one of their liking. We also observed a member of staff assist a resident to make their own lunch of a cheese sandwich. Neither of the meals that residents had were those on display on the picture board. Greater efforts should be made to ensure this accurately reflects meals residents can have. This will help promote residents involvement in decision making further. Despite this both residents appeared to enjoy their lunch. A menu is available. We noted that this does not offer a choice of main meals, however individual records of meals taken by residents demonstrate that on occasions different meals are eaten. Further work should be undertaken to ensure menus offer culturally appropriate meals that reflect the culture of 2 residents living at the home. Records do not demonstrate these are currently provided and care plans identify these should be offered. Two of the residents files that we examined demonstrate they are being supported with dietary needs associated with weight gain. This is positive as it promotes residents health and wellbeing. Care Homes for Adults (18-65 years) Page 15 of 31 Care Homes for Adults (18-65 years) Page 16 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that residents receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Minor amendments to some medication practices will offer further safeguards to residents. Evidence: Residents that we met during our visit appeared dressed appropriately for their age, gender and the time of year. Both had been supported by staff with their personal care and residents confirmed their satisfaction of the level of support given. Staff demonstrated good understanding of promoting peoples dignity. For example after lunch a member of staff was observed encouraging a resident to re-apply their make up, which the resident appeared very happy to do. As with other areas of support care plans and risk assessments are in place that inform people of the level of support people require in this area. This ensures a person centred approach to personal care support. We did note that both residents that we case tracked have risk assessments that instruct hourly observations are to be made throughout the night. For one of the residents we could find no evidence to support this practice. We discussed this with the deputy and a support worker who confirmed the resident has no health needs that Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: warrant this practice. We advised that the practice of hourly observations during the night for residents be reviewed to ensure peoples rights to privacy are not compromised. During our visit staff were seen taking residents to their bedrooms to assist them with personal care, ensuring doors were closed. This promotes individuals privacy and dignity. There are good systems in place for the monitoring and reviewing of residents health care needs. Records evidence that residents receive support to attend various health care professionals including dentists, chiropodists, opticians and dietitians. Each person has a Health Action Plan that helps promote holistic monitoring of health care. The home uses a monitored dosage system for the management of medication. Clear and accurate records are in place for medication entering, being administered and leaving the home. In addition we found sample signatures of staff who administer medication and a photograph of each resident in place with their individual administration records. These offer further safeguards to residents. Written protocols are in place for the use of PRN (as and when required) medication. It is advised that the contents of these are approved by the General Practitioner to ensure they are being administered safely. We also noted that one resident has a PRN protocol in place for a medication that is no longer given in this way. We advised that this be removed to ensure staff are not confused as to when it should be administered. The medication cabinent is located on the first floor of the home. The temperature within the cabinent is currently not monitored. During our visit the home was very warm. We advised that a system be introduced for monitoring the temperature within the medication cabinent to ensure medication is stored in line with manufacturers guidelines. Staff that administer medication receive training to do so. We asked the deputy if this includes competency assessments and were informed, we do a visual check but records are not maintained of these. We advised the home to obtain the CSCI guidance with regards to competency assessments for the administration of medication and to implement the recommendations. This will help ensure staffs practices reflect any knowledge they have gained through training. Care Homes for Adults (18-65 years) Page 18 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems for supporting residents to raise concerns would benefit from further development. This would help promote peoples rights to raise concerns. Not all financial practices ensure residents rights are upheld. Staff have a good understanding of complaints and protection. Evidence: There are systems in place for supporting people to raise concerns and making complaints. These include a formal written complaints procedure that we saw displayed on a noticeboard at the entrance to the home. Also each resident has a folder located in the office titled complaints. Each of these contains a copy of the homes service user guide and a copy of the complaints procedure that has been produced in large print, widget (a form of symbol) format. No complaints were found to be recorded on any of these files and we could find no evidence that the folder are put to use. We also found a separate complaints folder with evidence of 2 complaints received in the last 12 months. We noted that for one of these the commission was notified in line with Regulation 37 of the Care Home Regulations 2001. This should occur for any allegation of misconduct against a member of staff working at the home to offer additional safeguards to residents. Staff that we spoke to demonstrated good knowledge of supporting residents to raise concerns and from protecting them from harm. For example one member of staff Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: explained, some show they are unhappy by their actions, for example if they do not want to go to the day centre, of if behaviour changes. I would report to manager and would expect a meeting to discuss concerns. Behaviours are usually a way of knowing if someone is unhappy. As mentioned earlier in this report residents meetings take place on a regular basis. It is recommended that concerns and protection are included as a set item for discussion on the agenda to support residents further to raise concerns. We looked at the systems for managing finances on behalf of residents living at the home. Each person has individual records and receipts maintained that are regularly audited. The records for both residents that we looked at detailed personal monies having been spent on meals outside of the home. We discussed this practice with the deputy who informed us the home contributes an amount to meals taken outside of the home. This is also stated in the homes service user guide. We could find no evidence of this occuring and informed the deputy this practice must cease, an audit of records undertaken and residents reimbursed to ensure they are not placed at risk financially. When looking at financial records we also noted that one resident has purchased their own bed linen. The residents contract of residency states the home will provide 1 full set of bed linen with responsibility for additions above this being the residents. We discussed this with deputy asking when the home last purchased a set but this information was not known. It was also expressed that 1 set of bed linen was not enough for everyday use. We advised that inventories be implemented that detail purchases made by the home and also that the practice of supplying 1 set of bed linen is reviewed. Care Homes for Adults (18-65 years) Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables residents to live in a safe, well maintained and comfortable environment. Evidence: We toured the premises and found no major health and safety concerns. The building is domestic in style and in keeping with its surroundings. There is a spacious lounge and separate dining room on the ground floor, along with a fully equipped kitchen and laundry room. A small office is located on the first floor next to residents bedrooms. A resident invited us to view their bedroom. This has been furnished with items including a single bed, sink, curtains and carpet. There is no wardrobe however we were shown documentary evidence this is on order. We noted that a chest of drawers needs repairing. The resident indicated they are happy with their bedroom, smiling and nodding when showing us personal items. It was pleasing to see another residents bedroom was locked. Staff informed us all residents have a key to their bedroom and that the resident concerned chooses to lock their door when out of the building. There is a large, private garden to the rear of the building. This includes a paved area where residents can sit and a lawn with trees and shrubs. Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: There are toilet and bathing facilities on both floors of the home. It was noted attention should be given to improving the first floor bathroom as a strong odour was present, staining was seen around the walls of the toilet and the floor mat by the bath was badly stained. Improvements in this area will promote good infection control. Personal protective equipment including gloves and aprons was available for use in the home. Care Homes for Adults (18-65 years) Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and generally in sufficient numbers to support residents who live there. Recruitment practices offer safeguards to residents. Evidence: Staff that we spoke to demonstrated understanding of their roles, responsibilities and the support needs of people living at the home. Relationships between residents and staff appear good, with staff observed to treat residents with respect. Residents confirmed their satisfaction with the support they receive from staff, with one resident stating staff are nice. We sampled a number of records pertaining to staff training and found that in the main staff are suitably qualified to support people living at the home. For example the majority of staff have undertaken courses including epilepsy, autism and non violent crisis intervention. In addition to this some staff have received training in Makaton (a form of sign language) and the Mental Capacity Act. Many of the staff working at the home either hold a National Vocational Qualification (NVQ) or are in the process of completing this. This is another qualification that increases staffs knowledge and informs them how support should be given to residents. Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: We viewed the staff rotas for October and found that 2 staff are allocated on duty morning and afternoons, and 1 member of staff during the night. We did find one instance when only 1 member of staff was on duty but we were informed one resident was staying with family on that date, reducing residents in the home to 2. The manager left position at the home recently with the deputy covering the position until a permanent manager is recruited. The deputy has not been undertaking any supernumerary management hours although 15 hours per week are allocated. It is recommended the management hours are re-introduced to ensure efficient and effective management of the home. As mentioned earlier in this report we were informed residents have not been on holiday this year because of staffing. We have recommended action is taken to rectify this. Staffing levels should meet the needs of residents and the organization that owns the home must take responsibility to ensure this is monitored. We sampled the recruitment records of the 3 newest people to commence work at the home. All contained evidence that appropriate checks have been undertaken to ensure they are suitable to support people living at the home. These include obtaining references and enhanced criminal records bureau (CRB) disclosures. As already mentioned staff are provided with suitable training to meet residents needs. We also found evidence that staff receive induction to the home when first starting work there. This helps them understand their roles and the needs of people they will be supporting. Care Homes for Adults (18-65 years) Page 24 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In the main management of the home ensures residents health and wellbeing is promoted. Evidence: When we arrived at the home we were informed the manager has recently left and that the deputy is covering this position until a new manager is recruited. The deputy has worked at the home for a number of years and informed us he is currently undertaking the NVQ level 4 in care and the Registered Managers Award. There are a number of systems in place for monitoring quality within the home. These include audits for medication, health and safety, monthly visits in line with Regulation 26 of the Care Home Regulations 2001 and residents reviews. We asked if surveys are sent to residents, relatives, stakeholders and staff and were informed they are but these or the findings from these could not be found. The home should be able to demonstrate that the views of people are obtained and the findings incorporated into the development plan for the home. Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: In the main residents health and safety is promoted. For example accidents are recorded, water temperatures are monitored and fire audits undertaken. We could not find evidence that accidents are analyzed. It would be good practice to implement this in order that appropriate action is taken when incidents occur. When looking at health and safety the deputy was unable to confirm if West Midlands Fire Service have visited the home, stating, dont think they have ever visited us here at new premises. We advised that contact is made with the Fire Department and arrangements made for them to inspect the building to ensure the homes systems for the management of fire offer sufficient safeguards to residents. Good numbers of staff have received training in fire, food hygiene and first aid. This helps promote the health and wellbeing of residents. Care Homes for Adults (18-65 years) Page 26 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 31 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 1 23 13 In line with Regulation 13(6) 13/11/2008 An audit of residents financial records must take place and reimbursement made for any meals that a contribution has not been made by the home. This must happen to ensure residents financial rights are not compromised. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 It is recommended that the Statement of Purpose and Service User Guide are reviewed to ensure people have access to up to date information about the home. Residents and/or their representatives should sign care plans as evidence of their involvement in their compilation and agreement of their contents. Decision making care plans should be reviewed to ensure they comply with the Mental Capacity Act and to ensure residents legal rights are upheld. 2 6 3 7 Care Homes for Adults (18-65 years) Page 28 of 31 4 9 Risk assessments should be reviewed to ensure their contents are based on the individual needs of residents. This will promote a person centred approach to risk management. Arrangements should be made for residents to have an annual holiday as previously agreed with them. Greater efforts should be made to ensure the menu picture board reflects choices of meals offered to residents. Menus should offer culturally appropriate meals to meet residents needs. 5 6 14 17 7 18 The practice of hourly observations during the night for all residents should be reviewed to ensure residents rights to privacy are not compromised. The General Practitioners written consent should be obtained for the use of PRN medication. This will ensure it is administered safely. The temperature in the medication cabinent should be monitored. This will ensure it is stored in line with manufacturers guidelines. The CSCI guidance with regard to medication competency assessments should be obtained and implemented. This will help monitor staffs practices are safe. 8 20 9 22 Any allegation of misconduct against a member of staff should be reported to the commission to offer further protection to residents. Concerns and protection should be included on the agenda for discussion in residents meetings to promote residents rights further. 10 23 Inventories should be implemented for bed linen purchased by the home to ensure residents rights as detailed in contracts of residency are upheld. The home should review the practice of supplying one set of bed linen per resident. 11 30 Attention should be given to the first floor bathroom to promote good infection control. This should include eliminating odour, cleaning stains from around the toilet and replacing soiled floor mats. It is recommended that separate management hours are re-introduced to promote effective and efficient running of the home. 12 33 Care Homes for Adults (18-65 years) Page 29 of 31 13 39 The views of residents, relatives, staff and stakeholders in the community should be obtained and the findings incorporated into the development plan for the home. An analysis of accidents should be undertaken to ensure risks are appropriately managed. Contact should be made with West Midlands Fire Service and arrangements made for them to inspect the home. This will ensure the systems for fire management protect residents. 14 42 Care Homes for Adults (18-65 years) Page 30 of 31 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. 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