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Inspection on 10/02/07 for Home From Home

Also see our care home review for Home From Home for more information

This inspection was carried out on 10th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

After spending time with the residents there was no doubt that they are still very happy with their lifestyles. There were very friendly relationships between the owner and the service users. The one service user who was able to communicate well said they liked living here and were happy. Residents and records showed they had good social contact with their friends. The care plans and risk assessments at the home are reviewed every three months and showed how the resident`s needs were to meet. There were no unreasonable rules or routines in the home. Documentation and conversations confirmed the residents were still encouraged to make choices and take control of their lives wherever possible. A good example of this is that one resident loves to help out in the home. The owner purchased a dishwasher for the resident who takes great pride in helping load and unload it.. The home continues to offer residents a high standard of decor and has the feel of a true family home. Conversations with Mrs Whiley clearly showed how well she knows the residents. Interaction was pleasant and residents freely accessed the kitchen. Residents are encouraged to take daily exercise and often go visiting friends or take trips to the local shops. During the bad weather Mrs Whiley continues to encourage them to either take exercise in the garden, weather conditions permitting, or engage in number of indoor exercise routines for them to take part in.

What has improved since the last inspection?

Individual bank accounts have been set up for both residents. There are records available to see what personal allowances each resident receives and receipts are kept to show how they have spent it. A dishwasher has been purchased to enable residents to still be involved with the day-to-day activities in the home.

What the care home could do better:

There were no areas identified where the service could be improved in relation to the standards monitored on this visit.

CARE HOME ADULTS 18-65 Home From Home 104 Billingsley Road Sheldon Birmingham West Midlands B26 2EA Lead Inspector Mary Hall Key Unannounced Inspection 10th February 2007 10:00 Home From Home DS0000017124.V324213.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 Home From Home DS0000017124.V324213.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. Home From Home DS0000017124.V324213.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Home From Home Address 104 Billingsley Road Sheldon Birmingham West Midlands B26 2EA 0121 743 1971 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) Mrs Sheila Whiley Mrs Sheila Whiley Care Home 2 Category(ies) of Learning disability over 65 years of age (2) registration, with number of places Home From Home DS0000017124.V324213.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th November 2005 Brief Description of the Service: Home from Home is along a quiet residential road in the Sheldon area of Birmingham. It is a three bedroom semi-detached property that accommodates two service users, both of whom are adults, aged over sixty five with a learning disability. The home is generally well maintained and is within reasonable access of shopping facilities, local churches and regular public transport services. The home comprises of three bedrooms one of which is used by the owner. Access to the bedrooms is by one flight of stairs. There is a bathroom upstairs. The other facilities include a lounge, a kitchen with a dining area and a conservatory with a laundry area. There is a downstairs toilet. A level access shower room has recently been installed on the ground floor. The conservatory has a television. There is a garden leading from the conservatory. A wooden summerhouse has recently been built at the top of the garden for recreational use. There is parking in the road. The residents have lived in the home for sometime and live as part of the family with the owner, Mrs Whiley. Home From Home DS0000017124.V324213.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is a very small establishment and whilst subject to regulation a degree of balance has been made in the application of the standards and regulations. This means that residents can continue to live in a family environment and receive the care afforded to a member of that family. The key inspection was carried out on 10th February 2007. During the inspection a tour of the house was made, both of the residents files and a small amount of other records were inspected. The inspector spoke with service users, a visitor and the owner of the home who is also the registered manager What the service does well: What has improved since the last inspection? Individual bank accounts have been set up for both residents. There are records available to see what personal allowances each resident receives and receipts are kept to show how they have spent it. A dishwasher has been purchased to enable residents to still be involved with the day-to-day activities in the home. Home From Home DS0000017124.V324213.R01.S.doc Version 5.2 Page 6 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. Home From Home DS0000017124.V324213.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 Home From Home DS0000017124.V324213.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): 2 Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. No new residents are going to be admitted to the home. EVIDENCE: There had been no admissions to the home since the last inspection and the existing residents have lived in the home for a number of years. Mrs Whiley confirmed with the inspector that she would not be admitting any more residents to the home. She plans to retire when she has no residents. All the required regulatory information is in place and reviewed annually. Home From Home DS0000017124.V324213.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): 6,7,9, Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Care plans and risk assessments are reviewed every three months in consultation with residents and other professionals as needed. Residents are empowered as far as possible to make decisions about their everyday lives EVIDENCE: Both residents files were seen and contained care plans that included all aspects of care and support that were to be offered to them. The files also included relevant risk assessments. Mrs Whiley ensures that the care plans were reviewed regularly to ensure they reflect the current needs and lifestyles of the service users. Residents are encouraged and supported to make decisions and where support may be needed in this it was documented in the care plan. Both residents have limited contact with their family. However, one family member still maintains contact via telephone or written communication. There was the letter on file thanking Mrs Whiley for the care their relative received. Home From Home DS0000017124.V324213.R01.S.doc Version 5.2 Page 10 A relative of a previous resident at the home sent in a letter praising the care their mother had received. They felt the care given was second to none and that their mothers final years were full and happy under the care of Mrs Whiley. Mrs Whiley knows both the residents very well indeed and ensures their needs are met. Where changes are required these are included into the care plan and risk assessment updated if required. The record of health visits show that the residents receive regular check up at the dentist, chiropody, option, and visits to the doctor as required. Residents continue to have the opportunity to go out on a daily basis, usually with Mrs Whiley. Activities include shopping, cinema, theatre, the Darby and Jones club, visiting friends or just going for a coffee and cake at one of the many establishments in Solihull. This year residents enjoyed a visit to a local pub/restaurant on Christmas day with friends. The residents said how much they enjoyed their meal and presents. There are two three-week holidays planned for this coming year to Porthcawl. Home From Home DS0000017124.V324213.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 excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported and encouraged to make decisions and choices about their every day lives and to keep in contact with their friends. Mrs Whiley knows the preferred daily routines. Both residents have daily social contact with the community and their friends. EVIDENCE: Daily entries in the residents files clearly demonstrate the range of leisure activities and pursuits undertaken. These include, community outings and visiting friends or having friends visit them within the home and weekly visits to the Darby and Jones club. Food records were very detailed. Mrs Whiley records what choice at each meal was offered to the service users. Residents are asked on a daily basis what they would like to eat. Food records kept demonstrated a varied and nutritious diet. Residents are able to have snacks and fresh fruits and drinks throughout the day. Home From Home DS0000017124.V324213.R01.S.doc Version 5.2 Page 12 I had lunch with the residents. This was homemade vegetable soup with freshly cooked bread rolls, sliced bread and a platter of mixed cheeses. A selection of rice puddings was available with a choice of fruit. One resident laid the table and helped clear up. During the visit resident had numerous drinks and snakes offered. Mrs Whiley was well aware of any likes, dislikes and preferences. Mrs Whiley regularly checks residents weight and this is recorded in the records. Residents are encouraged to remain as active as possible and get involved in day-to-day tasks within the home if they wish. According to the daily records there are no imposed routines in the home. Residents make every day choices such as, when to go to bed, when to get up, what to wear, what to eat and how they wanted to spend their time. Residents choose how to spend their time in the home. The residents said they prefer to sit in the conservatory but confirmed they are free sit where they like. One resident told me how she had enjoyed picking the blinds for this room. Mrs Whiley ensures that both residents have two holidays per year. One resident told said how much they enjoyed these. Both residents appeared happy with their lifestyle. One resident who has limited verbal communication but is able to read well was able to share her views about living in the home. She said she was happy and liked living here. A friend of the residents from another local home was visiting. She also said how much she enjoyed coming over and how good the food was. Home From Home DS0000017124.V324213.R01.S.doc Version 5.2 Page 13 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 excellent. This judgement has been made using available evidence including a visit to this service. Residents personal and health care needs are met whilst maximising their independence and control over their lives. The medication system was safe and ensured the residents received the correct medication at the prescribed times. EVIDENCE: Both residents said they were able to choose their daily routines and receive the support they required in a way that maintains dignity and respected their choice. Residents needs in relation to personal care were detailed in their care plans. During discussions, Mrs Whiley was clearly able to demonstrate a good knowledge of the needs and requirements of both service users. There is an adapted shower room and toilet on the ground floor. Residents are registered with the general practitioner and there was evidence documented in the record of professional visits. The medication being administered in the home was minimal. The records evidence that the residents were receiving their prescribed medication at the correct times. Medication is stored in Mrs Whitley’s bedroom in a locked cabinet. Neither of the residents can access this room as it is kept locked. Home From Home DS0000017124.V324213.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to live their life knowing that they are listened to and protected from abuse neglects and self-harm. EVIDENCE: The home has a complaints procedure however this was not looked at on this visit. The CSCI have not received any complaints since the last inspection and Mrs Whiley confirmed that she had not received any complaints either. Residents are unable to handle their own money on a daily basis. The manager is the appointee for both the residents and this had been a long standing arrangement. The financial records were inspected during this visit. Records kept of financial transactions were auditable and at the appropriate level and in sufficient detail for the size of the home. Entries and receipts confirm that residents spend their personal allowance on social activities, clothing and holidays. Mrs Whiley confirmed that she pays the holiday in advance and weekly amounts are deducted from residents personal allowances. Mrs Whiley is to contact the Department of Work and Pensions to ensure residents are receiving their full benefit entitlement. Mrs Whiley currently has to subsidize residents finances to ensure they have all they need and can go out regularly. Home From Home DS0000017124.V324213.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30, Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides a very comfortable and well-maintained homily environment that ensures the safety of residents and visitors. EVIDENCE: The home continues to be well decorated and maintained to a high standard. Furnishings and fittings throughout the home were also of a high standard, domestic in style and very comfortable. The residents require limited aids or adaptations. These are provided as required. Residents have their own single bedroom and these were appropriately personalised and well decorated and furnished. Bedrooms are lockable by the residents if they wish. Bedrooms do not have wash hand basins but the bedrooms are in close proximity to the bathroom. There is an upstairs bathroom but residents prefer to use the adapted shower room on the ground floor. There is an additional toilet downstairs situated in close proximity to the conservatory where the residents choose to spend daytime hours when in the home. Home From Home DS0000017124.V324213.R01.S.doc Version 5.2 Page 16 The home throughout is well furnished, maintained to a high standard, homely and comfortable. There is a large well planned out rear garden accessed via the conservatory. Residents said they enjoy using the garden and sitting in the summer during the better weather. There has been a recent issue regarding the handrails fitted by Social Services. During the summer months the top rail became very hot and could burn residents hands. It has taken Mrs Whiley a great deal of time and effort to get this addressed. Currently Social Services are replacing the top rail with wood. All the required safety checks are undertaken regularly and equipment serviced in line with regulations. The home was very clean and hygienic and there were no issues raised in relation to infection control. Home From Home DS0000017124.V324213.R01.S.doc Version 5.2 Page 17 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): 32,34,35, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents needs are minimal and therefore adequately provided by one member of staff. Mrs Whiley has the relevant mandatory training in food hygiene, health and safety and manual handling and experience to undertake this role effectively and safeguard service users EVIDENCE: Mrs Whiley lives on the premises and manages to support the residents at this current time without the need for additional staff. On the odd occasion when additional support has been required, Mrs Whiley draws support from fellow professionals in the area. Mrs Whiley has been in the care industry for in excess of 20 years. Both residents have lived with her for over 16 years, as their needs are minimal Mrs Whiley is suitably experienced and competent to meet these. Mrs Whiley mandatory training in food hygiene, health and safety and manual handling are updated as required. Mrs Whiley has confirmed to the Commission that she has no intentions of admitting any other residents to the home. As and when the time arises Mrs Home From Home DS0000017124.V324213.R01.S.doc Version 5.2 Page 18 Whiley will retire. It has been agreed that in view of this the condition of registration that requires her to undertake her NVQ 4 has been removed. Mrs Whiley monitors the needs of residents on a regular basis. To date she is able to meet these with no difficulties. Should the situation arise where this is no longer the case Mrs Whiley will review staffing levels as require and take appropriate action. Home From Home DS0000017124.V324213.R01.S.doc Version 5.2 Page 19 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): 37,39,42, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Mrs Whiley ensures the smooth running of the home in a competent and empowering manner. The health and safety of the residents well maintained. EVIDENCE: Mrs Whiley is also the Registered Manager. She demonstrated a very good indepth knowledge of the residents in her care. The home is run very much like a family home but with an awareness of the need to meet requirements of regulation. The records inspected were up to date and Health and safety well maintained. Residents are informed daily and visitors verbally informed on arrival about fire procedures. Home From Home DS0000017124.V324213.R01.S.doc Version 5.2 Page 20 No formal quality assurance systems are in place but Mrs Whiley adjusts the service if required through consultation with the residents on a daily basis. Home From Home DS0000017124.V324213.R01.S.doc Version 5.2 Page 21 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 x 2 3 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 4 25 3 26 4 27 4 28 4 29 3 30 4 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 4 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 3 x 3 x x 3 x Home From Home DS0000017124.V324213.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action 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 Refer to Standard OP34 Good Practice Recommendations The manager should make enquiries to ensure that the residents are receiving all of the benefits Home From Home DS0000017124.V324213.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Home From Home DS0000017124.V324213.R01.S.doc Version 5.2 Page 24 - 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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