Inspection on 20/06/05 for Home From Home

This inspection was carried out on 20th June 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Home From Home 10/02/07

Home From Home 16/11/05

Home From Home 30/03/05

Home From Home 26/05/04

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Home from Home 104 Billingsley Road Sheldon Birmingham B26 2EA Lead Inspector Joan Franklin Unannounced 20 June 2005 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 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 Older People. 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 E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Home from Home Address 104 Billingsley Road Sheldon Birmingham B26 2EA 0121 743 1971 Telephone number Fax number Email 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 (2) registration, with number of places Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30 March 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 summer house has recently been built at the top of the garden for recreational use. There is parking in the road. The service users have lived in the home for sometime and live as part of the family with the owner, Mrs Whiley. Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was attempted on the afternoon of the 20th June 2005. There was no reply. The unannounced inspection took place on the 21st June for three hours in the morning. The inspector was a different inspector than for the previous inspection on the 30th March 2005. This was the first inspection for the year 2005/2006. The manager explained that she had to go to hospital on the 20th June following an accident when she dropped a pot on her foot. The manager arranged for the two service users to spend the night at another small home. A tour of the home took place. Care records were inspected as well as records relating the administration of the home. Discussions occurred with the manager and with the service users. It was possible to make observations of the interaction of the service users in the home. What the service does well: What has improved since the last inspection? The Complaint’s procedure now has a time limit for when a complaint would be completed. A level access shower has been installed on the ground floor which makes showering an easier activity than before it was installed. A summer house has been built in the back garden providing another place for the service users to use and spend leisure time. Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 6 The manager maintains a plan of decorating the home to provide a high standard of comfort and cleanliness in the home. 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. Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 4 There is sufficient information for prospective service users and their families or representatives to be able to make an informed choice about the home to decide on whether to chose to live there. EVIDENCE: The amendments from the last inspection still need including in the Statement of Purpose. There would be an opportunity to look at the facilities prior to a possible move into the home. The manager said that she is not going to attend the Level 4 NVQ Manager’s training. She has decided that she will not apply to the local Adult Placement scheme, as she does not have confidence that the home will receive any improvements to the current situation. The Statement of Purpose was inspected. There have been no admissions for fifteen years which is the length of time the current service users have lived in the home. The home does not offer intermediate care. Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 11 The home provides a high level of attention to the health needs of service users. Service users’ wishes and feelings are taken in consideration to try to ensure that their requests are followed. The recording on the medication records requires improvement to ensure details of when medication is received and that the amount that has been administered is accounted for. EVIDENCE: The care plans of the two service users were inspected. Details of health, social and personal needs were in the care plans. One of the service users had made a visit in the last few weeks to a consultant for attention to the development of senility. This now needs including on the care plan. The care plans are up-dated and reviewed on approximately a three monthly basis. The care plans include details of the wishes of the service users in the event of death including which songs they would like. The manager is very concerned Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 10 that the benefit system will in reality not allow for the burial of one service user but will impose a cremation. The manager intends to find out if the wishes can be met. The daily record sheets on each service user were seen. The daily records were up-to-date except for the most recent four days. The MAR chart was inspected. The manager had made some improvements since the last inspection though the medication is still not signed for when received and no record of the next amount when it arrives. The service users presented as well cared for including careful attention to their skin care with sun cream available should they be going out. The manager said that there is an annual review of each service user with Social Care and Health. The minutes of the last review have not been received. Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 14, 15 Service users have opportunities for service users to fulfil their wishes for socialising and entertainment. The residents are able to give their views as to what they would like to do. Activities and experiences rather than relying on a set routine are being developed for service users. The service users’ have a healthy, nutritious diet. EVIDENCE: The service users were observed eating a snack. They talked about how they enjoy their food. Fresh fruit was available for the service users to eat when they wanted. The manager talked about mashing the food of one service user to ensure that she eats an adequate amount. This has been recommended by a dietician as seen on the care plan. After the snack one of the service users was observed to do the washing up. She said that she enjoys this activity. The manager said that family and friends are welcome to visit the home but there is almost no contact from family. The service users talked about visitors who come to see them including service users who live in other homes who are their friends from when they attended a day centre. Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Complaints are taken seriously and conscientious responses maintain the care and protection of service users. The staff are prepared to challenge incidents that could be considered as abusive to service users. Financial arrangements of the service users may be open to abuse as insufficient records are kept. EVIDENCE: No complaints have been received at the Commission for Social Care and Inspection. The manager said that she has received no complaints since the last inspection. The manager did talk about complaints that have been investigated in the past and how she responded to these and that this has made her aware of the importance of the complaints procedure. The addition to the complaint’s procedure required at the last inspection was seen. The manager showed a photograph of a bruise on the cheek of one service user in 2003 after a visit to the dentist. The manager followed this up to ensure that the bruise was a result of a tooth extraction rather than neglect. One of the service users said, “I’m ever so happy here”. During discussions with the service users they talked of being settled at the home. Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 23, 25 and 26 The home is clean, comfortable and provides the service users with opportunities to have free access to the amenities. The décor and facilities are maintained to a high level and additions and adaptations are made to respond to the needs of the service users. A risk assessments is in place though action is required to ensure that the recent additions to the home are of the same level of safety as the existing amenities. EVIDENCE: A tour of the home showed that the décor was of a high standard. The service users talked about enjoying the amenities. They were sitting comfortably in the conservatory talking about the new addition of a summerhouse which they realised they could not visit until the steps had been made safe for them. The lavatories are clean and odour free. Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 14 One service user showed her bedroom which she said was comfortable and that she is “happy” with what it provides for her. The furniture was suitable. The mattress was adequate. The water in the bathrooms is regulated to the required temperature. The home has recently had a level access shower installed. The service users said that like the new shower. The manger said that a slight adjustment is required to the stool so the service users’ feet touch the ground. The manager said that there are occasional incidents of incontinence of urine and faeces. She said that she ensures that soiled clothes are not taken through the kitchen and the washing machine has a cycle of 90 degrees. Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28 No staff are employed. Provisions are in place for appropriate care in circumstances when the manager is not available in emergency situations. The manager should continue to explore alternative care arrangements to provide an opportunity for her to have break. The home is well managed though the manager is not qualified. EVIDENCE: The intended unannounced inspection could not take place as there was no one at the home. The next day when the inspection occurred the care of the service users overnight had been arranged at another small home following an accident to the manager’s foot requiring hospital treatment. The service users were observed returning to the home. They had enjoyed their overnight stop talking to the manager about various details. They know the manager of the other home as the two homes have occasional social events together. The manager has run the home for more than fifteen years. She has decided that she will not take the NVQ Level 4 to meet the requirements for registered managers. The manager realises that this could result in the CSCI making a decision to cancel registration. The manager said that she would appeal against such a decision. The manager does attend training to keep aware of developments in social care. Recently she has attended training on the administration of medication. Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 16 The manager is of the view that her knowledge and experience ensure that the service users have suitable care to meet their needs and that she attempts to respond to their requests for what they would like to do. The service users were seen to be pleased to see her on their return. The service users appeared safe and happy. The manger has attended a lifting and handling course for which she has a certificate in the past. She considers that she copes with the lifting and handling needs of the service users as there is little need at present. Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 34, 35, 37 and 38 The policies and procedures promote the protection and development of the service users. There has not been adequate completion of information of accidents to provide details of the response to such situations. The home is run in the best interests of service users, however, notifications to CSCI should reflect the requirements of Regulation 37. EVIDENCE: The manager has cared for the two service users for more than fifteen years. The manager was observed to welcome them home kindly after a night away. The service users’ presentation and movements around the house suggest they benefit from best interests being taken into account at all times. The records from the home were readily available, kept in a tidy order and were a few days away from being up-to-date. Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 18 A receipt that was requested for a pair of trousers for one of the service users could not be found. The manager said that she acts as appointee for both service users whose monies are paid directly into the manager’s own account. There is not a separate book for each service user of their financial affairs and this should be done. The records show that the manager helpfully subsidies the service users where needed, reclaiming the money at a later date. One of the service users spontaneously mentioned that she had a fall. There were details of the fall in her daily records but no details in an accident book and a section 37 notification had not been sent to CSCI. The service users are very used to each other’s company and relate well to the manager who they turn to for reassurance and support. The Registration Certificate was on display. The home had a current insurance certificate. Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x x 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 x 3 x 3 3 STAFFING Standard No Score 27 x 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 3 x 3 2 2 x 3 3 Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 20 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA 1 Regulation SCHE (1) & (2) Requirement The Statement of Purpose must include the qualification and training of the manager (Previous time scale of 1-5-05 not met) The manager must ensure that she is qualified to NVQ Level 4 in Care Management . (Previous time scale of 1-5-05 not met) The manager must ensure that the MAR charts have details of the amount of medication received with a signature to confirm that the amount given is correct. (Previous time scale of 1-5-05 not met) Include in the care plan of one of the service users the response needed to the development of senility The manager must contact Social Care & Health to adjust the height of the stool in the recently installed shower room There should be a statement in the service users plan that the manager is their appointee All receipts of items bought for service users should be available. The service users financial records should be kept Timescale for action 30-06-05 2. YA 37 9 (1) (2) (b) (i) 13 (2) 1-12-05 3. YA 20 30-06-05 4. OP 7 15 (b) (d) 30-06-05 5. OP 10.1 23 (2) (c)_ 15 (1) sche 4 (9) 30-06-05 6. 7. OP 7 .1 OP 18.1 30-06-05 30-06-05 Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 21 up-to-date. 8. OP 18.1 20 (a) (b) The manager must set up separate bank accounts for each service user and stop receipt of money into her own account. The manager should discuss the management of her accounts with her accountant All accidents must be recorded in an accident book The manager must send a regulation 37 notification to the CSCI when there has been an accident. 30-06-05 9. 10. OP 38.7 OP 38.7 schedule 4 12 (a) 37 (c) 21-06-05 21-06-05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 18.1 34.5 29 Good Practice Recommendations The manager should ensure that the financial details of each service user are kept separate in the book recording finances The manager should continue to make enquiries to ensure that the service users are receiving all of the benefits The manager should be aware of when her CRB expires and apply for a replacement. If the managers daughter intends to take on a caring role a CRB check must be obtained in advance. Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Birmingham and Solihull Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham, B2 4UZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Home from Home E54 S17124 Home from Home V233549 200605 Stage 4.doc Version 1.30 Page 23 - 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. 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