Inspection on 19/11/08 for Ideal Home

This inspection was carried out on 19th November 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

Ideal Home 21/05/08

Ideal Home 22/05/07

Ideal Home 02/05/06

Ideal Home 03/11/05

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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 older people Name: Address: Ideal Home Knowsley Drive Gains Park Shrewsbury Shropshire SY3 5DH     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: Karen Powell     Date: 1 9 1 1 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. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Ideal Home Knowsley Drive Gains Park Shrewsbury Shropshire SY3 5DH 08706092432 08706092435 debbie.byrne@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Minster Care Management Limited care home 50 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Ideal Home is situated in the village of Gains Park approximately 5 miles from the centre of Shrewsbury. It is located in a residential area, within walking distance of a local post office, shops and pub, with its own car parking and gardens. It is a private care home registered to provide care and accommodation for up to 50 people, including people with a mental disorder, both under and over 65 years old, older people and a small number of people with a physical disability. The home is owned by Minster Care Management Limited. Ms Pamela Johnson is the registered manager and is responsible for day-to-day running, staffing and the development of effective policies and procedures within the home. The accommodation has 3 fairly distinct areas, the Care Homes for Older People Page 4 of 26 Over 65 0 0 6 0 12 26 0 6 Brief description of the care home main house and converted coach house, which provide accommodation on ground and first floors and a purpose built extension to the rear of the property, which is all on one level. The manager stated that consultation with people who live at Ideal Home takes the form of annual questionnaires and residents meetings. Inspection reports about this service can be obtained direct from the provider or are available on our website at www.csci.org.uk Care Homes for Older People Page 5 of 26 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection of the service was unannounced and took place on 19th November 2008 by two inspectors over a period of four and a quarter hours. A range of evidence was used to make judgements about this service to include discussions with people using the service the registered manager, a senior manager of the organisation, visiting professionals and staff. We also examined a number of records to include care records for four people living at the home, staff training, staff supervision and health and safety records. Prior to the key inspection in May 2008 an Annual Quality Assurance Assessment AQAA document was posted to Ideal Home for completion. The AQAA is a self assessment Care Homes for Older People Page 6 of 26 and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for them to share with us areas that they believe they are doing well. By law they must complete this and return it to us within a given timescale. We carried out a random unannounced inspection on 13th August 2008 to monitor progress made regarding the requirements and recommendations issued as a result of the key inspection undertaken 14th May 2008. It was noted at this inspection that some progress was being made towards meeting the requirements and recommendations made, although at that time not all of the required timescales had been reached. The purpose of the inspection was to assess all 22 Key National Minimum Standards for Care Homes for older people and any further standards necessary, including the remaining requirements and recommendations made at the last key inspection of the service. A quality rating is provided throughout the report based on each outcome area for the people who use the service. These ratings are described as excellent/good/adequate or poor based on findings of the inspection. Fees are not available in the statement of purpose. Readers wishing to know more about this information should contact the service directly. What the care home does well: What has improved since the last inspection? What they could do better: The home can further develop care planning and review process by demonstrating the individual or their representative has been involved in the care planning and review process. Medication administration and recording must be in line with good practice and systems must be robust to ensure the safety of people who receive medication from staff. Staff are formally supervised and a record kept; this showed that although much progress is being made the frequency of formal supervision is not always as required by the minimum standard and the home must further improve in this area. Care Homes for Older People Page 8 of 26 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. Evidence: We looked at the file of the most recent person admitted to the home. We found that the registered manager had carried out a comprehensive assessment of the individuals needs. This had taken place prior to the individual moving into the home. Through discussion with the registered manager and examination of the assessment documentation it is evident that information was gained from a number of sources, including health care professionals and family to obtain a clear picture of the individual. The persons family were able to visit the home to look round and meet the staff and other people living at the home before making a decision about their relative moving in. Care Homes for Older People Page 11 of 26 Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users care needs and risk assessments are set out in their individual plans of care, which have been improved, to ensure staff are provided with sufficient information for the delivery of care. The home understands that medication policies and procedures must be in place, however staff need to be following good practice guidelines to ensure full compliance at all times. Evidence: We made two requirements in relation to this outcome group at the last inspection, which we consider the home have now met. These related to the home ensuring that a plan of care was generated following thorough assessments being undertaken. This was to demonstrate that peoples care and support needs could be identified and met and that plans are reviewed regularly and updated as peoples needs change. We also required that risk assessments must be in place to minimise risk to ensure that as far Care Homes for Older People Page 13 of 26 Evidence: as possible people living at the home remain safe. We examined the care plans of four people living at home in detail. All care plans had improved since our last visit and were seen to be well documented and an accurate reflection of assessed needs. Evidence that care plans had been reviewed and incorporated new information when circumstances of an individual had changed was seen documented. We saw that the home had liaised with the community mental health team where particular issues had been experienced with one individual the evening before the inspection. We also saw records of other healthcare professionals involved in peoples care, for example the general practitioner. It was acknowledged by the registered manager and area manager that further work is required to improve the review process, including consultation with the individual or their representative. Care plans would benefit from having the photograph of the individual included. This is particularly useful for new members who join the staff team. There is provision for this on the care plan but the home are not utilising the space to do this. We saw risk assessments in place where risk had been identified and how staff should follow the guidelines in place to minimise the risk. These included dealing with challenging behaviour and falls. Those people who we spoke to and who were able to contribute to discussions with us all told us that they felt staff respect their privacy and dignity at all times. We observed care staff to speak to people in a polite and respectful manner and to knock before entering a persons bedroom. Systems for storing administering and recording medication were examined in the extension area of the home. Medication is safely stored and administered only by senior care staff, who have undertaken an accredited training course. Generally records appeared well maintained, with residents photos details of allergies and clear information about the medication prescribed for each available, and signatures entered to indicate that drugs had been given. There were some aspects of medication administration, which were being managed very well. There was particularly detailed information and guidance available for the administration of warfarin, for assessing blood sugar for those people on medication for diabetes and for medication given as required, or at a variable dosage. However, where a variable dosage was permitted, staff had not always recorded how much of a drug had been given. It was found that some medication given that morning and lunchtime had not been signed for. In discussion, it was established that this was a recording error. It also Care Homes for Older People Page 14 of 26 Evidence: became apparent that some medication noted on the administration charts as being prescribed for a dose early in the morning, was in fact often not being given until later in the day. Although this demonstrates that the home is being sensitive to peoples choice for rising at a time that they prefer, records should be accurate as to the time given. This will provide a more precise record and allow for a safe time to elapse between repeat dosages. Where a drug is routinely being given late morning and then repeated a short time after at lunchtime, it would be worthwhile checking with the prescribing GP whether this is appropriate. Care Homes for Older People Page 15 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to choose their lifestyle, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet peoples expectations. People who use the service receive a healthy, varied diet according to their assessed requirement and choice. Evidence: The home provides individual and group activities for people who use the service. On the day of the inspection the newly appointed activities organiser had taken a person who uses the service shopping. This was an individual who we case tracked and found that the care plan had identified their past employment as working in retail. We spoke to the person upon their return. They were happy to talk to us about the trip and how much they had enjoyed it. We spoke to the activities organiser who told us that she had noticed people who perhaps did not get involved in activities when she first started work at the home now participating. A plan of the weeks activities were seen on the notice board and discussed with the new staff member. She told us that she involves the people living at the home in choosing activities, people we spoke to confirmed this. Care Homes for Older People Page 16 of 26 Evidence: Care plans documented the individual likes and dislikes of people in relation to their diet. Nutritional screening is also undertaken. We observed the lunch time meal and people told us that they had enjoyed the meal. Choices are offered and specialist diets catered for. Staff were seen to assist people in a sensitive manner. The meal was relaxed and unhurried. We saw evidence of drinks being offered during the visit. People can help themselves to tea, which is available outside of the kitchen at anytime. Care Homes for Older People Page 17 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to a complaints procedure, but few are made as any minor problems are sorted out quickly. Service users are protected from abuse through staff awareness and training. Evidence: There have again been no complaints made about the home. The manager reported that small issues are sorted out promptly and she and her team know people and their families well, which promotes early resolution of problems. Of the seventeen responses to the homes quality questionnaire seen, two said that they didnt know how to make a complaint. There were also comments within these about staff being approachable. The home has worked co operatively with the safeguarding adults team in the past and issues have been satisfactorily concluded. The manager has undergone an external adult protection course and the homes deputy manager and trainer are also going to attend. There was plenty of evidence in staff training files to show that abuse is explored thoroughly with new staff during their induction, and knowledge of the issue is promoted through refresher sessions around the policy. Care Homes for Older People Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is generally well maintained and the environment meets the needs of people living there. Evidence: The general state of the home is reasonable, with a better standard of surroundings and decor in the extension area than the old main house, which has some wear and tear. The kitchen and laundry were clean and tidy. There is a roof window in the food store where a grille cover has been provided as a means to prevent entry by insects but this may not be adequate to the task it was agreed that the manager will seek guidance on this from the environmental health officer. Staff have been provided with infection control training and were observed to be using gloves and aprons. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Ideal Home are supported by staff that have been checked as suitable to work there. Training opportunities for staff are good, with access to both internal and external training to support their development. Evidence: The staff recruitment files that we looked at were well organised and contained the checks that we expect to see. We were satisfied that the recruitment process followed by the home protects people living there. The home employs a training officer who works for four days per week, a valuable resource. Although the homes training officer was not on duty, we were able to see from records what training is made available to staff. The homes induction process, consistent with Skills for Care expectations, is thorough and conducted over a period of time. The home also makes use of training videos with accompanying questionnaires. This activity is supported by the training officer and the questionnaires showed where the trainer had discussed responses and any queries with the staff. External courses are also accessed, particularly for subjects such as moving and handling and first Aid. Staff are supported to gain National Vocational Qualifications and to progress through the levels. Detailed examination of three training folders, for established and newer members of staff, showed that staff are provided with a good Care Homes for Older People Page 20 of 26 Evidence: range of both basic and more specialist training. The manager told us that there was only one vacancy now at the home and that recruitment has meant a more stable and effective staff group is in place. Service user needs can now be met by the numbers and skill mix of staff deployed at the home. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users and staff are kept safe by systems in the home to ensure that people are competent to do the work they do and that equipment and the environment is well maintained. Service users best interests are safeguarded by the homes record keeping, policies and procedures Management audits and the use of quality questionnaires means that the manager knows what is happening throughout the home and how the service is perceived by its staff, service users and other interested parties Evidence: The homes manager holds the Registered Managers Award and a level 4 vocational qualification. She is well experienced in working with older people and younger adults. Care Homes for Older People Page 22 of 26 Evidence: People living at the home benefit from the overall management and staff training approaches which ensure that staff have a good value base and skills to equip them work with the residents and promote their well being. Feedback seen in questionnaires and from a visiting professional was that the home is well run and that staff deal well with people in their care. Staff are formally supervised and a record kept, this showed that although much progress is being made the frequency of formal supervision is not always as required by the minimum standard. Since our last inspection and the requirement made that the home must develop an effective quality assurance system, quality questionnaires have been used to elicit the views of residents, their relatives and staff. These are generally good with many positive remarks made about the approachability and friendliness of the staff. No significant concerns were raised through the questionnaires. Service users finances, where money is lodged with the home for safekeeping, are well managed and accounted for with detailed records kept of money given out or spent on someones behalf. Management systems are well established with good record keeping and audits to ensure that people are kept safe. All checks required such as of the fire safety systems, hot water systems, lifting equipment, gas and electricity are in place. Maintenance systems are audited. Staff records, referred to earlier in this report, show that staff access training in health and safety, fire safety, moving and handling, 1st Aid, food hygiene and infection control. People are protected through regular maintenance of systems and equipment and records to show this are well organised. Accidents and incidents are logged, recorded and reported to the appropriate authorities. Risk assessments are in place for general issues such as fire safety or hazardous chemicals and for specific people and activities. The accident records were examined and showed minor injuries through falls and everyday activities. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 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 9 13 Medication administartion and recording must be in line with good practice. This is to ensure people are protected by robust medication administration and recording procedures. 24/12/2008 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 7 The home should demonstarte that it involves people who use the service or their representatives in the care planning and review process. A photograph of the individual is contained within their care plan. Staff are given formal supervision at least six times per year. 2 3 7 36 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!