Inspection on 07/08/07 for Liberty House Care Homes

This inspection was carried out on 7th August 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.

Other inspections for this house

Liberty House Care Homes 05/08/09

Liberty House Care Homes 08/08/06

Liberty House Care Homes 04/01/06

Liberty House Care Homes 13/07/05

Liberty House Care Homes 15/03/05

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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 HOME ADULTS 18-65 Liberty House Care Homes 55 Copeley Hill Erdington Birmingham West Midlands B23 7PH Lead Inspector Nancy Johnson Key Unannounced Inspection 7th August 2007 8.15 Liberty House Care Homes DS0000062432.V347876.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 Liberty House Care Homes DS0000062432.V347876.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. Liberty House Care Homes DS0000062432.V347876.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Liberty House Care Homes Address 55 Copeley Hill Erdington Birmingham West Midlands B23 7PH 0121 327 0671 F/P 0121 327 0671 liberty55@btconnect.com 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) Liberty House Care Homes Ltd Miss Sonia Thompson Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Liberty House Care Homes DS0000062432.V347876.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered to accommodate 6 persons with a learning disability. Residents must be under 65 years of age. Date of last inspection 8th August 2006 Brief Description of the Service: The property is a large Victorian house at the end of a cul-de-sac, off a main road and adjacent to the Aston Expressway in the Erdington area of Birmingham. Public transport is close by and the service has its own vehicle. All community amenities including places of worship are accessible within a short distance of the premises. Liberty House offers accommodation to six residents with a learning disability. Accommodation is provided on both floors. To the front of the premises there are ramps provided. The service has recently seen refurbishment to the front of the exterior and driveway. There is an en-suite bedroom on the ground floor. Two bedrooms on the first floor have en-suite facilities and there is a bathroom and WC facilities on the first floor. The ground floor has a WC. There is a spacious lounge with separate dining area. Kitchen facilities are also available and there is a separate laundry area. There is an extensive garden to the rear of the property, which is well laid out and maintained. It includes a barbeque area. The garden slopes upwards and includes ramp and handrail facilities. Situated to the side of the garden is a large building, which the Registered Manager stated she is considering conversion to supported living accommodation. The fees charged by the service range from £731.78-£853.75 per week. Additional costs not covered by the fees include dry cleaning, hairdressing, Sky TV, telephone calls, toiletries and personal activities. Liberty House Care Homes DS0000062432.V347876.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection took place unannounced over the period of one day. We were able to speak to the manager and senior care staff who were on duty and later on a care worker and the maintenance worker. We also case tracked four residents files and Care plans, policies, Health and Safety records and training matrix were examined. Additional information was derived from the pre-inspection questionnaire sent to the home before the inspection. The service history for the home was also reviewed. Some observations of care practices and interactions between clients and staff were observed. We had telephone and face to face interviews with residents relatives. To see how the service has performed since the last inspection the report should be read in conjunction with the report for the last inspection dated 8 August 2006. What the service does well: What has improved since the last inspection? Liberty House Care Homes DS0000062432.V347876.R01.S.doc Version 5.2 Page 6 All requirements set at the last inspection have been complied with. Care plans have been reviewed and indicate preferences for gender care for both male and female residents. Foot care management plans are now detailed. Communication between staff and residents was improving due to the training that had been undertaken. One of the resident with complex needs was now able to communicate with the staff as to when they wanted a cup of tea. The physical appearance of the property has been improved and there is an ongoing programme for refurbishment. 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. Liberty House Care Homes DS0000062432.V347876.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 Liberty House Care Homes DS0000062432.V347876.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&5 Quality in this outcome area is good. It was evident from the inspection that each resident’s individual written contract had been reassessed to meet his or her individual circumstances. The service is therefore able to continue to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the last inspection it was recommended that the Statement of Purpose and Service User Guide be amended in line with the Care Homes Regulations 2001. The service has been working very hard on this and both the manager and Senior Care Worker have attended the Valuing People and Communication course. However, the service is still unhappy with the reviewed documents as due to the complex needs of the clients only one is able to understand them. They are therefore reviewing the documents again. The service was also requested to amend the resident’s individual contracts and resident guide in relation to specifying transportation and holiday costs. These documents now clearly state that these services are not included within the fees. The service has had no new admissions since the last inspection. Liberty House Care Homes DS0000062432.V347876.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 & 10. Quality in this outcome area is good. The service has recently reviewed their care plans and these are now very detailed and provide sufficient information on the residents and any associated risks so that the resident can lead as independent a lifestyle as possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four residents care plans were case tracked during the inspection. We found that each plan contained a comprehensive needs assessment which identified the residents needs, assessed their risks and also provided management plans. The plans also contained the resident’s health action plan, essential information and details of their likes and dislikes. For example, one resident enjoyed working with computers and it was detailed within his care plan that he attended a computer course and that a computer and printer had been purchased for him. Liberty House Care Homes DS0000062432.V347876.R01.S.doc Version 5.2 Page 10 It was noted at the last inspection that the care plan for one resident regarding their incontinence was not detailed enough this has now been amended. In addition to this a full risk assessment has been completed regarding their care when they are out of the home. A chart has been placed in their bedroom which indicates times when incontinence pads are to be changed which is then signed by their care worker. Liberty House Care Homes DS0000062432.V347876.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): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. Residents enjoy a wide variety of activities that suit their needs and preferences. The home consistently encourages and facilitates contact with their relatives. Care plans are comprehensive and details the residents’ likes and dislikes and individual care needs. The residents receive a well balanced diet and are able to participate in choosing their meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Resident records that were tracked all detailed the residents daily activities. The activities were varied and were either provided within the home or within the community such as a day centre or college. Three of the residents attended a day centre. Residents took part in music activities, arts and crafts, computing lessons, life skills, watching videos and trips to local libraries and the church. Liberty House Care Homes DS0000062432.V347876.R01.S.doc Version 5.2 Page 12 Staff, also take residents to visit their relatives on a regular basis. It was noted in the last inspection that one resident went by themselves home in a taxi however no risk assessment was in place for this. This has now been addressed and a risk assessment is in place. Residents are encouraged to regularly visit their family. The residents also have the use of a payphone in the lounge area that is screened for privacy. We were present during lunchtime at the home. The home provides a balanced and nutritious diet that was evidenced by review of the menus for the last four weeks. However, residents are able to indicate preferences for other meals and daily records are kept of what the residents have eaten. Meals are culturally sensitive and specific needs are identified in the resident’s records. Residents are able to have fresh fruit at any time. They are also encouraged to make their own drinks with support. Following the Valuing People and Communication course and the home obtaining pictorial references, one of the residents with more complex needs is now able to indicate when they want a hot drink by pointing to the pictorial reference and the cupboard containing tea bags. On speaking to one of the residents they indicated that they enjoyed the food. All cupboards were well stocked and supplies were varied. Liberty House Care Homes DS0000062432.V347876.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 good. Residents receive the personal support they require and are protected by the homes policies, procedures and staff knowledge. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Resident’s records indicate what level of personal care is needed for each resident. It was recommended at the last inspection that the views of the male residents should be sought in relation to the preference for personal care by male or female staff. This has now been reviewed and all have indicated no preference and their plans were updated accordingly. Of the four files tracked, all were clearly documented and up-to-date. Medication was locked in a secure cupboard. The medication administration records were reviewed and in order indicating medication had been dispensed as prescribed including as required medication. Records were signed by two staff. All staff, bar one, had attended medication training. The staff member Liberty House Care Homes DS0000062432.V347876.R01.S.doc Version 5.2 Page 14 that has not received medication training does not dispense medication. Records showed that medication records received regular management audits. The care plans have also been amended to include the management of foot care and details of chiropody appointments and self care. We discussed medication policy with a member of staff on duty. They were knowledgeable about policy and procedures as well as the receipt, returns, administering and the storage of medication. Liberty House Care Homes DS0000062432.V347876.R01.S.doc Version 5.2 Page 15 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 good. Residents have access to the complaints procedure and understand who they can speak to if they have any concerns. All staff have received adult protection training and relevant checks are up to date to protect the residents from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Commission within the last year has received no complaints. We read the recently reviewed complaints procedure that has been updated in a pictorial format. However, due to the complex needs of some of the residents most of them are not yet able to understand the document even in the reviewed format, therefore the service is continually striving to improve the document. All staff has now received adult protection and Vulnerable Adults training in March of this year. When spoken to, the staff on duty was able to answer questions both on adult protection and the homes complaints procedures. One of the residents advised that they would go to the manager if they had a problem. Four residents’ personal monies records were examined and found to be in order with accompanying receipts for purchases along with a record of withdrawals and expenditure. All entries were signed by the manager and another senior staff member. Liberty House Care Homes DS0000062432.V347876.R01.S.doc Version 5.2 Page 16 The Residents guide and individual contracts now clearly states that residents, bar one under a separate contract, would fund their own holidays as funding was not available through the home. Staff files were up to date and contained all necessary information including Criminal Records Bureau and Protection of Vulnerable Adults checks. Liberty House Care Homes DS0000062432.V347876.R01.S.doc Version 5.2 Page 17 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 & 30. Quality in this outcome area is good. The home provides a clean and homely environment for residents. Procedures in place ensure that hygiene is of importance to the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We toured the building and found it to be clean and tidy with no offensive odours. Improvements have been made to the building since the last inspection including the stairway being rebuilt, a bathroom being replaced, the dining area ceiling had been replaced and radiators have been covered. The service has a full programme for refurbishment and this is being undertaken by the full time maintenance worker. All residents room were personalised, clean and tidy and in general the home had a homely feel. The resident whose bedroom had peeling wallpaper at the last inspection has had their bedroom redecorated. Two residents showed us their bedrooms and informed her that they chose the décor for their own rooms. Liberty House Care Homes DS0000062432.V347876.R01.S.doc Version 5.2 Page 18 The kitchen and eating area were clean and we reviewed the procedure for infection control which was in order. Fridge and freezer temperature records were checked and found to be satisfactory. All foods where relevant were correctly labelled. Liberty House Care Homes DS0000062432.V347876.R01.S.doc Version 5.2 Page 19 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 & 36 Quality in this outcome area is good. Residents are supported by staff who receive good and regular training. Review of staff recruitment records indicates that residents are supported by the home practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff and training records were available at the time of inspection. Examination of these records indicated that since the last inspection two members of staff have left and they have been replaced. The new staff include a RGN (Registered General Nurse) and a carer. The carer is to commence NVQ training at level 2 in September. The staff member that was on compassionate leave at the time of the last inspection has now returned to work. Review of the staff training matrix showed that all staff had received adult protection training, Vulnerable adult training, medication training, First Aid and manual handling. We were informed that Epilepsy training was scheduled for Liberty House Care Homes DS0000062432.V347876.R01.S.doc Version 5.2 Page 20 earlier this year and had to be cancelled due to shortage of epilepsy trainers. The manager, however, is attempting to have this rescheduled as soon as possible. Examination of staff rotas for the last four weeks indicated that there was sufficient cover. Both managers had completed a Supervision and Mentoring Course. Records indicated monthly meetings with residents and regular key worker supervision sessions. Liberty House Care Homes DS0000062432.V347876.R01.S.doc Version 5.2 Page 21 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, 38, 39, 41, 42 & 43. Quality in this outcome area is good. Residents’ benefit from a well run home where correct procedures are followed to ensure the health, safety and welfare of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager was present at the time of the inspection. She was open with her responses and took on board areas for improvement as identified at the last inspection. The manager advised us that as part of the Valuing People and Communication training they had attended they were redeveloping the Residents plan based on a “This is my life” concept. It contains details as to who the resident is, what they liked, details of their families, their goals, eating preferences etc. These were being completed in conjunction with the Liberty House Care Homes DS0000062432.V347876.R01.S.doc Version 5.2 Page 22 resident, their families and staff. The booklets were easily accessible to residents. Records indicate that health and safety was satisfactory and appliances had been recently tested. Staff had recently received fire safety training. And records indicated regular fire drills. It was noted in the last inspection that correction fluid had been used on residents records. This practice had now ceased and we found no signs that it had been used within the last 12 months. Liberty House Care Homes DS0000062432.V347876.R01.S.doc Version 5.2 Page 23 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 2 3 4 5 CONCERNS AND COMPLAINTS Standard No Score 22 23 X 3 X X 3 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000062432.V347876.R01.S.doc LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Liberty House Care Homes Score 4 3 3 X 3 3 3 X 3 3 3 Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 YA6 Good Practice Recommendations It is recommended that the registered person continues to develop the Valuing People Communication system and skills for life quality assurance initiative. Liberty House Care Homes DS0000062432.V347876.R01.S.doc Version 5.2 Page 25 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 Liberty House Care Homes DS0000062432.V347876.R01.S.doc Version 5.2 Page 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. 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