Inspection on 30/03/09 for Milverton Road Care Home

This inspection was carried out on 30th March 2009.

CSCI found this care home to be providing an Good 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

Milverton Road Care Home 04/07/07

Milverton Road Care Home 04/07/06

Milverton Road Care Home 05/10/05

Milverton Road Care Home 13/10/04

Milverton Road Care Home 19/04/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Milverton Road Care Home 70-74 Milverton Road Bestwood Park Nottingham NG5 5RH The quality rating for this care home is: two star good 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: Rehana Rashid Date: 3 0 0 3 2 0 0 9 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. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (20092008) 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Milverton Road Care Home 70-74 Milverton Road Bestwood Park Nottingham NG5 5RH 01159160720 01159160748 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : www.mencap.org.uk Royal Mencap Society care home 6 Number of places (if applicable): Under 65 Over 65 6 0 learning disability Additional conditions: Registered for Learning disability (LD) - 6 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 27 A bit about the care home Milverton Road is a small home for adults with learning disabilities. Mencap is the registered provider. Mencap rent the premises, which are owned by New Era Housing Association. The detached property has been converted from three terraced houses. It is not accessible to wheelchair users. The home is sited within a residential community with access to a variety of local facilities and is within walking distance of Arnold town centre. Alternative communication methods are used with most service users and varying support is given to enable individuals to maintain some independence. At the time of the inspection the fees were £336.63 per week. Inspection reports and any other reports on quality monitoring at the service are available to service users and other stakeholders by request. Care Homes for Adults (18-65 years) Page 5 of 27 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 27 How we did our inspection: This is what the inspector did when they were at the care home This was an unannounced inspection carried out by one inspector, which took place over four and half hours. The previous key inspection took place 4 July 2007. The main method of inspection was case tracking, which involved sampling two people and examine their care records. Case tracking is used to establish if the needs of the residents are being appropriately assessed by the home and their needs are being catered for. Discussion were held with two staff members and one service user. Two staff files were examined. A partial tour of the building was carried out which included viewing communal areas and one service users bedroom. Before the visit the registered manager submitted an Annual Quality Assurance Assessment (AQAA), which is an self assessment detailing what the home was doing well, what has improved since the last inspection and any plans for improving the service over the next twelve months. Information from the AQAA was used within this inspection report. Prior to the inspection to assist with planning the AQAA, notifications and any other information received about the service were examined. Care Homes for Adults (18-65 years) Page 7 of 27 Three completed staff surveys were returned to the commission and one service user survey. What the care home does well Two care files examined contained detailed assessment of needs, which focused on the individual needs of the people using the service. Confidential information including staff files was kept securely. Staff spoken with demonstrated a good understanding of the needs of the people living at Milverton Road. Service users are provided with social activities both within the home and the community such as attending day care, attending church services and going to local shops. This enables their independence taking into account individual needs and choices. Staff interaction was observed with one person at home which was positive. A member of staff was observed giving the person choices they were asked what their preference was at lunchtime and what they wanted to do after lunch. Care Homes for Adults (18-65 years) Page 8 of 27 What has got better from the last inspection What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 9 of 27 If you want to speak to the inspector please contact Rehana Rashid 33 Greycoat Street London SW1P 2QF 02079792000 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 10 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 11 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a admissions procedure in place, which ensures that the home is suitable in meeting the needs of prospective service users. Evidence: Both the service user guide and statement of purpose were viewed and contained all the necessary information as listed in the regulations and provides sufficient information for people to make an informed choice about where to live. There have been no new admissions to the service since the last inspection. Care files were viewed for two people living at Milverton Road. Both these contained assessments by the placing local authority. One person spoken with at the inspection stated they had visited the service before moving in. The Annual Quality Assurance Assessment (AQAA) contained details of the assessment process, which involves gathering information from the person and any other professionals involved in their support. Care Homes for Adults (18-65 years) Page 12 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans and risk assessments are in place ensuring that staff are able to meet the needs of the people who use the service. Evidence: Two care plans were examined, these focused upon the individual needs of the person and were written in the first person. The care plans were detailed including information about the health, personal and social care needs of each person. The plans contained details relating to individual likes and dislikes. Pictures were also used. The care plans have been reviewed and updated to reflect changing needs. The AQAA submitted to the commission states that all support plans have been updated in the last 12 months and have been reviewed at least 6 monthly. Following discussions with staff it was clear that staff were committed in ensuring individuals were supported to take control of their own lives and to make informed choices. At the inspection a member of staff was observed with a person at home, giving the person the opportunity to make informed choices. The member of staff had Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: a discussion with the person at home as to how they wished to spend the day and what they would like at lunch. The staff member spoke with them in a caring and professional manner. Risk assessments were included in the care plan files where risks had been identified. For instance risk assessments were in place regarding going out into the community and using the kitchen. The two members of staff spoken with had a good understanding of the individual needs of the people living at the home and were aware of peoples personal preferences. Care Homes for Adults (18-65 years) Page 14 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience 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 experience a stimulating lifestyle that meets personal expectations and respects their rights. Evidence: The registered manager reported within the Annual Quality Assurance Assessment (AQAA) that they support people who use the service to actively engage with and participate in their local community and to develop and lead lifestyles that enable them to achieve the things that matter to them. At the time of the inspection five people who use the service were out attending day care services, whilst one person was at home. Discussion with the person at home and staff on duty confirmed that people are able to choose how they spend their time and also able to choose activities they wished to participate in. The person reported that they enjoyed watching television, reading and going out to day care. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: Staff spoken with talked about the activities available to people that use the service. This included the Milverton Road Rambling Group, going out to local shops in Arnold and the city center and having film nights at the home. People are able to continue to maintain and develop relationships with family and friends. Care plans viewed showed that people living at the home are involved in meaningful daytime activities of their own choice. One person told us that through their choice they have reduced the days they go to day care. Menu records viewed showed a variety of healthy meals with always two choices available. One person spoken with said, the food is very nice and you always get a choice. On the day of the inspection the person was assisted to prepare lunch. Staff confirmed menus are planned in conjunction with people who use the service and that meal times are flexible. Care Homes for Adults (18-65 years) Page 16 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users health and personal care support plans contained appropriate information and have access to a range of professionals ensuring their health care needs are met. Evidence: Both of the files viewed contained detailed health action plans which included information relating to individual health care support and needs. One person spoken with stated that they have been involved in putting the health action plans together. There was evidence of input from health care professionals such as GP and Opticians. One person spoken with stated that if they are unwell the staff at the home will contact the GP. People living at the home are supported to attend health related appointments such as hospital appointments. Since the last inspection there have been improvements in the management of medication. The two requirements issued have been met. Medication is stored in a secure cupboard. At the time of the inspection medication was audited for two people and the quantity was correct according to the medication administration record. The medication administration records were fully completed with no gaps in entries for the two peoples medication records viewed. Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: Information on the AQAA submitted to the commission states that staff are sufficiently trained in administering and managing the safe administration of medication at the service. It further stated in the last 12 months there have been improvements in the area of medication as staff have had an update on medication responsibilities and awareness of procedures within team meetings. Care Homes for Adults (18-65 years) Page 18 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience 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 Milverton Road are safeguarded by the homes complaints and safe guarding procedures. Evidence: The Commission for Social Care Inspection has not received any complaints about the service since the last inspection. A copy of the complaints procedure was displayed within the home. The complaints procedure was available in a couple of formats, which included easy read, and pictorial format. One person living at the home was spoken with said that if they were unhappy for any reason they would be able to tell staff. There is a policy for responding to suspicion or evidence of abuse, or neglect in place. Two staff members were spoken with both demonstrated an understanding of safeguarding adults and their responsibility to alert the manager of any disclosure or suspicion of abuse. Both commented that they had received training in adult protection. The AQAA stated that in the last 12 months since the previous inspection seven safeguarding adults referrals had been made. Care Homes for Adults (18-65 years) Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, comfortable and homely environment. Evidence: A partial tour of Milverton Road Care Home showed that the home is decorated to a good standard. The garden and the home were well maintained. There was a homely atmosphere around the home. One bedroom viewed was personalized. The communal areas of the premises viewed were kept clean and hygienic. The laundry room was contained an industrial washer and dryer. Sluicing facilities are in place. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The quality of staff recruitment and training ensures peoples welfare and safety is met. Evidence: On the day of the inspection two staff members and one person living at the home were asked about the staffing levels. They said that there were enough staff on duty. Comments from staff included Last year staffing levels were problematic, however at the moment there is a full team which meets the needs of the people living at the home. Another staff member said that staffing levels are ok and that there are enough staff on duty. They also said that relief staff are used should the need arise. In the three staff surveys received two staff members stated there had been a high turn over of staff. Two of the staff members when asked if there are enough staff on duty two said usually and one said sometimes. Two staff personal files were viewed, which demonstrated that the organisation has good recruitment practices. Both files included a photograph, proof of identification, application form, two written references and Criminal Records Bureau Checks (CRB). Two staff members spoken with confirmed that they had an induction when they started employment. All three staff surveys received confirmed that relevant training was provided. Comments in the survey included training is continuous and relevant. One member of staff wrote in the survey that time may come when I need training to help support someone from a different ethnic background which will ensure continued effective Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: personal care delivery. The AQAA submitted by the agency detailed that 70 of staff had achieved National Vocational Qualification (NVQ) Level 2 or above in care. Discussion with staff demonstrated they have a good knowledge of individual needs and how to support people. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health, safety and welfare are protected. Evidence: The registered manager has been managing the service for over five years. she is currently working towards the registered managers award which she has nearly completed. A quality assurance system is in place to obtain the views off people who live at Milverton Road to obtain their views about the service they receive. The last quality assurance audit took place during 2008. Comments from relatives questionnaires included I think you provide an excellent service and I have up most respect for all the staff. Portable appliance testing and gas appliances have been serviced annually. Information on the environment and safety section on the providers service review states which was carried out 6 March 2009 says fire drills should take place at least 6 monthly however the last drill was April 2008. In order to ensure the safety of people living at the home, staff and visitors fire drills need to take place at the required intervals by the regulatory body. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 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 Description 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 Description Timescale for action 1 42 23 The registered person make sure fire drills take place as advised by the fire officer. 18/06/2009 This will ensure the health and safety of people living at the home. As well as staff and visitors. 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 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.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 Adults (18-65 years) Page 27 of 27 - 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!