Inspection on 26/01/09 for Morris House

This inspection was carried out on 26th January 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Morris House 12/02/08

Morris House 04/10/07

Morris House 22/02/07

Morris House 05/10/05

Morris House 18/05/05

Morris House 29/09/04

Morris House 22/04/04

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10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Morris House Grange Farm Drive Kings Norton Birmingham West Midlands B38 8EJ     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: Kerry Coulter     Date: 2 7 0 1 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. that people have said are important to them: They reflect the things 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 31 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 Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Morris House Grange Farm Drive Kings Norton Birmingham West Midlands B38 8EJ 01214591303 F/P01214591303 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Morris House Limited Name of registered manager (if applicable) Catherine Dowe Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Residents must be aged under 65 years Date of last inspection Brief description of the care home Morris House is a modern two storey detached building situated in a residential area of Kings Norton. The home is registered to provide personal care and support to six adults who have a learning disability. The home is situated close to the local shops of Kings Norton and West Heath and is also within short walking distance to local bus routes. The home comprises of six single bedrooms, five of which have en-suite facilities consisting of toilet and wash hand basin. Two of the bedrooms are situated on the ground floor and the remaining four bedrooms are on the first floor. The home offers a choice of bathroom or shower room. There is level access to the ground floor of the building but people need to be able to use the stairs to access the first floor. There is a garden with patio area and seating for people to use when the weather permits. There is limited off road parking to the front of the building with additional Care Homes for Adults (18-65 years) Page 4 of 31 care home 6 Over 65 0 6 Brief description of the care home parking available on the road. Our inspection reports are available on the homes notice board and as part of the service user guide located in the lounge. The service users guide stated that the fees charged each week to live there range from £1,200 to £1,500. The information included in this report applied at the time of inspection and the reader may want to obtain more up to date information from the care service. Care Homes for Adults (18-65 years) Page 5 of 31 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 peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was carried out over two days, the home did not know we were going to visit. We visited the home on the second day to look at staff recruitment records. Access to these was not possible on the first day as the manager was not on duty and staff do not have access to these records. This was the homes key inspection for the inspection year 2008 to 2009. Our previous visit to the home was on 12th February 2008. The focus of inspections we, the commission, undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of Care Homes for Adults (18-65 years) Page 6 of 31 practice and focuses on aspects of service provision that need further development. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home and the Annual Quality Assurance Assessment (AQAA) completed by the manager. This provides information about the home and how they think it meets the needs of the people living there. We received surveys from everyone who lives at the home. We sent surveys to six care professionals and one was returned to us. Information from the surveys has been used within this report. Two of the people living in the home were case tracked. This involves establishing individuals experience of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. During our visit we spoke with everyone who lives at the home. We looked at parts of the home. A sample of care, staff and health and safety records were looked at. The manager and staff on duty at the time were spoken with. What the care home does well: What has improved since the last inspection? Care plans have been further developed so that staff have most of the information they need to meet peoples needs. Following meetings with people at the home an action plan is developed for things the home needs to do and this is put on the homes noticeboard for people so they know what the home is doing in response to their comments. Staff have had more training in safeguarding people from abuse so that they know how to protect people if they suspect abuse is occurring. Care Homes for Adults (18-65 years) Page 8 of 31 Planned refurbishment of the kitchen has taken place to make sure the kitchen is in good condition and infection control procedures are maintained. The home has in place a quality monitoring system based on seeking the views of the people living there so they decide how improvements are made. What they could do better: 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 Adults (18-65 years) Page 9 of 31 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 10 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the information they need so they can make a choice as to whether or not they want to live there. Assessment procedures could be improved to ensure that the home is able to meet peoples needs. Evidence: The service user guide for the home was readily available to people in the lounge. The guide is in a laminated format that includes some pictures making it more accessible to people. The guide includes information about the home, how much it costs to live there, the complaints procedure, a copy of a standard contract and a copy of our last report. Surveys we received from people living at the home indicated they have the information about the home that they need. One new person has been admitted to the home since our last inspection. We spoke with them and they told us they had the opportunity to visit the home before they moved in. Prior to their admission the home obtained lots of information to help establish if they could meet their needs, this included copies assessments and care Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: plans from other care professionals. The home also has its own format for assessment prior to admission but this had only been part completed and therefore did not show that the home had actually assessed that they were able to meet the persons needs. However a review meeting was held shortly after the person moved in, this showed that so far the placement had proved successful. Care Homes for Adults (18-65 years) Page 12 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have most of the information they need so they can support people in the way that the individual chooses. Some risk assessments need further development to ensure that staff have enough information to manage risks and help to ensure the well being and safety of people. Evidence: We looked in detail at the care records for two people, and sampled records for two other people. Each person had a care plan that had generally been regularly reviewed so that staff had up to date information on how to meet peoples needs. Care plans covered areas such as health, personal hygiene, communication, mobility, behaviour, meal times, community access and activities. Plans seen generally gave staff enough detail about how people needed to be supported. Where one person had a fall and suffered a fracture the home had put in place a temporary care plan to make sure staff knew what extra support they needed until it Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: was healed. People who live at the home are involved in their care plans and sign to say they agree with them. Easy read care plans have also been developed by the home that include pictures and detail peoples personal preferences and wishes for the future. At the time of our visit the home was working on a new format for these called Me and My Life, they hoped these would be easier for people and staff to use. People are supported to make decisions about their lives. During our visit staff were observed taking time to talk to people, offering choices for example what people wanted for lunch. Surveys received from people at the home indicate they are usually able to make their own decisions about things they want to do. A monthly residents meeting takes place. Records of these meetings show topics discussed include menus, activities, choosing holiday destinations, day trips and chores around the home. At our last inspection we recommended the home introduced a system that tracks the outcome of peoples requests at the meetings to make sure things get done. This has now been done. Following each meeting an action plan is developed for things the home needs to do and this is put on the homes noticeboard for people to see. Records sampled included individual risk assessments. These stated how staff are to support the person to minimise the risks from things such as diabetes, manual handling, accessing the kitchen, mobility, community access and traveling in vehicles. The majority of assessments that we looked at were up to date and detailed how staff are to support individuals to take risks in their day - to -day lives whilst ensuring that they can be as safe as possible. For one person who has recently moved to the home the manager said that the home was using some of the risk assessments from their previous home until staff got to know the person well enough to do new assessments. However some of the assessments in place are not fully applicable to Morris House. For example a risk assessment regarding access to the kitchen recorded that control measures in place included the kitchen being locked, but the kitchen at Morris House is not kept locked. The risk assessments in place need to be reviewed to make sure they are reflective of the persons current home. Care Homes for Adults (18-65 years) Page 14 of 31 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. Arrangements ensure that people living there experience a meaningful lifestyle that ensures their self esteem and well being. People are offered a healthy diet and enjoy their meals. Evidence: Each person has a weekly timetable of activities that includes planned activities such as attending college, and leisure activities such as going out to pubs, restaurants, shopping, ten pin bowling and the cinema. One member of staff is a qualified Reiki therapist and several people at the home enjoy participating in this activity. During our visit people went out ten pin bowling with staff. One person told us that they had been out to the gym that morning and that they go twice a week, they said they enjoyed it. Another person told us theres always lots to do. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: Sampling records and discussions with staff show that people go on a variety of day trips and holidays. In the last year people have been to places such as the Severn Valley Railway, a history festival and Althorpe Hall. One person showed us a holiday brochure, they said they were lookig through it to help them decide where they would like to go on holiday this year. There are a number of leisure activities also available within the home including television, DVDs, videos, music and books. Since our last visit the home has purchased a Wii Fit game, people told us they enjoyed playing this. The home has an open policy on visiting times to the home. Records indicated that people maintain contact with their families and friends and some have weekend visits to their parents, which is facilities by staff and ensures contact is maintained. Records showed that the home welcomes family and friends to the home and have invited them to organised events at the home such as a summer barbacue and a pre Christmas dinner. Records and discussion with people show that they are involved in planning the homes menu, this is completed on a weekly basis. We saw that the current menu was on the homes noticeboard so that people knew what was planned. Menus were observed to meet healthy eating guidelines, offer variety and meet peoples special dietary needs, to include vegetarian options. There was a good stock of food and a supply of fresh fruit and vegetables, so that healthy diet guidelines are followed. On the day of our inspection it was observed that people were offered a choice of lunch. During our visit some people who live at the home went out with staff to do the weekly food shopping. People told us they were happy with the meals on offer. People said foods nice and we talk about the menu and what we want at meetings. Care Homes for Adults (18-65 years) Page 16 of 31 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. The health and personal care needs of the people living there are met so ensuring their well being. Evidence: Most people who live at the home manage their own personal care, where people need support this is indicated in their care plan. It was evident that people are able to dress, use cosmetics and have hairstyles that are individual and of their own personal choice. People are supported by staff if needed to go for haircuts and to buy their own personal toiletries. During our visit one person was asked by staff if he needed any money for toiletries as he was due to go out shopping later that day. The home employs a mix of staff that reflects the gender and culture of the people living in the home so people can chose who they want to support them with their personal care. Interactions between staff and people who live at the home observed on the day were entirely positive and respectful. Records sampled showed that other health professionals are involved in peoples care Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: where needed. Records showed and staff said that they work with other professionals to ensure individuals well being. People also attend regular health check ups with the dentist and optician to ensure their health needs are met. One person at the home has diabetes and there was some good information in their care plan about how this is managed. Another person has kidney disease. Staff spoken with demonstrated a good understanding of this and were aware of foods that needed to be avoided. Records showed that the person is supported by staff to have monthly health checks. One health professional returned a survey to us, they said that peoples health needs were met by the home and that health advice was acted on. People at the home have a health action plan, this is a plan about the support people need to stay healthy. For one person at the home their records seemed to indicate that they had put on weight recently. The manager said she would ensure this was followed up to make sure their was no underlying health issues. Information received from the manager indicates that this person had seen the nurse at the well woman clinic the day after our visit and has indicated a wish to get involved in a more active lifestyle. Medication is stored in a locked cupboard. The cupboards were observed to be clean and organized so that medication could easily be located. The homes medication system consisted of a monitored dose and box system with Medication Administration Record (MAR) sheets. MARs sampled had been signed when medication had been given indicating that medication had been given as prescribed. To make sure staff know about the medication they are giving the home has developed a list of what people are prescribed and why. Records and discussion with staff indicate that only staff who have had training administer medication. The home usually retains copies of the original prescription for repeat medication, so they are able to check the prescribed medication against the MAR chart when it enters the home. Unfortunately copies of prescriptions had not been obtained for the last two months, staff said they had forgotten to do this but would make sure it was recommenced. One person at the home administers their own insulin. At our last inspection we saw that this practice had been risk assessed to make sure the person was safe. At this visit staff were unable to locate the assessment. Another person administers their own inhaler but staff were unable to locate the risk assessment for this too. Risk assessments need to be completed and available in the home to ensure that people are safe to do their own medication. A few days after our visit to the home the manager sent evidence to us that risk assessments for self administration of inhalers Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: had now been completed. Insulin is stored in a locked container in the fridge in the kitchen. At our last inspection we recommended that a dedicated medication fridge is purchased of a type that can be kept locked, this is good practice as recommended by the Royal Pharmaceutical Society. This has also been recommended by the homes pharmacist. The home have not yet obtained a medication fridge. The manager told us that the pharmacist had agreed to supply one to the home and that she would chase this up. Some people at the home are prescribed medication on an as required basis. Written guidance was available for the majority of these so that staff know in what circumstances it should be given. However for one person who was prescribed as required medication for their behaviour the only guidelines in place were from the persons previous home. These guidelines were extremely brief and contained little information for staff on the circumstances when the medication should be used. Follwing our visit to the home the manager sent us evidence that she had acted on our recommendations and updated the as required medication protocol. Care Homes for Adults (18-65 years) Page 19 of 31 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. Arrangements ensure that the views of the people living there are listened to and acted on and they are protected from abuse so ensuring their well being. Evidence: We have not received any complaints about this home in the last twelve months and the homes annual quality assurance assessment records the home has not received any direct complaints. The complaints procedure stated how people could make a complaint if they are not happy with the service provided at the home. It is available in a format that includes pictures so that it is easier for people to understand. Picture cards have also been developed to assist people to express what they want to complain about. Peoples care records show that they have had the procedure explained to them. Surveys we received from people at the home show they are aware of the procedure and know who to speak to if they are unhappy. Records showed and staff said that they have had training on safeguarding adults who are vulnerable so they know how to recognises signs of abuse and report this so that the people living there can be safe. Staff we spoke with during our visit gave satisfactory answers regarding what they would do to keep people safe if they suspected someone was being abused. Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: Sometimes people who live at the home can display behaviour that may be challenging to others. Records and discussion with staff show that staff have had training on how to manage peoples behaviour. Records showed that several staff had training in the Mental Capacity Act. The Mental Capacity Act came into force in April 2007. This legislation requires an assessment of peoples capacity to be done if there is any doubt that the person does not have the capacity to make a decision about their health and welfare. It is good that staff know about this legislation so they are aware of the implications of this for the people living there. Reports from the care directors visits to the home show that peoples money is regularly checked to ensure it is being well looked after. We looked the finance records of two of the people living there to ensure that their money was being looked after appropriately and was safe. Records were seen to be accurate and receipts were available for expenditure. Recently some of the people at the home had contributed towards a collection for a member of staff who was having a baby. We spoke with two people at the home who confirmed they had wanted to contribute to the baby collection. It is recommended that the home ensures this is in line with its own policy re staff gifts and that signed agreement is obtained from the people concerned that they want to contribute towards the collection. Care Homes for Adults (18-65 years) Page 21 of 31 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. Arrangements are generally sufficient to ensure that people live in a homely, clean, and comfortable environment. Evidence: The home is a domestic style property that provides six single bedrooms for the people who live there. The home was clean, warm and free from offensive odours throughout. The ground floor accommodation consists of a staff office and sleep in room, two bedrooms, a bathroom, kitchen, lounge and conservatory, which is used as a dining area. The first floor comprises of four bedrooms, a bathroom with toilet and a shower room. The first floor is accessed via a stairway with handrails and people need to be mobile to access rooms on this floor. Bedrooms in the home are not very big and not all of them have en suite facilities. The provider is looking at improving this. The annual quality assurance assessment completed by the manager recorded that a planning application had been made to extend the home making rooms larger and having full ensuite facilities. At our visit to the home the manager said she thought the application had been rejected. She said that consideration was being given to moving to alternative premises. Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: We looked at two peoples bedrooms, they were seen to be well decorated and furnished. There were photographs of people important to the person and pictures and ornaments that reflected their interests. One person told us that their room had recently been repainted and that they had chosen the colour themselves. It has been identified at previous inspections that refurbishment of the kitchen was needed. This has now been done and new units and worktops have been fitted. A new dishwasher has been purchased but staff they had been waiting three weeks for this to be plumbed in. Records showed that the first floor shower had been out of action for several months after one of the people who lived at the home pulled the shower from the wall. Staff said that there had been a delay in repairs as originally they were told that the maintenance man would resecure it to the wall. Staff said that the manager wanted this job to be done by a qualified electrician to make sure the shower was safe and that waiting for this had caused the delay. One staff spoken with said that there were often delays in getting maintenance issues attended to, they gave examples of the dishwasher. They also said the home was waiting for repairs to the steps of the summerhouse. We spoke with the manager about the delays in getting maintenance work done. The manager told us she had spoken with the care director about this and had been informed that an additional maintenance person had been recruited and they would be starting work soon. Following our visit to the home the manager wrote to us and said that the steps to the summerhouse had been repaired the day after we visited. Care Homes for Adults (18-65 years) Page 23 of 31 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 staffing arrangements generally ensure that the people living there are supported by a trained staff team who can meet their individual needs. Evidence: Staff training records show that just over 50 of staff have a National Vocational Qualification in care, either at level 2 or 3 so that people are supported by qualified staff. We saw that staff interactions with people at the home were positive and friendly. One person at the home told us staff help me. Surveys from people at the home recorded that staff usually treat them well and listen to them. Discussion with staff and the homes staff rota show that the home does not use agency staff. This means that people are supported by staff who know them well. There were enough staff on duty on the day of the inspection to meet the needs of people living at the home. Observation of the rota shows that there are usually three staff on duty during the day, the manager when on duty is usually extra to the staffing numbers. Staff spoken with told us there were always enough staff on duty. We looked at the recruitment records for four staff. For all staff employed the home had obtained written references and a criminal record bureau check. Some Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: improvement was needed to the homes risk assessment procedures where staff have committed an offence. Discussion with the manager indicates that where there has been an offence committed an assessment is made of the staffs suitability to work with vulnerable people. However a written assessment is not completed, this needs to be done to show the factors that have been considered to ensure staff are suitable. A few days after we visited the home the manager forwarded evidence to us to show that she had completed a risk assessment for the member of staff concerned. New staff receive an induction so that they have the basic skills needed to do their job. In addition, staff have the opportunity to train towards completing the Learning Disability Qualification, (LDQ) so that they have the necessary knowledge to work with people in the home and ensure their needs are met. Staff spoken with said they get the training they need, one told us the training was excellent. Training records show that staff receive training in first aid, food hygiene, health and safety, safeguarding people from abuse, physical intervention, infection control and fire. Several staff have also completed training in epilepsy, mental health and autism. Records showed that staff receive regular formal supervision sessions with their manager so that they are supported and know how to meet the needs of the people living there. Care Homes for Adults (18-65 years) Page 25 of 31 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. The management arrangements ensure that the home is well run in the way that the people living there want. Evidence: The manager has been working in the home since 2003 and has completed the Registered Managers Award as well as an NVQ at level 4. This means the manager has the right qualifications to manage the home. The manager was not available on the first day of our visit but at the home on our second day. The manager co operated throughout the visit and demonstrated she knew the people living there and how to support them. One staff said the manager is approachable, the last home I was at it was difficult to raise issues but here I feel confident to raise things. The care director visits the home monthly and writes a report of their visit. These reports showed that the views of the people living there had been asked for. People Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: living there and their relatives had also completed Comment Cards that asked for their views about the home. As identified earlier in this report monthly meetings are also held with people at the home to seek their views on the running of the home. Since our last inspection the manager has completed information on identified areas for improvement and progress in the home. Areas identified include completing more user friendly contracts, improving opportunities for self medication and the introduction of a suggestion box. Fire records showed that staff test the fire equipment regularly to make sure it is working. There are regular fire drills and records show that fire procedures have been explained to people who live at the home. This means that staff and the people living there should know what to do if there was a fire so minimising the risks to their safety. Information that we have received from the West Midlands Fire Service show that they feel the fire precautions at this home are satisfactory. Records showed that staff tested the water temperatures regularly to make sure they are not too hot, which could put people at risk of being scalded. A certificate was available to show that gas installations in the home were safe. At the end of November a check of the electrical installations in the home was carried out. This identified some work that needed to be carried out to make sure the electrics were safe. A certificate to show that this work had been completed was not available when we visited. However a few days after our visit the manager sent us a copy of a certificate that showed the electrical work needed had been completed in December. Care Homes for Adults (18-65 years) Page 27 of 31 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 Adults (18-65 years) Page 28 of 31 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 The home needs to review 10/03/2009 peoples risk assessments to ensure they are reflective of peoples current living arrangements. So that people are protected from unnecessary harm. 2 34 19 The home should complete a 10/03/2009 written risk assessment for any staff who have a criminal conviction. This will help to ensure that the suitability of staff to work with vulnerable people has been fully considered. 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 2 The home should improve arrangements for assessing the needs of potential new people by fully completing its own format for assessment so that people know the home is able to meet their needs. Page 29 of 31 Care Homes for Adults (18-65 years) 2 20 Where people administer their own medication the home needs to make sure that the assessemnt to make sure this practice is safe is available to staff in the home. This will help ensure staff are fully aware of peoples ability to self medicate and help ensure they have their medication safely. Further development to one persons protocol for the use of as required should be undertaken so that staff have more information about when it should be used. Recommence the practice of photocopying prescriptions for medication so that staff can check that the medication received by the home is as prescribed by the GP, and people have the medication they need to stay healthy. Where people at the home contribute money towards collections for staff their agreement to do this should be fully documented to make sure they have actively chosen to do this and their money is being well looked after by the home. Improve arrangements for carrying out general maintenance of the home so that repairs and maintenance are addressed more quickly and people are not kept waiting. 3 20 4 20 5 23 6 24 Care Homes for Adults (18-65 years) Page 30 of 31 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. 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