Inspection on 11/01/06 for The New House

This inspection was carried out on 11th January 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The New House 03/03/09

The New House 04/02/08

The New House 31/07/06

The New House 30/06/05

The New House 13/10/04

The New House 15/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 New House, The 17 Stonerwood Avenue Hall Green Birmingham West Midlands B28 OAX Lead Inspector Sarah Bennett Unannounced Inspection 11th January 2006 14:00 New House, The DS0000017084.V278040.R01.S.doc Version 5.1 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 New House, The DS0000017084.V278040.R01.S.doc Version 5.1 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. New House, The DS0000017084.V278040.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service New House, The Address 17 Stonerwood Avenue Hall Green Birmingham West Midlands B28 OAX 0121 778 6391 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) Mrs Mary McNamara Mrs Mary McNamara Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places New House, The DS0000017084.V278040.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Three service users, by reason of mental disorder (3MD) exc. LD and DE aged under 65 years The two current service users who were under 65 at time of admission can continue to be cared for in this home for such a time that their needs can be met. The home must ensure assessment is undertaken by a qualified person to ascertain bathing facilities in the home meet the needs of service users. The home must reassess needs regularly to ensure that increasing physical needs are recognised and met. 30th June 2005 3. 4. Date of last inspection Brief Description of the Service: The New House is a detached two-storey house that was constructed in 1991 for the purpose of providing residential care to three adults for reasons of mental illness. Accommodation consists of three single bedrooms, one of which has en suite facilities and a separate bathroom on the first floor. Ground floor accommodation includes a lounge, kitchen/dining room, conservatory, with a lobby off the kitchen providing access to a toilet and sleep-in room /lounge for visitors and staff. There is a small, well-maintained garden to the rear of the property with off road parking at the front. The home offers ongoing support to residents with mental health needs, residents are actively involved in the day-to-day running of the home. New House, The DS0000017084.V278040.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was conducted by one Inspector over three hours. This was the second of the statutory inspections for this home for 2005/2006 and not all of the National Minimum Standards were assessed. To get a full picture of the home it is advised to read this report in conjunction with the report from June 2005. At this inspection time was spent observing interactions and support from staff. A tour of the home was made. Resident’s records, risk assessments and a number of Health and Safety records were inspected. The Inspector had the opportunity to talk with residents, a member of staff and the Manager. What the service does well: What has improved since the last inspection? Many of the requirements from the last inspection have been met. Another member of staff has been employed to work at the home. This has helped the Manager who is now doing less sleep-in duties at the home. An occupational therapist has visited and grab rails have been put on the bath and the shower. This will make it easier for residents as they get older to use the bath and shower. Staff have had training in medication and adult protection. They are going to have training in fire safety and manual handling. This will help staff to know how to keep residents safe from harm. New House, The DS0000017084.V278040.R01.S.doc Version 5.1 Page 6 Boots now supply the medication to the home. Staff said that the Boots system is easier to use. Water temperatures are tested regularly to make sure that they are not too hot or to cold. 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. New House, The DS0000017084.V278040.R01.S.doc Version 5.1 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 New House, The DS0000017084.V278040.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 5 Resident’s individual aspirations and needs are assessed. Residents have individual contracts so that they are aware of the terms and conditions of their stay at the home. EVIDENCE: The current residents have lived at the home for some time. Previous inspections have found that before residents moved into the home an assessment was completed to ensure that the home could meet the individual needs and goals. The manager said that in December 2005 a social worker visited the home to assess two of the residents for suitability to move on to supported living accommodation. The assessment concluded that the home was meeting their needs and that supported living accommodation was not a viable option. Residents records sampled included an individual contract that stated the terms and conditions of their stay at the home. The resident and the Manager had signed the contract, however, it was not dated. New House, The DS0000017084.V278040.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Arrangements are adequate to ensure that staff know how to support each individual to meet their needs and achieve their goals. Residents are supported to make decisions about their lives. Residents are not adequately supported to take risks within a risk assessment framework. EVIDENCE: Residents records sampled included an individual care plan. The care plans are not very detailed but contain enough information so that staff know how to support the individual. The care plan is monitored monthly and updated when necessary. Residents said that they make decisions about their daily lives what they do, where they go, what they eat, wear and who they make contact with. Residents said that they chose who they spent time with over Christmas and what they did. Residents said that they look after their money and choose how they spend it. New House, The DS0000017084.V278040.R01.S.doc Version 5.1 Page 10 The manager said that in December 2005 a social worker visited the home to assess two of the residents for suitability to move on to supported living accommodation. The assessment concluded that the home was meeting their needs and that supported living accommodation was not a viable option. Residents said that this assessment had caused them stress, as they are happy living at the home and thought that they would have to move. Resident’s records sampled included only two risk assessments, one for using their bedroom and the other for fire safety. Risk assessments are required for all activities that residents participate in the home and the community to ensure that any risks to their well-being are minimised. New House, The DS0000017084.V278040.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 17 Adequate arrangements are in place to ensure that people living in the home experience a meaningful lifestyle. EVIDENCE: Residents said that they spend their time doing the activities they choose to do and what interests them. These include Tai Chi, dancing, keep fit and walking. Since the last inspection one of the residents has been going to a daycentre one afternoon a week. Residents daily records sampled stated that they regularly go shopping, to pubs and restaurants. Residents use public transport. Residents said that they enjoyed Christmas and went to a lot of parties. They were supported to visit their relatives and their relatives visited where appropriate. Residents were observed making their own drinks when they wanted them and asking other residents and staff if they wanted one. Residents said each day one of the residents chooses the main meal and they can choose what they want to eat and drink. Residents were observed helping to prepare the evening meal. New House, The DS0000017084.V278040.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 Adequate arrangements are in place to ensure that resident’s health needs are met. Arrangements for the administration of the medication are not sufficient to ensure that residents are protected from harm. EVIDENCE: Residents records sampled showed that residents have regular dental checkups. Residents have regular appointments with the Psychiatrist who reviews their medication. Records of healthcare appointments are kept that state the date attended, the outcome of the appointment and any changes to the resident’s medication or care. Residents records sampled showed that they are weighed monthly. In the last year one resident has steadily lost 11lbs and has almost reached their ideal weight. Boots supply the medication to the home using the monitored dosage system. All staff have completed the Boots half day training in administering medication. The Manager has completed and another member of staff is doing the accredited ‘Safe Handling of Medicines’ training. Medication is currently stored in a locked file box in a filing cabinet. New House, The DS0000017084.V278040.R01.S.doc Version 5.1 Page 13 The Manager said that Boots supplied the home with a very large medication cabinet for which there was not enough space and it was not suitable for the home. Another more suitable cabinet has been ordered. One of the resident’s medication administration records (MAR) had not been signed for on two occasions. The other two residents MAR had been signed when medication had been given. Copies of all prescriptions are kept so it is clear what the GP has prescribed for individuals. New House, The DS0000017084.V278040.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Arrangements are generally adequate to ensure that resident’s views are listened to and acted on. Adequate arrangements are in place to ensure that residents are protected from abuse, neglect and self-harm. EVIDENCE: The complaints procedure included details of the CSCI head office in London. It should include details of how to contact the Birmingham & Solihull office. There have been no complaints since the last inspection. Three members of staff including the Manager have completed training in adult protection and the prevention of abuse. Residents records sampled included a detailed inventory of the resident’s belongings. These were signed by the resident and a member of staff but not dated. New House, The DS0000017084.V278040.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 29 Residents live in a homely and comfortable environment that meets their individual needs. EVIDENCE: Since the last inspection the Manager has sought advice from a private occupational therapist that has visited the home. They assessed the bathing and shower facilities and how residents are able to access them. A grab rail has been fitted on the side of the bath and two grab rails have been fitted in the shower. Residents said that they choose whether they have a bath or shower. One resident has an en suite shower room, however they said that they prefer to have a bath. Another resident said they prefer to have a shower and use the other residents en suite when they are not in there. The Manager said that the resident who prefers a shower was given the option of moving to this bedroom when it became vacant but chose not to. Residents said that they are happy with this arrangement. New House, The DS0000017084.V278040.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36 The arrangements for staffing the home, their recruitment, support and development are generally adequate. EVIDENCE: Since the last inspection an additional member of staff has been employed to work at the home. Residents said that they get on well with all the staff. One member of staff is doing NVQ level 3. The Manager has started NVQ level 4. Staff rotas showed that minimum staffing levels are always met. The Manager is doing less sleep-in duties than at the last inspection. The rota for thirty- five nights showed that on fifteen of nights the Manager did the sleep-in. Staff recruitment records included proof of identity, two written references and evidence that a Criminal Records Bureau check has been undertaken. The records included personal information of the member of staff and contact details and the date that they commenced their employment at the home. Staff records sampled did not include a recent photograph as required in the Regulations. Three members of staff including the Manager have completed training in adult protection and the prevention of abuse. One member of staff has completed an Intermediate course in Infection Control. Staff have completed training in food hygiene. New House, The DS0000017084.V278040.R01.S.doc Version 5.1 Page 17 The Manager and staff said that all members of staff have been booked to do fire safety and manual handling training during January 2006. A letter confirming that these places are booked was seen. The manager said that since the last inspection she has been able to do regular, formal, supervision sessions with staff. New House, The DS0000017084.V278040.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Arrangements are generally adequate to ensure that residents benefit from a well run home. Resident’s views do not underpin all self-monitoring, review and development by the home. Arrangements are generally adequate to ensure that the safety and welfare of residents is promoted and protected. EVIDENCE: As required at the last inspection the Manager has started NVQ level 4. Since the last inspection the Manager has worked hard to ensure that the home meets the requirements of the Care Home Regulations. The Manager undertakes regular training to update her skills and knowledge. A quality assurance system is not in place. The home must have a quality assurance system that seeks the views of the residents and where appropriate their representatives. New House, The DS0000017084.V278040.R01.S.doc Version 5.1 Page 19 Fire records showed that staff last completed the weekly fire testing on 1/12/05. Every month a member of staff talks to residents about what to do if there is a fire and they then practice evacuating the home. A risk assessment as to how individual residents respond to fire drills is available and what the risks are for them. All the resident’s smoke and the lounge is the designated smoking room in the home. A fire risk assessment for the premises is available and was dated April 2005. Risk assessments are in place for the premises, food hygiene and storage and hazardous substances. Water temperatures are tested weekly and records showed that these are generally 41 degrees centigrade. Water temperatures must not be higher than 43 degrees centigrade to prevent the risk of residents being scalded. The fridge and freezer temperatures are tested weekly and these recorded as the recommended safe limits to store food. However, these need to be tested daily, preferably at night when the fridge is being opened and closed less. Daily testing and monitoring will lessen the risk of food being stored at the incorrect temperature and therefore decrease the risk of food poisoning. An electrician tested the portable electrical appliances in October 2005 to make sure that they are safe to use. An electrician completed the five - year testing of the electrical wiring in March 2005 and stated that it is in a satisfactory condition. A Corgi registered engineer tested the gas equipment in April 2005 and stated that it was in a satisfactory condition. A valid certificate of employers liability insurance was displayed in the home. New House, The DS0000017084.V278040.R01.S.doc Version 5.1 Page 20 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 X 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 X 29 3 30 X STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 1 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 2 X 2 X 1 X X 2 X New House, The DS0000017084.V278040.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Yes - one STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA9 Regulation Requirement Timescale for action 28/02/06 2. 3. 4. 5. YA20 YA20 YA34 YA39 6. 7. YA42 YA42 13(4)(a,b,c) Risk assessments must be in place for all activities that residents participate in. These must include specific measures taken to reduce the risk and must be regularly reviewed. Previous timescales of 31/01/06 & 31/08/05 not met. 13 (2) All medication must be signed for as it is given. 13 (2) Suitable storage must be provided for the medication. 19 A recent photograph must be Sch 2 (1) available for all staff employed at the home. 24(1)(2)(3) A formal quality assurance system must be in place. This must include the views of residents and their representatives. 23 (4)(a) Staff must test the fire alarm (c)(v) weekly and a record of this must be kept. 13 (4) Fridge and freezer temperatures must be tested daily and a record kept. 11/01/06 12/01/06 28/02/06 31/05/06 12/01/06 31/01/06 New House, The DS0000017084.V278040.R01.S.doc Version 5.1 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA5 YA22 YA23 Good Practice Recommendations Each residents contract should be dated when signed by the resident and the registered manager. The complaints procedure should include details of the local office of the CSCI. Inventories of resident’s belongings should be dated when signed by the resident and a member of staff. New House, The DS0000017084.V278040.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI New House, The DS0000017084.V278040.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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