Inspection on 30/06/05 for The New House

This inspection was carried out on 30th June 2005.

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 but made no statutory requirements on the home.

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 11/01/06

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 B28 0AX Lead Inspector Sarah Bennett Announced 30 June 2005 th 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 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 Stationary 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 E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service New House, The Address 17 Stonerwood Avenue Hall Green Birmingham B28 0AX 0121 778 6391 Telephone number Fax number Email 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 Care Home registration, with number of places New House, The E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Three service users, by reason of mental disorder (3MD) exc. LD and DE aged under 65 years. 2. 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. 3. The home must ensure assessment is undertaken by a qualified person to ascertain bathing facilities in the home meet the needs of service users. 4. The home must reassess needs regularly to ensure that increasing physical needs are recognised and met. Date of last inspection 13th October 2004 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 E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over five hours. A tour of the premises took place. Care, staff and health and safety records were looked at. Two residents records were sampled. Three residents and the owner/manager were spoken to. What the service does well: What has improved since the last inspection? A free view box has been bought so that residents who want to watch various sport programmes can do so. This is provided in the staff office/lounge and is available to residents who choose to watch it. Each resident has a care plan that states how staff are to support them and how they are supported to make decisions about their day-to-day lives. A statement of purpose of the home and a service users guide have been written so that prospective residents can make an informed choice about whether they want to live at the home. Water temperature regulator valves have been fitted to all water outlets used by residents to prevent the risk of residents getting scalded. Water temperatures are tested regularly. Staff regularly test the fire equipment to make sure that it is working. New House, The E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 Page 6 Staff records include evidence that Criminal Records Bureau checks have been undertaken for all staff employed to work at the home. When things are bought on behalf of residents receipts are kept and clear records are made. Liquid soap and disposable hand towels are provided in all toilets. A fire alarm was installed in January 2005 and staff regularly test the fire equipment to make sure it is working. 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 E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection New House, The E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 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 standard(s) 1, 5 Prospective residents have the information they need to make an informed choice about where to live. Resident’s contracts are not adequate to ensure that all residents are informed of the terms and conditions of their stay at the home. EVIDENCE: The service users guide contains all the relevant and required information. A statement of purpose has been developed since the last inspection that includes all the relevant and required information. Resident’s records included individual contracts. These were not signed or dated by the resident and the registered manager. New House, The E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 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 standard(s) 6, 9 Some further development is needed to ensure that all residents assessed and changing needs are reflected in their individual plan and staff know how to support individuals. Residents are not adequately supported to take risks within a risk assessment framework. EVIDENCE: Records sampled included individual care plans that stated how staff are to support the resident with their personal hygiene, diet and nutrition, medication, household tasks, social and leisure activities, health needs, sleep, family contact and finances. Records sampled, observations made and from talking to the owner/manager it is evident that it is not always possible to meet the needs of all residents. This needs to be reported to the relevant social worker and discussed. Records sampled included risk assessments for residents using their bedroom. Risk assessments were not in place for activities that residents participate in. Risk assessments were not in place stating how risks to residents were to be minimised when it had been identified that their behaviour in the community might place them at risk. New House, The E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 Page 10 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 standard(s) 13, 14, 15, 16, 17 Arrangements are in place to support residents to be part of the local community and have appropriate family relationships. Residents are offered a service that respects their rights. Residents are offered a variety of food and enjoy their meals. EVIDENCE: Two residents are able to go out on their own. One resident needs support from staff to go out. Where they choose to residents go to day centres, clubs, exercise and dancing classes and lunch clubs. Records sampled indicated that residents go shopping, to parks, the library and for walks. Residents have a bus pass if they want to. Residents said they could go on holiday if they want to and one resident said they went to Majorca last year supported by staff. Records indicated and residents said that where appropriate they are visited by their family and are supported to visit their families. Residents said they visit their friends and can telephone their friends and family when they want to. Residents were observed participating in household tasks and records sampled indicated that residents regularly participate in these. Residents made drinks New House, The E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 Page 11 for themselves and for each other. Residents are able to vote at general and local elections if they wish to. Residents said they can get up and go to bed when they want to and there are no fixed bedtimes. Residents said they love the food provided at the home. They always have fish on Fridays and also enjoy stew, pork chops, steak, salad in the summer, beef pies and mixed grill. Puddings are also provided and they enjoy rhubarb pie, trifle and gateau. Menus indicated that a variety of food is provided for residents. New House, The E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 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 standard(s) 18, 19, 20 Residents receive personal support in the way they prefer and require and their health needs are met. Arrangements for the administration of medication are not adequate to ensure residents are protected from harm. EVIDENCE: Care plans sampled stated how staff are to support individual residents with their personal hygiene. Residents records sampled indicated that residents have regular check ups at the dentist and chiropodist where appropriate. Where appropriate health professionals are involved in the care of residents including the GP, psychiatrist and speech and language therapist. Records indicated that residents are weighed monthly. Medication is stored in a locked cabinet. Medication administration records cross-referenced with the label on the medication boxes and bottles. Records were signed for appropriately. The owner/manager had signed for the majority of medication and resident’s records indicated that it was the responsibility of the owner/manager to administer the medication. The owner/manager has completed accredited training in the ‘Safe Handling of Medicines.’ Other staff must receive this training and be competent in administering medication so it is not the sole responsibility of the owner/manager. Medication audited crossreferenced with the amount received and administered on the medication administration record. A homely remedies policy is in place that has been signed by the GP agreeing what homely remedies can be administered to each resident. Copies of resident’s prescriptions are not kept. New House, The E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 Page 13 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 standard(s) 22, 23 Arrangements for complaints are not adequate to ensure that residents know their views are listened to and acted on. Staff have not received training to ensure they protect residents from abuse, neglect and self-harm. EVIDENCE: The complaints policy does not include details of the CSCI that residents can complain to at any time. There have been no complaints about the home. The adult protection policy is in line with the Birmingham Multi-Agency Guidelines on the Protection of Vulnerable Adults. Resident’s records indicated and residents said that they manage their own money and have their own post office accounts. The owner/manager keeps a record of all money that residents have coming in and going out. Receipts are kept of all purchases made by residents. The money kept in the cash boxes cross-referenced with the amount on individual residents records. Inventories of resident’s belongings were not dated or signed. Staff training records indicated that none of the staff have received training in adult protection. New House, The E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 Page 14 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 standard(s) 24, 26, 27, 28, 29, 30 Residents live in a clean, homely and comfortable environment, which suits their individual needs and lifestyles. Specialist equipment is not provided so if resident’s needs change as they age they will not be able to maintain their independence. EVIDENCE: Resident’s bedrooms were decorated according to individual tastes and interests and contained many personal possessions. One bedroom has en suite facilities. A separate bathroom is provided on the first floor and a WC is provided on the ground floor. The owner/manager said that they have arranged for the hall to be redecorated. The home was decorated and furnished to a good standard. A requirement was made at the last inspection for a referral to be made to an occupational therapist to assess the suitability of the bathing facilities for the residents. The owner/manager stated that they have had difficulty in accessing an occupational therapist. The owner/manager and residents said they are able to access the bathing facilities. Therefore, a referral needs to be made so that they can go on the occupational therapists waiting list and if resident’s needs change in the future an assessment can be made. The home was clean and free from offensive odours. Liquid soap and disposable hand towels were provided in all toilets. New House, The E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35, 36 The arrangements for staffing the home, their support and development was variable. EVIDENCE: Residents said that they get on well with all the staff. The owner/manager said that there is currently three staff employed who regularly work at the home. An agency member of staff occasionally works at the home. The owner/manager does the majority of sleep-in duties at the home. Staff records were looked at. These showed that a Criminal Records Bureau check has been undertaken for all staff. Records included proof of identity and personal details. Records did not include the dates that the member of staff started working at the home, position held, number of hours worked, two written references and a completed application form. The owner/manager said that most of the staff have worked at the home for about fourteen years. References and completed application forms must be obtained for any staff employed to work at the home in the future. Staff training records showed that two staff have received training in fire prevention. One member of staff has completed an Intermediate course in Infection Control. The owner/manager has completed accredited training in the ‘Safe Handling of Medicines. Formal, recorded staff supervision sessions do not take place. The owner/manager said that she is always at the home so is available to supervise staff. New House, The E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 42 The safety and welfare of residents is not adequately promoted and protected. EVIDENCE: The owner/manager said that she has not yet started NVQ level 4 but hopes to enrol to start in September 2005. The owner/manager has booked to do first aid training in July 2005. The fire risk assessment is detailed and dated April 2005. There are individual fire risk assessments for each resident that detail how they will be at risk in the event of fire according to their individual needs and how these risks can be minimised. Two staff have received training in fire safety. Staff test the fire alarm and equipment weekly to make sure they are working. The fire alarm was installed in January 2005. Fire drills take place at least every six months. Portable electrical appliances were tested in October 2004. The electrical wiring was tested in March 2005 and was in a satisfactory condition. The gas equipment was checked in April 2005 and was in a satisfactory condition. New House, The E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 Page 17 Staff check the water temperatures weekly and these are generally 41 degrees centigrade. Water temperatures should be 43 degrees centigrade. There was no indication of any action taken to increase the temperature of the water. Staff take the fridge and freezer temperatures weekly and records showed that these are maintained at safe levels. Risk assessments are in place for the premises and food hygiene. Staff have not received training in moving and handling. One member of staff has received training in infection control. New House, The E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x x x 2 Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 3 3 2 3 Standard No 11 12 13 14 15 16 17 x x 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 2 2 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 New House, The Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 2 x E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 Page 19 Yes Are there any outstanding requirements from the last inspection? 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. 2. Standard 5 6 Regulation 5 (1) (b) 12 (1) (a), 15 (1) Requirement Each residents contract must be signed and dated by the resident and the registered manager. Where the home is unable to meet residents individual needs this must be discussed with the relevant social worker. Appropriate outcomes for the resident must be sought. 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 timescale of 31st January 2005 not met). All staff must be competent to administer medication to residents. All staff who administer medication to residents must complete an accredited course in the Safe Handling of Medicines. (Previous timescale of 28th February 2005 not met). The home must maintain current copies of GP prescriptions with the Medication Administration Records. (Previous timescale of 28th February 2005 not met). Timescale for action 31st July 2005 & ongoing 31st July 2005 & ongoing 3. 9 13 (4) (a, b, c) 31st August 2005 & ongoing 4. 20 13 (2), 18 (1) (a) 30th November 2005 & ongoing 5. 20 13 (2) 31st August 2005 & ongoing New House, The E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 Page 20 6. 22 7. 29 8. 34 9. 36 10. 11. 37 42, 35 12. 42, 23, 35 13. 42 The complaints procedure must include details of how to contact the CSCI. It must state that the complainant can contact the CSCI at any time if they wish to. 23 (1) As part of the conditions on the (a), 23 registration of the home, the (2) (n) home must ensure that an assessment is undertaken by a qualified person to ascertain whether the bathing facilities meet the needs of the residents. 17 (2), Records for all staff must contain Schedule the following information: 2&4 - Dates employment commenced and ceased - Position held - The number of hours worked - Copies of two references - Application form - Individual training record All the above must be maintained in the home and made available for inspection. (Previous timescale of 31st January 2005 not met). 18 (2) Formal staff supervision must be undertaken six times a year and records kept in the home.(Previous timescale of 31st January 2005 not met). 9 (2) (b) The registered manager must (i) enrol to undertake NVQ level 4 in management and care. 18 (1) ( c) All staff must undertake training (i), 23 (4) in fire prevention starting with (d) induction and updated every six months. (Previous timescale of 13th November 2004 not met). 13 (3) (4) All staff must receive training in (5) (6), moving and handling and adult 18 (1) ( c) protection.(Previous timescale of (i) 31st March 2005 not met) 12 (1) Appropriate action must be (a), 13 taken to ensure that all water (4) (a, b, temperatures are maintained at c) 43 degrees centigrade. E54 S17084 NewHse V226888 300605 - Stage 4.doc 22 (1) 31st August 2005 Referral to be made by 31st August 2005 30th September 2005 & ongoing 31st August 2005 & ongoing 30th September 2005 31st July 2005 & ongoing 31st October 2005 & ongoing 31st July 2005 & ongoing New House, The Version 1.30 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 23 Good Practice Recommendations Inventories of residents belongings should be signed and dated by the resident and the owner/manager. New House, The E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Birmingham and Solihull Local 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 E54 S17084 NewHse V226888 300605 - Stage 4.doc Version 1.30 Page 23 - 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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