Inspection on 04/02/08 for The New House

This inspection was carried out on 4th February 2008.

CSCI found this care home to be providing an Adequate service.

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 5 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 31/07/06

The New House 11/01/06

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 0AX Lead Inspector Susan Scully Unannounced Inspection 4 February 2008 10:00 th New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service New House, The Address 17 Stonerwood Avenue Hall Green Birmingham West Midlands B28 0AX 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.V342170.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 31st July 2006 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 there is 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. The fees at the home are £326.44 per week. New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 Star. This means the people who use this service experience adequate quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for the people who use the service and their views of the service provided, meaning they tell us if the home is meeting their needs, if the home is flexible and suits their life style, and if the home enables them to maintain their independence, preferences and choice of how they want to be supported. This process considers the agencies capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development The inspection was completed over one day. The home did not know that an inspection of the service was taking place. As part of the inspection process we look at peoples files this is called case tracking this involves establishing individuals experiences of the service provided or observing practises of individual staff and how they have been trained to deliver a service that promotes the person well being and choices. We also discuss people’s care focusing on outcomes for people. Case tracking can help us understand the experiences of people who use the service. In addition to this, information is looked at during the inspection such as polices and procedures, and the general operation of the home in relation to meeting peoples needs. We also contact other professionals involved with the home such as contract monitoring officers for their views of the service provided. The home is also required to complete an annual quality assurance assessment (AQAA). The Commission sends this document to the provider before the inspection. The AQAA shows what the home is doing well and if and what the home could do better. The completion of the AQAA is a legal requirement that the provider must complete. This had been completed prior to the inspection and showed the improvements made since the last inspection. New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 8 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.V342170.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A pre assessment and contract of terms and condition is provided to the person wishing to live in the home to show how the service provided will meet peoples individual needs in respect of their health and welfare. EVIDENCE: There have been no admissions into the home since the last inspection. The records sampled to establish the admission process and pre assessments showed that the manager completes an assessment before people move into the home. The AQAA tells us that relatives and the person wishing to move in to the home are invited to look around the home before they make a decision. Records also tell us that a risk assessment is completed before they move into the home. As part of the pre-assessments the person is invited to have an over night stay at the home to give them an idea of what the home is like. When a person moves into the home a three-month trial period is arranged to ensure the person likes living in the home and the home is able to meet the person needs. Each person is provided with a contract of terms and conditions, which includes the amount of fees payable. This ensures that the person knows their rights New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 10 and has the information to ensure they know what they can expect from the service. New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care planning system in the home was good but the manager needed to ensure the plans were regularly updated to reflect the current needs of the residents and that any assistance required was specified. Further improvements were needed to individual risk assessments to ensure all risks were minimised. Residents made decisions about their lives on an ongoing basis. EVIDENCE: Three care plans were sampled that gave good information about the person needs. The care plans however did not identify the changes that had taken place, which was discussed at length with the senior care worker during the visit. The contents of the discussion with the senior care worker will not be referred to in the report as this is of a confidently nature and would identify the individual. New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 12 The senior care worker said each person living in the home discuss their needs with staff, regarding their care and the support they receive. This needs to be documented to ensure all staff are aware of the person needs on a daily basis and to ensure the persons needs are met. One care plan showed one person attended a day centre, and had regular contact with family and friends. The care plan also contained information about medical conditions, past history, activities the person attends, such as socializing, in the community, what medication they are taking and the details about health care, such as doctors visits, hospital appointment, dentist. The staff hold regular meeting with the people living in the home to ensure their views can be taken into consideration on how to improve the service further. New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Records demonstrate choice and personal development for the people living in the home. EVIDENCE: Standard 17 was not assessed during this visit, as the people living in the home were not at home to discuss the meals provided. Menus seen showed a variety of foods available, however the senior care worker said that the people living in the home normally have the same as each other and this can change on a day to day basis depending on what they feel like on the day. Care files sampled showed people live an activate lifestyle, going out and pursuing activities of their choice. This may be a meal out or attending the day centre, or visiting friends and family. New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 14 The senior care worker said the people who live in the home are rarely in during the day. Organised activities that the people living in the home attended included luncheon clubs, ballroom dancing, day centre, and bingo afternoon and keep fit. The residents daily records evidenced that they regularly go shopping go out for walks, have pub meals and go to the library. Records showed each person is encouraged to participate in activities of their choice. Activities are discussed in meetings, which are held regularly. New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service ensures the health and well being of people by ensuring they attend regular health care checks with other health care professionals when required. EVIDENCE: Care plans seen provide details of other health care professionals involved in the care and support the people living in the home receive. There was evidence of the supporting provided by staff to enable each person to attend appointments, such as doctor’s appointment or dentists. The people living in the home are independent and require very little personal care. Each person is encouraged to be as independent as possible with the support form staff when required. There was good information in care plans to show that the people living in the home are have regular health checks to ensure their health and welfare is maintained at all times. Medication continued to be administered via a 28 day monitored dosage system and this was very well managed. Medication was acknowledged when received into the home and signed for when administered, this was not always New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 16 being done at the last inspection; copies of prescriptions were being kept so it was clear what the doctor had prescribed. At the time of the last inspection the storage for medication was not appropriate this had been rectified and a specific drug cabinet had been purchased. All staff were administering medication and had received some training from Boots. The manager and one other staff member had completed their accredited training and the other staff were undertaking this. New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home ensures people are protected against abuse or harm by ensures the policies and procedure of the hoe are regularly reviewed and updated. Risk assessment need to show how the risks are managed to ensure the persons safety at all times. EVIDENCE: The home had not received any complaints and none had been lodged with the CSCI. There was an appropriate complaints procedure on display in the home, which had been amended since the last inspection and included details of the CSCI office in Birmingham. Risk assessment needed more details to show how risks were managed and any action taken to reduce the risks further. The risk assessment must be reviewed and identify any changes to the person using the service and if the risk to the individual has been resolved. Training records were not available for inspection to assess if staff had training in areas of manual handling and adult protection. Evidence from the AQAA tells us that staff have completed further training in Mental health and health and safety. Previous inspection reports tells us that staff have received training in adult protection so staff are fully aware of the safe guarding of vulnerable people. New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24&30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a comfortable safe environment that presents its self as a family home. EVIDENCE: There was adequate communal space in the home with a lounge, kitchen diner, small conservatory and an additional small lounge area if residents wanted some additional private space, this also doubled up as the sleeping in room. All the communal areas were clean, fresh and nicely furnished and some had recently been repainted. The home was found to be clean and hygienic. Since the last inspection the fridge and freezer temperatures were being taken on a daily basis to ensure foods were kept an appropriate temperatures. The inspector looked at people’s bedrooms to see if these were clean and had suitable furnishing. The bedrooms seen were well kept clean and very personal to the individual. New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 19 It was pleasing to see many personal belongings of the people living in the home, which gave the impression of a family home. New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Training records showed staff had received training in areas to ensure people were cared for safely. EVIDENCE: Staff files were not available for inspection. This is acceptable as the visit was an unannounced visit, Previous evidence from the last inspection shows us the following: There had been no changes to the staff team since the last inspection, which comprised of the manager, three permanent care staff and one bank staff member. The staffing levels appeared to meet the needs of the residents, as they were fairly independent. One member of staff slept in at the home each night, these duties were shared between the staff team. Recruitment procedures were checked at the last inspection and found to be robust and as there had been no new staff were not checked at this visit. The only requirement made was that there must be a recent photograph included in staff records and this had been met. New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 21 Since the last inspection the manager had completed NVQ level 4 and one of the care staff NVQ level 3, another member of staff was undertaking her NVQ level 2 which will give the home the required 50 when she has completed. Staff had undertaken training in COSHH, fire procedures, adult protection, food hygiene, first aid and manual handling. Infection control and medication training was ongoing at the time of the inspection. It was strongly recommended to the manager that she explored the availability of training specifically related to mental health needs. It was pleasing to note the recommendation from the last inspection had been completed. The manager and staff have recently completed mental health training. New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,43 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The overall heath and safety of service users is the agency polices practises. EVIDENCE: The home is run as a family where the people who live there contribute to the running of the home. The manager was not available during the visit however evidence from the last inspection clearly demonstrated the manager experience and personal development in maintaining an environment that is comfortable and clean. The people who live in the home were out during the visit so their views were not assessed as to how they felt about the home. Health and safety checks are completed regular to ensure the environment is safe for people to live in such a gas safety, electrical safety and fire extinguisher. New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 23 promoted and protected by Records sampled showed some inconsistence in the testing of the fire alarm on a weekly basis. This was brought to the attention of the senior care worker during the visit. The senior care worker said this would be completed immediately. Every month a member of staff talked to the residents about what to do in the event of a fire and there was a fire risk assessment however this was in need of review. A valid liability insurance certificate was displayed in the entrance to the home. The health and safety of the residents and staff were generally well managed. Staff had received training in safe working practices. New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 24 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 3 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X X X X 2 X New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 25 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 Standard YA6 Regulation 15(1) Requirement Care plans must be updated with the changing needs of the person. This will assist in the monitoring of people health and wellbeing. Risk assessment must show how the risks are managed and be regular reviewed. This will ensure all identified risks are monitored to reduce the risk to each person living in the home. Timescale for action 01/04/08 2 YA9 13(4)(a-c) 01/04/08 3 YA39 24(1)(2)(3) A formal quality assurance system must be in place. This must include the views of residents and their representatives. (Previous time scale of 31/05/06 not met) Not assessed at this inspection. 01/04/08 4 YA42 23(2)(c) The fire alarm system must be 01/04/08 tested weekly. This will ensure the manager and staff are made aware of any faults and action is then taken. New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 26 5 YA42 23(4)(c)(v) The fire risk assessment must be reviewed and updated if necessary. 01/04/08 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 YA23 YA25 YA25 Good Practice Recommendations It is strongly recommended that the manager obtain a copy of the multi agency guidelines for adult protection. It is recommended that the locks on the bedroom doors be of a type that can be opened by staff in an emergency. It is strongly recommended that residents have a lockable facility in their bedroom for the storage of personal effects or money. New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI New House, The DS0000017084.V342170.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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