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Inspection on 25/01/07 for 339 Pershore Road

Also see our care home review for 339 Pershore Road for more information

This inspection was carried out on 25th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users have a clear and detailed timetable of weekly activities. They attend church, college courses and have links with the local community. The home has a stable team of staff and have not had to use agency staff. Both staff and service users are at ease with each other and this makes for a warm and pleasant environment. The home promotes individual choices and this was evidenced by the individualised bedrooms and flexibility in choice of mealtimes and menu.

What has improved since the last inspection?

A comprehensive Health Action Plan for each resident has been introduced in line with `Valuing People` recommendation. Each resident has an up to date inventory on their personal file. Adequate systems are now in place to control the risk of the spread of infection. Health and safety matters in relation to electrical and fire safety has been dealt with. Staff recruitment policies are now in place and a sampled selection of staff files audited contained all the relevant documentation including CRB checks.

What the care home could do better:

The home should ensure that good practice in followed with regards to the renewal of CRB checks. The home should also ensure that any recommendations recorded by the Environmental Health Officer is actioned.

CARE HOME ADULTS 18-65 Pershore Road (339) Edgbaston Birmingham West Midlands B5 7RY Lead Inspector Nancy Johnson Key Unannounced Inspection 25 January 2007 09:30 Pershore Road (339) DS0000016885.V326709.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 Pershore Road (339) DS0000016885.V326709.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. Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pershore Road (339) Address Edgbaston Birmingham West Midlands B5 7RY 0121 472 0224 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) PershoreRdOcs@aol.com Optimum Care Services Miss Dezmin Hazle Care Home 6 Category(ies) of Learning Disability (6) registration, with number of places Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. Residents must be aged under 65 years. That Desmin Hazle completes the registered Managers Award/ NVQ 4 in Care by 2005. The Home can continue to accommodate one named service user over 65 with a learning disability. That 339 Pershore Road apply for a variation on behalf of future service users who reach the age of 65. That details regarding how the specific care and social needs of people over 65 will be met must be included in the service user plan. Future admissions, and the statement of purpose be amended to reflect the age of service users accommodated. 18th October 2005 Date of last inspection Brief Description of the Service: The home is registered to provide personal care and accommodation for up to six adults who have a learning disability. All of the service users at the home are male. It is a detached building situated on a main road, on a bus route and fairly close to the centre of Birmingham. Accommodation for service users is provided in two single bedrooms on the ground floor and four single bedrooms on the first floor. All have wash hand basins and most have been personalised to reflect the individual tastes of service users. The home has a large fitted kitchen, a dining room, lounge, small laundry and a bathroom and shower room. The front of the house has a driveway that provides parking for several cars. The rear garden is large in size and has a patio area. There are shops within walking distance of the home and Cannon Hill Park and the MAC centre are nearby. Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector undertook this unannounced inspection over seven hours. The inspector was pleased to meet with the residents, staff on duty and the Manager. The inspector looked at all the communal areas of the premises and most bedrooms. The Inspector spent time talking to service users and observing support and interaction between them and the staff. The Inspector looked at the records of care and the care plans for three of the people that live at the home. Other records including fire safety records, rotas, staff supervision and training were inspected. Information was provided by the Manager on the CSCI pre-inspection questionnaire. What the service does well: What has improved since the last inspection? A comprehensive Health Action Plan for each resident has been introduced in line with ‘Valuing People’ recommendation. Each resident has an up to date inventory on their personal file. Adequate systems are now in place to control the risk of the spread of infection. Health and safety matters in relation to electrical and fire safety has been dealt with. Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 6 Staff recruitment policies are now in place and a sampled selection of staff files audited contained all the relevant documentation including CRB checks. 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. Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 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 Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 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): 1, 2, 4, 5 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The Statement of Purpose and Service User Guide provide prospective service users with relevant information about the home to enable them to make a choice about if they want to live there. This information is available in text and pictorial formats. Written procedures ensure that assessment of new users will be completed prior to admission to ensure the home is suitable for their needs. The existing service users views are taken into account when considering any new service users. EVIDENCE: The home’s Statement of Purpose has been slightly amended to include “We would like to be able to provide our client’s with a home for life, if only we can continue to meet their needs.” There is also an accompanying Service User Guide which is available in pictorial format. There have been no new admissions to the home. The home’s policies have been extended so that the views of the current service users will be considered before a prospective service user moves into the home. A sampled selection of service users files included the statement of terms and conditions for the home. Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 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, 8, 9, 10 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The care planning system was good with support needs being based on identified needs. The system provides staff with the information they need to meet service users needs. EVIDENCE: The care plans for five service users were sampled. Plans sampled were up to date with evidence of recent review and identified support required by staff. Observation and discussion with staff confirmed that staff were aware of the support needs of service users and risk management plans in place for each the service user. Each service user has a daily timetable of activities and a daily diary record is completed which details of what activities were done, what the service user has eaten, any incidents or accidents that have occurred, any visitors and night time routines. Monthly evaluations by the key worker were documented Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 10 and health assessments, care plans and risk assessments were up to date. It was evident from records that inspite of the service users complex communication needs they were encouraged and supported to make decisions about their lives, with appropriate risk assessments in place where necessary. Each service user has a pictorial communication card which is used to indicate their mood or that they wish to talk to the staff about an issue. Detailed health action plans are reviewed every six months in line with the Government White paper “Valuing People”. Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 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): 11, 13, 14, 15, 16, 17 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Arrangements are in place so that the service user has a meaningful lifestyle and their rights are respected. EVIDENCE: The service users have planned weekly activities which include progressive mobility, music, church activities and visits to the Midlands Art Centre (MAC). A daily activity diary is completed each day to indicate what activities the service users have taken part in. Community facilities are regularly accessed through travel, training and church activities. The home has still not replaced its vehicle but the Inspector was advised that plans are in place to do so. At present the residents take taxis where needed. The records indicate regular leisure activities such as Arts and crafts, shopping, walks, football and service users preferences are taken into consideration. Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 12 At the time of the inspection one of the service users had a birthday and invited all the other residents for a meal which they attended at a restaurant. Family links and friendships are encouraged with the service users. A visitors book was made available on arrival clearly recording date, name, reason for visit, times of arrival and departure. In the hallway was a visitors’ information folder containing inspection reports for the home, the home’s statement of purpose, the service user guide, visitors comments cards and the complaints procedure. There was evidence to support that the staff encouraged and welcomed appropriate family involvement in the lives of the residents. Some of the residents regularly went to see to their relatives. The inspector had the opportunity of having lunch with staff and service users. The food that was provided was enjoyable and appropriate and fresh ingredients were used. Food stocks were low but the inspector was advised that shopping was to be done shortly. There was a variety of fresh fruits available. The meals observed were varied, nutritious and alternatives were available. Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 13 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): 18, 19, 20, 21 Quality in this outcome area is good. Service users emotional and health needs are met. The medication administration system is good and easily audited. There system is robust ensuring the appropriate receipt, administration and recording of resident’s medication. EVIDENCE: There was clear documentation regarding daily records and monthly evaluations sheets for all health care appointments that the service users attended including GPs, opticians, chiropody and dental appointments. The service users diet is monitored regularly and their weight is reviewed monthly. All medication is appropriately monitored and policies are reviewed and actioned accordingly. The medication administration records (MAR) were sampled for all service users. All documentation was satisfactory and records were up to date. All medication sheets were signed by two staff members after it was administered. A copy of each prescription was kept on file and weekly medication audits were completed. Several of the service users have medication on a PRN basis and PRN protocols were in place and correctly followed. The system was very easy to audit and no discrepancies were found. Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 14 Comprehensive health plans have now been introduced in line with the Government White Paper “Valuing People”. All healthcare needs, mobility assessments and risks assessments are contained within the plan and all record were up to date. The home has a policy to deal with the wishes of the service user in respect of what happens if they become ill, the ageing process and what happens to them upon their death. All staff are familiar with that policy and the service users wishes are treated with respect. Discussions are also taken place with the service users families. Service users also understand that as a part of the home’s statement of purpose that they will continue to live there as long as the home is able to meet their needs. Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 15 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 Quality of this outcome is good. This judgement has been made using available evidence including visit to this service. The home has a satisfactory complaints system and there are systems in place to ensure that comments are received from visitors to the home. The renewal system for CRB and POVA checks needs to be reviewed to ensure that all the necessary statutory checks are renewed appropriately. EVIDENCE: The home has an adequate complaints procedure in place. The records indicate that there have been no complaints in the last 12 months. CSCI has not received any complaints regarding this home. Visitors are made aware of the complaints procedure within the visitors pack. The inspector had the opportunity to sample some of the visitors comments questionnaire, “very welcoming and warm atmosphere. Clients look well cared for, good staff team. Would have any relative live here.” There was also a comment from a professional which stated, “all clients well cared for”. All staff files were audited and records were up to date. Most staff files had up to date CRB and POVA checks however two staff files showed that CRB checks were in excess of three years and required renewal. All staff receive regular training and the inspector had the opportunity of reviewing the training log post October 2005. All staff have either completed or Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 16 are undertaking their NVQ in Care. Recent training has included Manual Handling, Fire Safety, Medication Competency and Infection Control. Service users monies are managed by the managers of the home and two signatures are required to withdraw service users funds from the bank. The inspector reviewed all service user financial records and these were satisfactory and receipts were available for inspection. All service users have up to date inventories, which is contained with their personal files. Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 17 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, 25, 26, 27, 28, 29, 30 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. Service users benefit from living in a warm and homely environment where their safety and well-being is promoted. However, improvement is needed in some areas which the home is planning to address. EVIDENCE: The home has good access to local facilities and transport. The home was clean and had a welcoming environment. The service users bedrooms were personalised and were equipped according to their needs and promoted independence as far as the service users are able. There are sufficient washrooms and toilet facilities for all service users. The home has passed fire safety checks in line with Standard 24. The heating system was checked by the Inspector and was found to be in working order. The water temperature was also checked and found to be satisfactory. Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 18 It was evident that the ground floor shower room was in urgent need of redecoration. This was listed in the maintenance book but was yet to be completed. The home has planned for the renovation of the kitchen and the plan was approved in October 2006. No date has been set for the work to commence at present. The fridge freezer had a broken handle and required replacing, however it was noted that the fridge freezer was still in working order. These remain outstanding from previous inspection. The Manager has stated that the fridge freezer would be replaced when the kitchen was renovated. The light at the entrance to the property was not working and as the home caters for partially sighted service users this could pose a health and safety hazard and requires urgent attention. Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 19 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): 31, 32, 33, 34, 35, 36 Quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a stable and trained staff team. Staff are aware of their roles and responsibilities and they benefit from regular supervision. Policies need to be in place to ensure the regular renewal of CRB checks. EVIDENCE: The staff at the home are a stable team and most have worked there for a number of years. No agency staff has been used. Staff levels were adequate for the number of residents and both appear comfortable in each others presence. There are ten members of staff and there is a minimum of three on duty at any one time. Although the service users have communication difficulties it was quite clear from observation, the interaction witnessed indicated that the relationships were good. Staff files were audited and all contained CRB and POVA checks, application forms, proof of identity and written references, however, two sampled files showed that the CRB checks had not been renewed for three years. Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 20 Throughout the inspection the Manager was observed to be aware of what the staff were doing and regular staff meetings take place which involve the residents. Staff supervision records were sampled and were found to be well organised. All staff have a Supervision and Personal Development Record and provide clear action points for development. The home is committed to training and all staff have completed or are currently undertaking their NVQ in Care. Recent training has included Fire safety, Manual Handling, Infection Control and Medication Competency. Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 21 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, 38, 39, 40, 41, 42, 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run by a competent management team. The service users rights and best interests are safeguarded by way of policies and procedures in place and well maintained records. The manager is currently completing the NVQ Level 4 in Care. EVIDENCE: The Manager has completed the Registered Managers Award and has nearly completed the NVQ level 4 training. She also has extensive experience in various aspects of social care. She had a good overview of the service and management of the home. Throughout the inspection the manager was cooperative and commented that she saw the inspection as an opportunity to gain feedback on the quality of the service. Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 22 The Manager has recently been absent for a period of two and half months and during that time the Deputy Manager and another Manager from another Optimum home covered the service. The Health and Safety concerns that were raised in the last inspection have all been addressed. Several fire safety exercises and drills had taken place since the last inspection. All health and safety checks have been undertaken and appropriately recorded. The manager receives regular support and supervision from her line manager and copies of the Regulation 26 visit reports were available for inspection. Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 23 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 3 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 2 25 3 26 3 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 4 3 LIFESTYLES Standard No Score 11 3 12 X 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 2 3 Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 YA30 Regulation 16(2)(j) 23(2)(d) Requirement All recommendations recorded in the report from the Environmental Health Officer must be actioned – re: fridge freezer. (Outstanding requirement from 30/05/05) The home should ensure that good practice is followed in that CRB checks are renewed at least once every 3 years. Timescale for action 01/03/07 2. YA23 13 (6) 01/05/07 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. Refer to Standard YA24 YA24 Good Practice Recommendations The light to the entrance of the building needs to be repaired. Ensure that the patio area is cleaned and that this is added to the homes cleaning schedule Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 25 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 Pershore Road (339) DS0000016885.V326709.R01.S.doc Version 5.2 Page 26 - 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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