Inspection on 18/01/06 for Sayer House

This inspection was carried out on 18th 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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sayer House 29/11/06

Sayer House 16/06/05

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

Ravenhurst

Polesworth Group 64 Long Street

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

CARE HOME ADULTS 18-65 Sayer House 2 Newholmes Monyhull Hall Road Kings Norton Birmingham B30 3QF Lead Inspector Sarah Bennett Unannounced Inspection 18th January 2006 09:50 Sayer House DS0000062605.V279588.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 Sayer House DS0000062605.V279588.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. Sayer House DS0000062605.V279588.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Sayer House Address 2 Newholmes Monyhull Hall Road Kings Norton Birmingham B30 3QF 0121 443 2871 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) South Birmingham Primary Care Trust Family Housing Association Limited Ivy Winters Care Home 6 Category(ies) of Learning disability (6), Physical disability (6), registration, with number Sensory impairment (6) of places Sayer House DS0000062605.V279588.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. A qualified nurse must be working in the home at all times and must not have responsibility for any of the other Newholmes bungalows. 16th June 2005 Date of last inspection Brief Description of the Service: Sayer House was previously registered as part of the Newholmes registration of six bungalows. In May 2005 the homes were registered separately. Sayer House provides nursing care to six people who have a learning disability. Some residents have additional physical disabilities, sensory impairment and dementia. Sayer House is a six- bedroom bungalow that is fully accessible to all residents. Communal areas consist of an open plan kitchen, dining room and lounge. There is an additional small room off the lounge. There is a bathroom, shower room and a separate WC. Ceiling track hoists are fitted in bedrooms and bathrooms. Adapted bathing and shower facilities are provided. To the side of the bungalow there is a garden with grassed areas, pots and hanging baskets. The garden has a fence around it making it private. The home is situated in the grounds of what was once Monyhull hospital. However, a new housing estate has been built around the bungalow which now makes it part of the local community. Family Housing Association owns the premises. The home is managed and staffed by South Birmingham Primary Care (NHS) Trust. Sayer House DS0000062605.V279588.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over four hours. The Manager and the staff on duty were spoken to. The residents were not able to give a view of the home due to their communication needs. A partial tour of the premises took place. Care, staff and health and safety records were looked at. A relative had sent a letter to the CSCI before this inspection expressing their satisfaction of the home. 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. What the service does well: The staff team provide a specialist service to people who have a learning disability who are coming to the end of their life. Other health professionals from Cornwall and Manchester have visited the home to look at the service provided, as there are few other services like this in England. Residents are treated as individuals and staff spend time talking to them. Residents often go out to places in the local community that they like going to. A team of health professionals work with residents and with the staff so that resident’s individual health needs can be met. Staff talk to residents relatives to try to find out how they can meet individual residents needs. Residents go on holiday. One resident really wanted to go to Disneyland Paris and staff supported her to do this. A relative said: “ We would like to commend the staff of Sayer House on their forward –looking approach to our relatives quality of life. We are extremely pleased that our relative is regularly taken out into the community and went on holiday for a week to Bognor Regis.” Residents individual health needs are met and residents have regular health check ups. Sayer House DS0000062605.V279588.R01.S.doc Version 5.1 Page 6 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. Sayer House DS0000062605.V279588.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 Sayer House DS0000062605.V279588.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): These standards were not assessed. Standard 2 was met at the last inspection and since then no residents have been admitted to the home. EVIDENCE: Sayer House DS0000062605.V279588.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, 9 Residents assessed needs and goals are reflected in their individual care plans so that staff know how to support each individual. Residents are supported to take risks within a risk assessment framework. EVIDENCE: Residents records sampled included an individual care plan. Residents care plans are very detailed and had been regularly reviewed and updated to reflect any changes. Daily records are kept, which are detailed and record all nursing care that is given to the individual. Daily records of activities that residents have participated in include the individual’s response to the activity. Resident’s records sampled included individual risk assessments. These were detailed and had been reviewed monthly and updated where necessary to reflect any changes. One risk assessment for the resident accessing the community stated that due to their health needs a qualified member of staff must always accompany the resident. A qualified member of staff and a social care worker had accompanied the resident to Ikea a couple of days before. Sayer House DS0000062605.V279588.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 14 Adequate arrangements are in place so that people living in the home experience a meaningful lifestyle. EVIDENCE: Residents spent most of their time in the lounge as the decorators were decorating their bedrooms. One resident was out at a day centre. Staff said the resident attends the day centre when they are well enough to keep in contact with their friends. Residents spent some time asleep in their reclining chairs and staff respected individuals need to sleep because of their health needs. When residents were awake, staff spent time talking to them and giving those who wanted it a foot massage. A musical DVD was on in the lounge and staff said that this was a particular favourite of the residents. There is a fish tank in the lounge, which was visible to residents as they were sitting in their chairs. Staff supported two residents to go out to a local pub for lunch. Residents records sampled showed that they go shopping, for local walks, drives, to the cinema, restaurants and pubs. In October residents had a day trip to Blackpool Sayer House DS0000062605.V279588.R01.S.doc Version 5.1 Page 11 supported by staff. Staff said that there are three members of staff who can drive the minibus so that residents can access the local community. In a letter dated November 2005 to the CSCI a relative said, “Our relative is regularly taken out into the community and has recently returned from a week’s holiday top Bognor Regis; we have been extremely pleased, as she had been unable to leave her home for a number of months.” Staff meeting minutes showed that a Minister from a local church had attended part of the meeting. The Minister visits the home regularly and spends time with individual residents. Three of the residents regularly attend the church supported by staff. There were several framed photographs of residents in the lounge, some of the photographs were of residents who had previously lived at the home but were known to some of the current residents. Staff supported all but one of the residents to go on holiday last year. Two residents went to Bognor Regis, two residents went to Northumberland and one resident went to Disneyland Paris. The other resident moved into the home last summer but staff said that they would be going on holiday this year. Sayer House DS0000062605.V279588.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): 18, 19, 20, 21 Residents receive personal support in the way they prefer and require and their health needs are met. Adequate arrangements are in place to ensure that the management of the medication protects residents from harm. The ageing, illness and death of a resident are handled with respect and as the individual and their relatives would wish. EVIDENCE: Residents records sampled included a manual handling assessment. This is reviewed monthly and updated to reflect any changing needs. Some residents require bedsides to be fitted to prevent them from falling out of bed. A risk assessment is in place that is reviewed monthly to ensure that all risks of the resident being injured are minimised. Staff were observed moving residents to more comfortable positions. Staff were talking to residents and encouraging them to move as much as possible themselves. Residents records sampled showed that the multi-disciplinary team of health professionals are involved in the care of residents. These include the Speech and Language Therapist, Physiotherapist, Psychiatrist and Older Adult Liaison Sayer House DS0000062605.V279588.R01.S.doc Version 5.1 Page 13 Nurse. Staff support residents to go to the Seating Clinic for advice on wheelchairs and adapted chairs to use at home. Resident’s records included a nutrition and pressure area assessment. These cross-referenced to care plans to ensure that staff know how to support the resident to have adequate nutrition and how to prevent them developing a pressure sore. Residents have regular dental check ups, eye tests and chiropody appointments. Residents records sampled showed that they regularly go to the weight clinic and a record of their weight is kept. The residents weight was generally stable and they had gained weight since their admission to the home. In a letter dated November 2005 to the CSCI a relative said, “ The staff have attended to our relatives physical requirements, as well as her emotional, spiritual and psychological needs, which we would like to commend the staff of Sayer House on their forward-looking approach to our relatives quality of life.” Health Action Plans have been developed for residents. These are being produced using pictures and are kept in resident’s bedrooms. Health Action Plans cross-reference to resident’s individual health records. The Manager and staff said that other health professionals are surprised as to how well individual residents have been since they have been living at the home. Medication is stored in a locked cabinet. Boots supply the medication to the home using the monitored dosage system. The qualified nurses give the medication to the residents. Medication Administration Records (MAR) had been signed and these cross-referenced with the blister packs indicating that medication had been given as prescribed. Where residents are prescribed PRN (as required) medication a protocol is in place that states when and in what dosage this should be given. At the last inspection the qualified nurse was also expected to administer medication on some of the other bungalows that were previously registered together as Newholmes. The Manager and staff said that this no longer happens. Staff test the temperature of the medication fridge daily and this was recorded as between 3-6 degrees centigrade. The recommended temperature is between 2-8 degrees centigrade. Resident’s records sampled included a detailed care plan of what to do in the event of the residents health deteriorating and the need for them to receive palliative care. This has been discussed and agreed with the resident’s relatives and the multi-disciplinary team. Resident’s records included a Supportive Care Pathway. This was blank and the Manager said that this would be completed when the multi-disciplinary team agrees that the resident is at the stage of needing palliative care. A local hospice supports the home and staff have received training in palliative care. Sayer House DS0000062605.V279588.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 Adequate arrangements are in place to ensure that resident’s views are listened to and acted on. Arrangements are generally adequate to ensure that residents are protected from abuse. EVIDENCE: There have been no complaints since the last inspection. There were several letters of compliment and cards expressing appreciation of the work that the staff do. A relative sent a letter to the CSCI in November 2005 complimenting the staff on how they care for their relative. The relative asked that the Inspector pass on their thanks and appreciation to the staff at Sayer House. A copy of the Birmingham Multi-Agency Guidelines on the Protection of Vulnerable Adults is available in the home. All but one member of staff have received training in adult protection and the prevention of abuse. Sayer House DS0000062605.V279588.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, 26, 27, 28, 29, 30 Residents live in a homely, clean and comfortable environment that meets their individual needs. A new minibus would enable residents to maximise their independence. EVIDENCE: Decorators were working in the home. Staff said that all resident’s bedrooms and the hall were being redecorated. Three of the bedrooms were being totally redecorated. In the other three the paintwork was being touched up and repainted where necessary. The decorators were also going to replace the flooring in the bathroom and the carpet in the hall. The kitchen units are going to be resealed in the future. No other redecoration work is planned for the kitchen. The lounge and dining room are well decorated. Residents have their own adapted chairs and wheelchairs. Ceiling track hoists, mobile hoists, hi lo beds, adapted bathing and shower facilities are provided. The home has a minibus that residents use to access the community. The Manager said that it is difficult for some of the residents to access the minibus, as their wheelchairs are heavy. A more suitably adapted minibus is needed that would make it easier to enable residents to access the community. Due to the residents needs and the size of some of their wheelchairs it is not possible for them to use the Ring & Ride service or wheelchair accessible taxis. Sayer House DS0000062605.V279588.R01.S.doc Version 5.1 Page 16 Therefore, so that residents can maintain their current good quality of life it is essential that they be provided with suitable transport that can enable them to access the community. The home was warm and clean and free from offensive odours. Sayer House DS0000062605.V279588.R01.S.doc Version 5.1 Page 17 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, 36 Arrangements are not sufficiently adequate to ensure that residents are always supported by qualified, effective and well supervised staff. Staffing levels are adequate. EVIDENCE: Staff said that two members of staff have NVQ Level 2 and three members of staff are currently completing this. The Manager is a NVQ assessor and is responsible for assessing some of the staff. Rotas showed that minimum staffing levels are being met. Staff said that they have not gone below the minimum staffing levels. There are two staff vacancies, however, the Manager said and rotas showed that the permanent staff cover these vacancies doing bank shifts. There are currently two ‘D’ grade development nurses working at the home. If they do not stay at the end of their development contract there will be four vacancies and it will be necessary to recruit to these posts. There have been six staff meetings in the last year. Detailed minutes of these meetings are kept. Individual residents needs are discussed at staff meetings and staff discuss how they can support residents to meet their needs. Staff supervision records sampled showed that all day staff have received between six to ten recorded, formal supervision sessions in the last year. However, one of the night staff has only had one supervision session and the other two night staff have had two. Sayer House DS0000062605.V279588.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 Resident’s benefit from a well run home. Resident’s views do not underpin the self-monitoring, review and development by the home. Arrangements are generally adequate to ensure that the health, safety and welfare of residents is promoted and protected. EVIDENCE: The Manager is registered with the CSCI and is a qualified learning disability nurse. She has NVQ level 4 and is a NVQ Assessor. The Manager has also completed the ‘End of Life Pathway’ course and has received training in Palliative Care. The last available report of the Social Care Manager visiting the home was dated November 2004. The Manager said that the Social Care Manager does audits but the reports of these are not always available. Staff said that a representative from Family Housing Association had visited the home recently however they had not regularly visited prior to this. A formal quality assurance system is not in place and this is required. Sayer House DS0000062605.V279588.R01.S.doc Version 5.1 Page 19 A Corgi registered engineer tested the gas equipment in 2005 and stated that it was in a satisfactory condition. An electrician tested the portable electrical appliances in December 2005 and stated that they were safe to use. Fire records showed that staff test the fire alarm weekly and the emergency lighting monthly to make sure they are working. In December 2005 the Trust Fire Officer reviewed the fire risk assessment. A fire drill took place in December 2005 and staff were given a lecture on fire safety. Staff carry Scope alarms so that they can summon assistance from other staff when needed. Staff test these weekly to make sure that they are working. Risk assessments were in place for the premises, staffing levels, using the minibus and general issues concerning the safety of residents and staff. These were last reviewed in December 2004 and now require reviewing and updating if necessary to reflect any changes. A valid certificate of employers liability insurance was displayed in the home. Sayer House DS0000062605.V279588.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 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 3 28 3 29 2 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 X 35 X 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 3 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 4 3 X 1 X X 2 X Sayer House DS0000062605.V279588.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? No 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. 3. 4. 5. Standard YA24 YA29 YA36 YA39 YA42 Regulation 23(2)(b) Requirement Timescale for action 31/03/06 31/08/06 28/02/06 30/04/06 28/02/06 The kitchen units must be resealed. 12(1)(a) A suitably adapted minibus for 23(2)(n) the residents must be provided. 18(2) Night staff must receive regular, formal, recorded supervision sessions with their line manager. 24(1)(2) A formal quality assurance (3) system must be in place. 13(4)(a-c) The premises and general risk assessments must be reviewed and updated to reflect any changes. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Sayer House DS0000062605.V279588.R01.S.doc Version 5.1 Page 22 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 Sayer House DS0000062605.V279588.R01.S.doc Version 5.1 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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