Inspection on 28/02/06 for 23 Serpentine Road

This inspection was carried out on 28th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

23 Serpentine Road 20/02/07

23 Serpentine Road 14/09/05

23 Serpentine Road 11/03/05

23 Serpentine Road 12/01/05

23 Serpentine Road 11/12/03

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Serpentine Road (23) Selly Park Birmingham West Midlands B29 7HU Lead Inspector Kerry Coulter Unannounced Inspection 28th February 2006 11:10 Serpentine Road (23) DS0000016961.V285009.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 Serpentine Road (23) DS0000016961.V285009.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. Serpentine Road (23) DS0000016961.V285009.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Serpentine Road (23) Address Selly Park Birmingham West Midlands B29 7HU 0121 472 1722 0121 472 1722 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) autism. west midlands Ms Nazli Yacoob Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Serpentine Road (23) DS0000016961.V285009.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents must be aged under 65 years. Date of last inspection 14th September 2005 Brief Description of the Service: Serpentine Road is known as the poplars. The home is a detached residential property situated within the Selly Park suburb of Birmingham. It is close to the Bristol Road, which provides public transport to access shops, parks, pubs, restaurants and places of worship. The main area of the home provides accommodation for four service users with Autistic Spectrum Disorders and Aspergers Syndrome and an attached self-contained flat for a further service user who enjoys a more independent lifestyle. The main area of the house has four single bedrooms and a staff sleep-in room, which includes WHB and shower. The communal areas consist of a lounge, dining room, large kitchen and extensive garden, all of which the service user who is living in the flat may utilise. The flat has been established from the converted garage and includes lounge, kitchen, bathroom, bedroom and a small laundry. The garden is well laid out and maintained to a high standard and includes a decked area leading directly from the house and garden furniture. The front garden has been converted to off road parking for up to six vehicles. Serpentine Road (23) DS0000016961.V285009.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 and a half hours. The Manager was available for all of the inspection. Several service users were spoken with. During this visit the Inspector did not have the opportunity to speak with relatives but spoke with one health professional. A partial tour of the premises took place. Care and health and safety records were looked at. 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 September 2005. What the service does well: What has improved since the last inspection? Serpentine Road (23) DS0000016961.V285009.R01.S.doc Version 5.1 Page 6 Recommendations made at the previous inspection have been met. Since the last inspection staff have worked hard to ensure care plans cross reference with risk assessments so that the reader is naturally directed from one to the other. Medication competence assessments have been introduced for staff. Staff have completed training on portion control with the Health Eating Coordinator. The quality assurance system has been further developed and is proving to be a good tool in assisting the Manager to identify areas for improvement. The home has also been awarded the Investors in People award, this recognises the training and support systems in place for staff. 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. Serpentine Road (23) DS0000016961.V285009.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 Serpentine Road (23) DS0000016961.V285009.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): N/A EVIDENCE: These standards were not assessed. Standards 1 and 2 were found to be met at the inspection in September 2005. Serpentine Road (23) DS0000016961.V285009.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, 8, 9 Individual plans include good quality information about how support should be given. The systems for service user consultation in this home are good with a variety of evidence that indicates that views are both sought and acted upon. EVIDENCE: Each service user had a care plan. Sampled plans were seen to be extremely well constructed with detailed information about the levels and type of support required by service users in accordance with their assessed needs. Individual plans also include information about service users preferred routines and the activities they take part in. The service user and their key worker regularly review their care plans. Care plans included service users short and long term goals and how staff are to support them to achieve these. Care plans cross reference to other relevant documents such as policies and procedures. Since the last inspection staff have also worked hard to ensure care plans cross reference with risk assessments so that the reader is naturally directed from one to the other. Daily care records were of a good standard. Staff generally write detailed entries enabling the reader to track all the care provided. Serpentine Road (23) DS0000016961.V285009.R01.S.doc Version 5.1 Page 10 During the inspection many positive examples of service users being encouraged, or enabled to participate in the life of the home were observed. This included staff including service users in conversations, and activities such as preparing lunch. From talking to service users and staff, from records and from observations made it is evident that service users can make decisions about their day-to-day lives. Regular service user meetings are held in the home, records of these were available. Areas discussed include activities, holidays, menus and feedback from previous CSCI inspections. Service users are also consulted via questionnaires as part of the home’s quality assurance system. Service users are supported to take manageable risks, and staff encourage individuals to have an independent lifestyle. Service users records sampled included a risk management plan. These were detailed and included all the risks to the individual and how staff are to support them to minimise the risks. All the risk assessments had been recently reviewed and updated where necessary. Serpentine Road (23) DS0000016961.V285009.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 17 Service users are supported to live independent lifestyles and arrangements are in place to enable residents to engage in a range of activities. Service users are fully involved in meal planning and are supported to eat a healthy diet. EVIDENCE: Service users are offered a wide variety of activities both within the home and in the community. Opportunities are available to attend college and go on holidays. Each service user has a weekly time-table that is a combination of both leisure and activities to develop independent living skills. Activities include cooking, ironing, shopping, meals out, swimming, church, horse riding and recycling. A computer is available in the dining room for the use of service users. On the day of the inspection several service users were observed playing a game of Jenga with staff. Discussion with both service users and staff indicate that an enjoyable Christmas was had by all. Some service users visited relatives whilst those at home went to Church on Christmas morning and then Serpentine Road (23) DS0000016961.V285009.R01.S.doc Version 5.1 Page 12 the pub accompanied by the Manager whilst staff prepared the Christmas dinner. Service users spoken with were happy with the choice and quality of food on offer. One commented that he had the opportunity to shop and choose food, another said that he enjoyed helping staff cook brunch as he was able to cook his bacon just as he liked it. Food stocks in the home were plentiful and varied with a choice of fresh fruit available to include fresh pineapple as well as the usual apples and oranges. Since the last inspection staff at the home have completed training on portion control with the Health Eating Coordinator. Serpentine Road (23) DS0000016961.V285009.R01.S.doc Version 5.1 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 The health and personal care needs of service users are met. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure service users receive the medication they need. EVIDENCE: Service users appearance was very individual in style, age appropriate and reflected their personality. One service user returned from the barbers having had a hair cut, proudly showing staff the style he had chosen. Care plans sampled clearly documented the support that was needed for personal care. A sample inspection of health records indicates that service users are receiving routine access to general health services, such as well person’s checks, dentist, eye tests and chiropodist. It is an area of good practice that health action plans have been completed. This is something that the Government paper, ‘Valuing People’ recommended that each person with a learning disability had by 2005. This is to ensure individuals receive all the care they need to stay healthy. Referrals are made to other health professionals as required. The Inspector had the opportunity to meet with the Community Nurse who was visiting at the request of the Manager due to an increase in epilepsy seizures of one service user. The Serpentine Road (23) DS0000016961.V285009.R01.S.doc Version 5.1 Page 14 Community Nurse expressed the opinion that the staff team were always willing to learn, were approachable and friendly. Some service users are receiving regular input from the dietician and are on healthy eating diets. As part of this they are also taking part in Walk 2000, this encourages regular walks as part of a healthy lifestyle. The system for the administration of medication is satisfactory. Medicines were seen to be stored appropriately in a secure location. Stock checks are completed on a regular basis and copies of prescriptions are retained. Sampled medication administration records were appropriately completed. Where required, protocols were available for ‘as required’ medications to guide staff as to when medication should be administered. The Inspector was informed that all staff that administer medication have received accredited training in its administration from Solihull College. It was recommended at the last inspection that medication competence assessments are introduced for staff, this has now been done. The Manager said she intended to complete these on an annual basis for staff. Serpentine Road (23) DS0000016961.V285009.R01.S.doc Version 5.1 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): N/A EVIDENCE: These standards were found to be met at the inspection in September 2005. Serpentine Road (23) DS0000016961.V285009.R01.S.doc Version 5.1 Page 16 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, 29 Service users enjoy the benefit of a comfortable house that is kept clean and safe. EVIDENCE: There is a range of communal space available to include a large kitchen, dining room and lounge. One resident has a self contained flat which includes kitchen facilities. The home has a large garden that includes a ‘decked’ area. This can be accessed via the dining room. The home operates a no smoking policy, however a covered area in the garden is provided if service users wish to smoke outside. Infection control procedures were satisfactory. The home was clean. Food in the fridge was date labelled and records of fridge/freezer temperatures evidence that food is stored at safe temperatures. The laundry is situated in a separate area in the hall. A cleaning schedule is in place to ensure staff clean all areas of the home on a regular basis. Discussion with the Manager indicates that the lounge, office, dining room and bedrooms are due for repainting soon. When this is being done the bathroom ceiling will also be repainted where it was repaired following a leak. The Manager said it is intended that service users will go on holiday whilst the work is carried out. In general the home is well maintained and homely in style. However the location and style of staff lockers and formal style of notices on Serpentine Road (23) DS0000016961.V285009.R01.S.doc Version 5.1 Page 17 service users bedroom doors does detract from the homely style. It is recommended that staff lockers are relocated from the dining area or thought given as to how they could blend in to the room. It is also recommended that a review of the amount and style of notices on display is carried out to ensure they do not detract from the ‘homely’ style of the premises, whilst recognising that some notices are necessary, eg fire procedure. Serpentine Road (23) DS0000016961.V285009.R01.S.doc Version 5.1 Page 18 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, 35 The staffing arrangements ensure service users are supported by sufficient numbers of knowledgeable staff to meet their needs. EVIDENCE: It was noted that both staff and service users appear comfortable in each other’s company and enjoy a good general rapport. They give support with warmth, friendliness and patience and treat people respectfully. Seven out of the twelve staff have completed an NVQ 2 or 3 in care, this meets the standard of having at least 50 of staff having completed an NVQ. Satisfactory levels of staff are on duty to meet service users needs. Four staff were on duty during the inspection to enable some 1:1 activities with service users. Discussion with the Manager indicates the home is fully staffed and has no vacancies. The Manager has developed an organised system for the tracking of training received by staff. A printout of each topic records the date and the staff who attended, with copies of the certificates available in staff files. Records evidence that staff receive the training they require to effectively meet the needs of service users. Forthcoming training arranged for some staff includes refresher training in health and safety, fire, food hygiene and studio III (physical intervention). One member of staff spoken with was satisfied with the training she had received and felt appropriately supported in her role. The Serpentine Road (23) DS0000016961.V285009.R01.S.doc Version 5.1 Page 19 home has recently been awarded the Investors in People award, this recognises the training and support systems in place for staff. Serpentine Road (23) DS0000016961.V285009.R01.S.doc Version 5.1 Page 20 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): 39, 40, 42 The quality assurance and monitoring system ensures that all service users views are taken into account appropriately. Health and safety of staff and service users was well managed. EVIDENCE: At the last inspection a new quality assurance system was observed that had been developed by the Manager. This is based on a month by month basis and includes CSCI reports, staffing, leisure and procedures. The Manager has developed forms to analyse reasons for service users and staff who leave the home and of the occurrence of accidents and incidents. The format also seeks the views of service users and relatives. Since the last inspection the system has been further developed and is proving to be a good tool in assisting the Manager to identify areas for improvement. Sampled policies and procedures included Missing persons, Adult Protection and Physical Interventions were satisfactory and indicate that service users rights and best interests are safeguarded by the home’s policies and procedures. In addition to organisational policies the Manager has also Serpentine Road (23) DS0000016961.V285009.R01.S.doc Version 5.1 Page 21 developed some local polices and procedures, for example emergency procedures. Regular health and safety audits are completed. Records evidenced the regular testing and servicing of fire alarms. Equipment in the home is regularly serviced. COSHH items were observed to be securely stored. Up to date detailed risk assessments for the premises, risk of fire, staff and food had been completed. Staff had also received recent fire training. Since the last inspection a firm has been contracted to undertake regular testing of the water supplies to include temperature monitoring to ensure it is safe for service users. Serpentine Road (23) DS0000016961.V285009.R01.S.doc Version 5.1 Page 22 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 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 3 30 X STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X X X 3 3 X 3 X Serpentine Road (23) DS0000016961.V285009.R01.S.doc Version 5.1 Page 23 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. Standard Regulation Requirement Timescale for action 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 It is recommended that the metal grey staff lockers are relocated from the dining area or thought given as to how they could blend in to the room. Review the amount and style of notices on display to ensure they do not detract from the ‘homely’ style of the premises. Serpentine Road (23) DS0000016961.V285009.R01.S.doc Version 5.1 Page 24 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 Serpentine Road (23) DS0000016961.V285009.R01.S.doc Version 5.1 Page 25 - 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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