Inspection on 17/05/07 for The Poplars

This inspection was carried out on 17th May 2007.

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 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Poplars 10/05/06

The Poplars 21/10/05

The Poplars 02/06/05

The Poplars 12/01/05

The Poplars 06/07/04

The Poplars 25/03/04

Similar services:

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

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

CARE HOME ADULTS 18-65 Poplars, The 889 Chester Road Erdington Birmingham B24 0BS Lead Inspector Amanda Lyndon Unannounced Inspection 17th May 2007 08:15 Poplars, The DS0000033636.V336310.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 Poplars, The DS0000033636.V336310.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. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Poplars, The Address 889 Chester Road Erdington Birmingham B24 0BS 0121 373 0288 0121 386 2460 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) Munira_Rahemtulla @ Birmingham.gov.uk www.birmingham.gov.uk Social Care and Health Ms Munira Rahemtulla Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: This is currently under review 1. 2. 3. That the home is registered to accommodate 9 adults under the age of 65 who are in need of long-term personal care for reasons of learning disability. Currently residing people who are over 65 may continue to be accommodated provided their needs can be met appropriately. Minimum staffing levels to be: Monday to Sunday: AM - 7.30am - 4.00pm, 3 staff to include the duty manager (shift leader) PM - 4.00pm - 9.30pm, 3 staff to include the duty manager (shift leader) Night - 9.30pm - 7.30am, 2 waking night care assistants and 1 sleep-in manager Re provision plans to progress at a pace which is acceptable to CSCI to allow continuation of registration. 10th May 2006 4. Date of last inspection Brief Description of the Service: The Poplars is a Home owned by the Local Authority and is registered to provide personal care and support for up to 12 adults with a learning disability. Accommodation was originally provided in three houses and access between these is through a series of hallways and staircases, therefore is not considered to be ideal. In addition, the internal layout and a number of facilities provided at The Poplars are no longer deemed to be fit for purpose. For example there is no passenger lift and this may have been required for people living there in the future, therefore there will be no further admissions to the Home prior to re provision plans being implemented. Accommodation is currently provided in two houses that are interlinked and run as one unit. The Poplars has its own large frontage, rear gardens and there is ample off road parking at the front of the houses. There are a number of local bus routes, local shops, and a railway station near by. The Home is well located to access Erdington and Sutton Coldfield. Residents have a choice of lounges and dining areas and the main dining room is large and decorated in a homely style. The bedrooms at the Home vary in size, are all for single occupancy and residents are encouraged to personalise these. There are no call bell facilities provided at the Home. There are six bathrooms and seven toilets and staff are available to provide assistance in these areas as required. The main house dose not have a toilet located on the ground floor. Residents are supported to pursue leisure activities based on their personal interests and abilities. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 5 Residents are not permitted to smoke within the building during day time hours and there is a designated smoking area provided for residents during the night Copies of the most recent CSCI report and newsletters were on display for anyone interested to read. The weekly accommodation fee to live at The Poplars is set by Birmingham City Council. Items not covered by this fee include clothing, leisure activities and toiletries. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. Information obtained and used in the planning of this field work visit included Regulation 37 notification reports of any accidents or incidents involving people using the service and two concerns received by CSCI since the last key visit at the Home. A random visit was undertaken at The Poplars on 13 February 2007 in order to monitor the progress made since the previous key visit dated 10 May 2006. The outcome of this was positive and a number of requirements made during the last key visit had been addressed and work practices had been revised as a result of this to improve outcomes for residents living at the Home. Additional requirements were made during the random visit regarding the need for the carpets to be cleaned, the maintenance of accident records and the appropriateness of wording used within the care planning system. This information was also taken in to consideration when planning for this visit. The unannounced key field work visit referred to in this report was undertaken over one day by one Inspector when there were nine residents living at the Home. Information was gathered by speaking with all of the residents, the Registered Manager and all of the staff members on duty. There were no visitors at the Home during the field work visit. An additional method of obtaining information was “case tracking” two residents in order to find out what it is like for these people living at the Home. This includes examining the care, medication, staffing and health and safety records relevant to these people. A partial tour of areas of the Home relevant for these people was also undertaken. No immediate requirements were made on the day of the visit. Prior to the field work visit a self assessment was sent to the Home and this was being completed at the time of the visit in order to obtain further information about the service provided and the quality of outcomes for residents living there. What the service does well: The service is being re developed and residents are being supported to choose new homes that they might like to live in. One resident said “I have enjoyed living at The Poplars, it has been nice and friendly here”. Residents are involved in the planning of their care and this ensures that they receive support in the way that they prefer. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 7 Residents are encouraged to develop their life and social skills so that their independence is promoted. Most residents attend day centres or work placements and they have opportunities to meet people of similar ages and interests at this time. Residents can choose to do the things that they enjoy each day and there are lots of activities on offer that residents can choose or choose not to do. One staff member said “Residents get lots of choices with what they want to do and don’t want to do”. Residents are supported to form friendships with each other and with people outside of the Home. One resident said “We had a lovely party and buffet last night..” Visitors are welcome at the Home and residents are supported to keep in touch with their families. Residents have a choice of healthy and tasty meals that meet any special requirements. There are no rigid rules or routines and residents can choose the times that they go to bed at night and get up in the morning. One resident said “I like to go to bed at 9pm and then I don’t wake up in the night”. Residents are invited to take part in group meetings to discuss their lives at The Poplars and put forward their views about living there. Residents can continue to practice their religions whilst living at the Home so that their personal beliefs are respected and promoted. Staff provide support to residents ensuring that they access health care as required. Residents receive their medication at the times they require. Residents are confident that any issues raised about the Home are acted upon. Residents are provided with a clean living environment and are encouraged to decorate their bedrooms with their personal things so that they feel comfortable and relaxed. One resident had recently had new furniture in her bedroom and said “ I have chosen all my new furniture”. Another resident said “I love my photographs, they give me good memories”. Staff have a good understanding of residents’ individual support needs. One staff member said “ It works well here because of excellent staff teamwork”. One resident said “I like all of the staff here”. Staff undertake training so that have the skills and knowledge to support residents in a competent manner. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 8 There is a good system for the safekeeping of small amounts of residents’ money should they choose to use this facility. Residents’ health and safety is generally protected whilst living at the Home. What has improved since the last inspection? What they could do better: Written plans must be available that include guidelines for staff to follow in the event of medical emergencies so that residents are kept safe from harm. Residents must be addressed and supported in a way that promotes their dignity and choice at all times. The layout of the Home and some of the facilities provided are no longer fit for purpose or need. There are plans to re develop the service to provide a better place for people to live. Carpets in some areas of the Home must be cleaned or replaced and the ceiling in the corridor between the two houses must be repaired in order to safeguard residents. Assisted bathing facilities must be provided that meets the needs of all residents living at the Home so that everyone has the choice of having a bath or shower. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 9 A risk assessment must be undertaken about the office door being wedged open and what would happen if there was a fire at the Home so that residents are protected. 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 be made available in other formats on request. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 10 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 Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 11 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents have enough information and support in order to make informed decisions about where they would like to live in the future. EVIDENCE: Due to the re provision of the services provided at The Poplars there had been no new admissions to the Home for a long period of time, therefore the pre admission process could not be assessed on this occasion. A number of residents living there had done so for many years. The Registered Manager stated that due to the ageing process a small number of residents were being re assessed for alternative accommodation as their physical and mental health care needs could no longer be met at The Poplars. A service user guide had been produced for the people currently living at the Home and this was available in an easy read format so that it was accessible to all people. The Registered Manager stated that any updated documents would also be available in other languages on request to make them easier for residents to understand. On the morning of the visit one resident was moving from The Poplars to a new home within a supported living environment. He stated that he had chosen his new home and had had the opportunity to visit there so that he could make an informed decision about whether he wanted to live there. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 12 It was pleasing that both the Registered Manager and a care worker were escorting him to ensure that he arrived at his destination safely. Staff had ensured that he had bought adequate food supplies to cover the first few days at his new home and this would help him to settle in. The resident said “I have enjoyed living at The Poplars, it has been nice and friendly here”. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 13 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): Quality in this outcome area is good 6, 7, 8, 9 & 10 This judgement has been made using available evidence including a visit to this service. Residents are supported to lead safe and fulfilling lives and are generally supported in a respectful and appropriate manner by the staff team so that their confidence, dignity, self-esteem are promoted. Residents are involved in the running of the Home and any suggestions put forward are acted upon for the benefit of the people living there. EVIDENCE: All residents had an individual care plan outlining their care and support needs and the actions required by staff in order to meet these needs. These are written and reviewed with the involvement of residents and their families in order to ensure that any preferred routines in respect of their daily lives are maintained whilst living at the Home. Information about resident’s individual interests and hobbies were recorded in good detail so that these could be pursued whilst at The Poplars. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 14 Comprehensive personal risk assessments had been written based on any identified risks to individual resident’s health, safety and well-being so that they could lead fulfilling lives based on their personal interests and abilities. It was evident that the Home’s staff were proactive and undertook risk assessments promptly when any new hazards were identified, reflecting the changing care needs of residents living at the Home. All risk assessments sampled were signed and dated by the staff team as evidence that they were aware of the specific support required for residents in the identified risk areas. One staff member said “We let residents take appropriate risks” Daily reports included good detail of the activities that residents had engaged in during the day, any multi disciplinary input or when friends/family had visited. It was pleasing that improvements had been made regarding the appropriateness of wording used within these in order to respect residents’ dignity. The care planning system is audited by senior staff each week to ensure that residents are receiving the support required to meet their individual needs and any shortfalls regarding this is rectified promptly. Residents are involved in the running of the Home and are invited to regular group meetings to discuss the services provided and to put any suggestions for improvements forward. The minutes of the most recent “residents’ meeting” was on display in a large print format for ease of reading. This included discussions about food provided and residents had put forward some menu suggestions. Activities including ideas for those people unable to participate in group activities were also discussed. Newsletters are produced each month and include information of interest for residents, their visitors and staff. There were a number of notice boards located throughout the Home and these displayed information of interest to residents, their visitors and staff. On the day of the visit residents had been supported to choose clothing relevant for the time of year, and which reflected their age, gender and culture. One staff member stated that one resident liked a particular colour of clothing as it reflected his favourite football team colours. Residents’ preferred form of address was recorded within their individual plans and staff were observed to be using these preferred names. With the exception of the two areas of concern regarding staff attitude and approach as outlined within this report, residents were cared for in a respectful manner by staff working at the Home. Residents leaving for college or work were sensitively reminded by the staff team to take their money with them and put their coats on, ensuring that they were supported in these areas. All residents are offered the key for their bedroom door and on the day of the visit a number of residents had chosen to lock their doors when they went outside of the Home. There was a payphone available for residents’ use located in the visitors’ room so that residents could use this facility in private if they wished. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good 11, 12, 13, 14, 15, 16 & 17 This judgement has been made using available evidence including a visit to this service. The activities and opportunities for social, leisure, religious and personal development meet the needs and expectations of residents. The choice of healthy meals meet any special dietary needs for reasons of taste, health or cultural/religious beliefs. EVIDENCE: Residents are supported to gain and develop life skills in order to lead fulfilling lives in which their independence is promoted. A kitchen duty rota is followed and residents are involved in light housekeeping tasks and the laundry of their personal clothing with the support of staff. One resident chooses to distribute the post, bring the milk and bread in and empty the bins as his contribution to being involved in life at the Home. The majority of residents are supported to use public transport and are encouraged to make their own hot beverages and snack meals. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 16 Plans are in place to develop a gardening club for residents who are interested in being actively involved in this area. New garden furniture had recently been purchased for residents to use in warmer weather and one resident had been involved in painting this. The garden was accessible to people with impaired mobility so that all residents living at the Home could enjoy this facility if they chose to do so. Residents have the choice of participating in a range of activities and leisure pursuits based on their interests and abilities both inside and outside of the Home. These include sports, garden games, quizzes, pub meals and day trips. A trip on a river boat and a day trip to Portsmouth are planned for the near future. One resident expressed her satisfaction about going swimming twice a week and said that she really enjoyed this activity. Individual activity planners had been developed for each resident and it was pleasing that residents had been consulted about these thus promoting person centred care. One resident said “I love knitting, I’m knitting a scarf at the moment”. Residents are encouraged to be involved in activities within the local community and have the opportunity to meet with people of similar ages and interests. With the exception of two residents who have become frail due to the ageing process, all residents attend day centres and work placements and residents met stated that they enjoyed going to these. On the day of the visit one resident who had stayed at home was colouring whilst listening to the radio and she stated that she was enjoying doing this. A gym facility had recently been created at The Poplars and residents stated that they enjoyed keeping fit. Individualised fitness programmes had been developed by health care professionals in order to promote the health, safety, well-being and fitness of residents. Birthdays are celebrated and residents are encouraged to choose what presents they would like so that their individuality and interests are maintained. Families and friends were welcomed at the Home and a number of residents chose to visit their families and friends outside of the Home. There were no rigid rules or routines at The Poplars and it was evident that residents felt confident and relaxed in their surroundings. One staff member said “Residents get lots of choices with what they want to do and don’t want to do”. One resident said “I visit my family for the day and they phone me”. Residents can choose the times that they go to bed at night and get up in the morning. One resident said “I like to go to bed at 9pm and then I don’t wake up in the night”. It was evident that good friendships had formed between residents and between residents and staff as all of the residents had lived at The Poplars for a long period of time. During the evening prior to the field work visit a leaving party had been held for a resident who had chosen to move to supported living accommodation. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 17 Leaving presents were being exchanged and residents and staff were helping him to move his personal belongings from his bedroom in to the reception area of the Home. It was pleasing that plans were in place for residents to visit him at his new home. One resident said “We had a lovely party and buffet last night and we gave presents”. Opportunities are provided for residents to continue to practice their chosen faiths and residents are supported to attend their chosen places of worship. One resident attends a weekly group meeting at the church and there were currently no residents of non Christian faiths living at the Home. There was a religious festivals calendar on the wall for residents and staff to refer to if they should choose to do so. Healthy eating is encouraged at The Poplars, for example brown bread is encouraged and fresh fruits are easily accessible to residents. Meal times are flexible, the main meals being predominantly in the evenings after college/work as this suits the lifestyles of the majority of residents living there. On the day of the visit residents were served their breakfast at times to suit them and their commitments for that day. Snacks are available at all times so that residents are not hungry. Light lunches were served to the residents who have not gone out and this was soup and bread and butter on the day of the visit. One resident said “I really enjoyed the soup, it was lovely”. The main meal options served at tea time on the day of the visit were lasagne or southern fried chicken. Special diets could be arranged for reasons of taste, health, culture/religious preferences and diabetic meals are being prepared at the current time. Menus were on display in the dining rooms for residents to refer to in order to make their meal choices and residents are currently involved in the planning of the summer menu. Menus identified a variety of meals to meet any taste, for example traditional roast meals and spicy dishes. Take away meals are purchased and buffet teas are arranged in order for residents to experience a variety of foods. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 18 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 & 21 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Systems used for care planning are generally good and care provided to residents ensures that their physical and emotional health and well- being are promoted. Residents receive their medication in a safe manner at the times they require. Residents are encouraged and supported to lead healthy lives. EVIDENCE: All residents living at The Poplars had done so for a long period of time and as a consequence of this, a number of residents were now over sixty- five years of age. A number of these people were experiencing difficulties with reduced mobility and frailty. It was evident that the staff team had been proactive and had sought the support of the multi disciplinary team in order to reassess whether The Poplars were still able to meet their care needs. A personal support plan had been written about each resident and this included detail of the specific support required by staff in order to meet residents’ individual needs and the wishes of residents in respect of this. A health plan had been written regarding the support required by staff to manage diabetes, however a health plan had not been written about the support required by staff Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 19 in respect of a resident living at the Home who had epilepsy. This may prevent the staff from acting competently and effectively in the event of a seizure. Staff stated that they were aware of any preferences residents may have regarding the gender of staff member assisting with personal care however a written record of this was not kept. Care reviews were held regularly involving residents, their families, the key worker and social worker so that everybody had an opportunity to discuss the care and support being provided and put forward any suggestions for improvements if required. Residents had access to Health Care Professionals, for example community nurses, clinical psychologists, dieticians, opticians, dentists, physiotherapists and general practitioners. It was pleasing that staff support residents to attend medical appointments rather than being visited at the Home as this promotes their life skills. One resident was recently diagnosed as having a hearing impairment and a hearing aid had been obtained for this person. Staff supported her to wear this on a daily basis to ensure that her hearing was adequate. A number of residents wore reading glasses and staff support these people in ensuring that their eyesight is checked regularly. One resident was under the care of the community dietician and was currently trying to lose weight. The resident spoke to me about the types of food that she liked to eat and the Registered Manager stated that all people involved in her care both within and outside of the Home were aware that she was following a weight loss programme so that they could support her with this. A fitness programme had been developed specifically for this person by a physiotherapist and she expressed her satisfaction about this. The menu choice records identified that this person had chosen a variety of meals, some of which were not always considered to be a healthy choice for example southern fried chicken, fish and chips and apple crumble and custard. The Registered Manager stated that smaller portions of these are served so that she could have the foods that she enjoyed and healthier options at other times were served, for example fruit, vegetables and yoghurts. She visits a dietetic “drop in” centre on a monthly basis to be weighed and staff provide support to encourage her regarding this. Comprehensive behaviour plans and recording charts had been written and this include good detail of the management techniques/support require by staff in this area and staff had a good knowledge about the content of these. For example, on the day of the visit a resident became distressed as a result of another resident moving out of the Home. Staff members provided support to this person in an appropriate and timely fashion in order to ease his distress. Most residents were aware of the timings of their medication and the number of tablets that they were prescribed and none of the residents had been assessed as being able to self administer their own. Residents were encouraged to come to the care office to collect their medication as this Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 20 promoted their independence. There were good systems in place for the management of medication including controlled medication and there was good information available for staff and residents about the types of medication being administered. Medication administration charts were well maintained and general practitioner (GP) consent had been obtain in respect of the administration of homely remedies. Staff responsible for the administration of medication had received appropriate training so that they could administer this in a safe manner. Regular medication audits are undertaken to monitor for staff competence in this area and medication reviews are undertaken regularly so that the effectiveness of treatments prescribed are monitored. Audit trails of medicines sampled during the visit were found to be accurate. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 21 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): 22 & 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are confident that any issues they may raise will be listened to and acted upon so that they are safeguarded from harm. On a small number of occasions, inappropriate staff approach, poor attitude towards residents and lack of support will result in negative outcomes for the people using the service. EVIDENCE: Since the last field work visit CSCI had received two concerns and these were pertaining to poor staff attitude and approach to residents on a small number of occasions that had resulted in negative outcomes for a number of residents living at the Home. These were brought to the attention of the Team Manager and addressed accordingly in order to promote the choice and dignity of residents. In addition, there was one complaint recorded in the complaints register regarding a pest control problem within the garden of the property next door to the Home as a result of debris being left in the garden of The Poplars. Appropriate action was taken by the management team in order to address the issue in a timely manner to the satisfaction of the complainant and rectify the problem. There had been no further causes for concern regarding this problem. The complaints procedure was on display in the reception area of the Home and in the visitors’ room and this could be made available in a large print or alternative language format on request. In addition each resident had recently each been given a leaflet “Your right to be heard” explaining how they could Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 22 make a complaint should the need arise. Residents stated that they were familiar with this if they had any issues to raise. The adult protection policy had been updated recently and this included local multi agency guidelines, contact numbers and a “whistle blowing” policy. This should ensure that staff have the confidence and knowledge to notify all relevant people in the event of alleged or actual abuse so that residents are protected. In addition to this, the majority of staff had undertaken training about the protection of vulnerable adults and training was scheduled for any staff yet to receive this in the near future. Policies and procedures for the management of residents’ money was good and residents confirmed that they were encouraged to choose their own items purchased out of their money and this promotes their independence and choice. Receipts were available as confirmation of purchases and this safeguards residents. Staff support residents to manage and budget their own finances and this includes trips to the bank and shops. Written consent had been obtain from residents confirming that they were happy for staff support in this area. A facility for the safekeeping of small amounts of residents’ money was provided and this was audited each week in order to identify any inaccuracies. The written records in respect of these were good and the balances of money sampled on the day of the visit was found to be correct. During the visit one resident stated that she did not like a pair of shoes that had been bought for her by staff members, her ankle was blistered as a result of wearing these and the style of the shoes was not considered to be age appropriate. The Registered Manager and care worker confirmed that this was not the case and the resident had been involved in choosing the shoes. We would, however, recommend that she should have had guidance from the staff members in choosing an appropriate and comfortable style. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 23 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, 25, 27 & 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents are provided with a clean and generally comfortable living environment in which they feel safe and relaxed. Facilities, aids and adaptations provided do not meet the needs of all residents living at the Home and limits the choice, privacy and freedom of a number of people living there. EVIDENCE: The internal environment of the Home was found to be clean, fresh and of a comfortable temperature for the time of year and was decorated in a homely style. Although no final decisions have been made regarding the future of The Poplars and it had been agreed that some areas of the Home were no longer fit for purpose with regard to layout and facilities provided, remedial action had been undertaken regarding some areas of the premises since the last visit. All external windows and pipe work had been repainted so that residents were provided with a more attractive place in which to live and two fire doors had been replaced in order to safeguard both residents and staff. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 24 Two bathrooms had been fully refitted to a good standard with domestic style baths and a walk in shower, a communal toilet had been refitted and other toilets had been redecorated. This should enhance the comfort of residents when using these facilities, however it was identified that one resident was no longer able to use the domestic style bath due to older age and frailty. Other aids and adaptations provided included grab rails near to toilets and baths and hand rails in the corridors and on the stairs. The building is not designed to accommodate wheel chair users and people requiring a hoist, however one resident uses a walking aid. The Home does not have a passenger or stair lift therefore this would restrict the freedom of people with impaired mobility. The Home was generally well decorated, in a homely style however a number of carpets were worn or stained throughout. Plaster was damaged on the ceiling in the corridor between the two houses and this may be a health and safety risk for residents and staff. Residents’ bedrooms contained personal items and were decorated in appropriate styles that reflected the age, gender, interests and culture of individual residents. One resident had recently had new furniture in her bedroom and said “ I have chosen all my new furniture”. Another resident said “I love my photographs, they give me good memories”. Call bell facilities were not provided in residents’ bedrooms however an intercom system had recently been purchased so that one older resident could call for assistance whilst in her bedroom. Residents had a choice of lounges and dining areas and a large screen television had recently been purchased for the main lounge. Residents expressed their satisfaction about this. The lounges were decorated in homely styles so that residents felt comfortable in these areas. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 25 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): 31, 32, 33, 34, 35 & 36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are generally supported by an adequate number of appropriately recruited and trained staff so that they receive support in a competent and safe manner. EVIDENCE: All residents and staff met during the visit expressed their satisfaction about the current staffing levels. Sleep- in managerial support is provided every night so that the person in charge of the shift can seek their advice if needed. One staff member said “ We work as a team, when I first came here the Manager and staff were very supportive”. Staff turnover is low and agency staff are not used ensuring continuity of care for residents. The Registered Manager stated that due to the reduction in occupancy she is not recruiting new workers at the current time. One resident said “ I like all of the staff here”. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 26 Staffing rotas identified that there were four staff on duty including a senior staff member on duty during the afternoon of the visit and two waking night staff with sleep in support. Housekeeping and kitchen staff provided ancillary support to the care staff on duty so that all of the residents’ needs were being met. Staff had a good understanding of residents’ individual support needs and it was evident that the staff were enthusiastic about their job roles and generally a good rapport had built up between residents and staff. Residents stated that they felt comfortable with the staff team and that they felt well supported by them. On the day of the visit a number of residents were welcomed in to the main office if they wished to have a chat to the staff that were in there at that time and this illustrates that they feel confident and included within their home environment. One resident said “ I like the staff, we have a laugh and a joke”. English was the first language of all residents living at the Home. The gender and culture mix of staff generally reflected the gender and culture mix of residents so that staff provided support in an understanding manner. Since the last visit to the Home there had not been any new workers at the Home and all existing staff were deemed as safe to work with vulnerable adults. There were no areas of concern regarding staff recruitment during the last visit to the Home. The most recent person who had commenced employment at the Home had undertaken a comprehensive in–house induction programme and was due to commence the NVQ Level 2 qualification so that they had the appropriate knowledge to provide a good standard of care for residents. In addition staff have the opportunity to train towards completing the Learning disability Award Framework, (LDAF) so that they have the skills and knowledge to work with residents. There was an abundance of staff training on offer and staff had undertaken recent training about fire safety, first aid, challenging behaviour, nutrition, communication and dementia awareness. All staff were working towards a comprehensive award about health and safety issues so that they have the appropriate knowledge to work in a safe manner. Training about moving and handling, autism, epilepsy and managing aggression are planned for the near future. A fire drill had been undertaken recently and the outcome of this was good. This ensures that residents and staff act appropriately and safely in the event of a fire. Over 50 of the care staff team had achieved NVQ level 2 in care so that they had the appropriate knowledge to provide a good standard of care and support to residents. A number of staff had achieved NVQ level 3 other staff members were working towards this. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 27 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, 39 & 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. This service is generally run in the best interests of residents living there and their views are listened to. Residents live in an environment in which their health and safety is protected. EVIDENCE: The Registered Manager has been in post for four years and predominantly positive comments have been received about her management style during this time. One staff member said “ It is very relaxed and happy here, I get very good support from my Manager”. There were clear lines of accountability amongst the staff team including external managers, in- house managers, senior staff, key workers and ancillary staff. Handover/staff allocation records were used and this ensured that all staff members were aware of their responsibilities during the shift. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 28 Quality monitoring visits are undertaken by external Senior Managers each month and this involves consulting with the residents about their daily lives at the Home. The reports of the findings of these were however, not available on the day of the visit and must be provided for review. Service satisfaction questionnaires had recently been distributed to residents in order to obtain their views about the service provided at The Poplars. The feedback from these was positive identifying that residents were contented with their lives at the Home. A comprehensive quality assurance programme is due to be implemented at the Home. Staff meetings are held regularly and this ensures that staff are informed about for example training opportunities, revised policies and procedures, health and safety and resident support issues. Accident records were well maintained and identified that there were few accidents involving residents living at the Home. Regular health and safety checks of equipment are undertaken to ensure that they are safe to use, for example the fire alarm system and emergency lighting. A comprehensive fire risk assessment had been undertaken regularly and staff were familiar with this so that they had the appropriate knowledge to work in a safe manner. The office door had been wedged open and this will result in the spread of fire in the event of an emergency. A risk assessment must be undertaken in respect of this so that residents are safeguarded. Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 29 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 3 4 3 5 2 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 2 25 3 26 x 27 2 28 x 29 x 30 3 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 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 3 3 3 3 2 x x 2 x Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 30 Are there any outstanding requirements from the last inspection? Yes, regarding the living environment 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 YA19 Regulation 12(1)(a) Requirement Health plans must be written for any medical conditions that residents may have and be available for staff to refer to in the event of a medical emergency so that their health and well-being is protected. Residents must be addressed and supported in a way that promotes their dignity and choice at all times. The ceiling in the corridor between the two houses must be repaired in order to safeguard residents. Carpets in some areas of the Home must be cleaned or replaced. (This requirement was made during a previous visit to the service. Timescale had not elapsed). Timescale for action 15/07/07 2 YA23 12(4)(a) 30/06/07 3 YA24 23(2)(b) 15/07/07 4 YA24 23(2)(d) 01/06/07 Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 31 5 YA27 23(2)(n) Assisted bathing facilities must be provided that meets the needs of all residents living at the Home. (This requirement was made during a previous visit to the service. Time scale had not elapsed) 01/09/07 6 YA42 23(4)(a) Fire doors must not be wedged open unless by suitable means that would be activated in the event of a fire. A risk assessment must be undertaken about this in order to safeguard residents. 30/06/07 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 YA5 YA18 Good Practice Recommendations All residents should have a contract of terms and condition of residency. A written record of any preferences that individual residents may have regarding the gender of staff member assisting with their personal care needs should be maintained so that residents wishes regarding this are respected. Staff should provide support to residents whilst purchasing clothing to ensure that it fits well and is of an age appropriate style in order to uphold the dignity and comfort of residents. Reports of the findings of quality monitoring visits undertaken by external senior managers should be available as evidence of residents’ involvement and areas audited during these visits. DS0000033636.V336310.R01.S.doc Version 5.2 Page 32 3 YA23 4 YA39 Poplars, The 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 Poplars, The DS0000033636.V336310.R01.S.doc Version 5.2 Page 33 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!