Inspection on 15/02/09 for Wells Road Care Home

This inspection was carried out on 15th February 2009.

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

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

Wells Road Care Home 19/03/08

Wells Road Care Home 05/09/07

Wells Road Care Home 11/04/07

Wells Road Care Home 20/04/06

Wells Road Care Home 15/02/06

Wells Road Care Home 21/03/05

Wells Road Care Home 29/03/04

Wells Road Care Home 10/11/03

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Wells Road Care Home 280-282 Wells Road St Anns Nottingham NG3 3AA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alison Hilton     Date: 1 6 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Wells Road Care Home 280-282 Wells Road St Anns Nottingham NG3 3AA 01159338214 01159502066 mvickis@ncha.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Nottingham Community Housing Association care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Service users shall be within category LD Date of last inspection Brief description of the care home 6 Wells Road Care Home is situated in the residential area of St Anns, close to shops and amenities and is registered to provide accommodation and support for up to six adults with a learning disability. The home itself is comprised of a pair of semidetached houses joined together and the accommodation consists of communal lounge, dining room and kitchen on the ground floor and six single bedrooms with shared bathing facilities on the upper floor. There is currently one vacancy. The home has enclosed front and rear gardens accessible to people who use the service. The registered provider is Nottingham Community Housing Association. Deatils of the current fees are available from the home. Items such as clothing, magazines and hairdressing are not included. This information is in the Statement of Purpose, which is made available to prospective service users along with other relevant information about the service upon request. Care Homes for Adults (18-65 years) Page 4 of 26 Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We, the Commission for Social Care Inspection (CSCI) carried out a key unannounced inspection at Wells Road Care Home on Sunday 15th February and Monday 16th February 2009 using the Commissions methodology described below. This report makes judgements about the service based on the evidence we have gathered. Staff, people who live at the home and the manager were spoken to. An Annual Quality Assurance Assessment (AQAA) was completed and returned to the Commission prior to this inspection. Surveys were sent to care workers, people living in the home and other professionals. Information they provided will be in the body of the report. A number of records were seen, together with three personnel files and two files of Care Homes for Adults (18-65 years) Page 6 of 26 people living in the home. There were five people resident at the home during the inspection and one bed was vacant. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –03000 616161. Care Homes for Adults (18-65 years) Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have information provided in a format that is suitable for their abilities, and are admitted only if the staff are confident they can meet their needs. Evidence: The contract is provided using signs and symbols and the manager said staff explain things again in language the people who use the service will undertsand. There were notices using simple words and symbols about things such as how to make a complaint. There were copies of these on files. There have been no new admissions so it was not possible to check if people visited before placement, but the manager stated in the AQAA that this would always be arranged to ensure the person had the information necessary to make a decision about living at Wells Road. Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are involved in the planning of their care so that their needs and choices are at the centre of the plans. Evidence: The manager said that independent advocates will only act on behalf of those without family members (as they are usually the people to do it for them), or if there is an issue with the family taking on that role. There is also an issue that they will only undertake specific pieces of work that are time limited. One person in the home has had the same advocate on several occasions so there has been some continuity. The manager said that when the next annual review is due the advocate would be contacted to ensure the voice of the person living in the home was heard. There was evidence of contact and input of the advocate on file. Care plans are kept on the computer in a system used by all homes in the Nottingham Community Housing Association (NCHA) organisation, with paper copies kept securely Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: in the office. On the first visit to the home the system was not working and daily notes had to be written by hand in a log book. The details in the care plans seen showed all aspects of care had been thought about. For example where challenging behaviour was an issue specific details of how to minimise distress and ensure the safety of all people was shown. During the inspection it was evident that staff knew how to met the needs of those living in the home in a very positive and caring way. No-one was hurried or spoken to in anything but a courteous and pleasant manner. Both new and long term staff were aware of the care plans and what they contained, actions were observed and these linked to the care plans seen. The home has risk assessments in place where necessary Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are involved in a variety of activities arranged in consultation with and on behalf of them. Evidence: Surveys returned by two care managers showed they felt the home needed to improve and provide appropriate level of daytime activities and community trips for those using the service. People who live at Wells Road have the opportunity to take part in activities inside and outside the home. Staff said that during the week four of the five people living there attended day centres. The other person had a timetable of activities discussed with her and used Monday to Friday and included music therapy, walks to the local shops, and she completes some weekly health and safety checks within the home. There is a form Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: she has to fill in and sign to say that the areas are OK. Staff commented that she is a stickler and reports any faults such as lights not working. Staff said that weekends were less organised and on the Sunday of the inspection one person was on a home visit and due back that evening, one person was in her bedroom (information about this was discussed with staff) and three people were in the lounge/kitchen/garden areas of the home. One staff member was cooking tea and ensuring people remained safe, the other assisted one person to shower and then was also around the home. One person showed us some drawings she had done earlier in the day, one took us outside to wave to people going by and then showed us his personal photograph album and another talked to us and looked at our identification badge. People were encouraged to make their own drinks (under supervision). One person was watching the television but the picture quality was poor and staff said this was being looked into. People in the home go on holiday and photos were shown to the inspector by them. Staff said choices were given and the person chose where they wanted to go. One person had been to Greece last year whilst others go the the coast in the UK. There are currently only three staff who have permission to drive the car owned by the home and this makes trips out difficult to arrange. Also more staff must be on duty at those times as the home cannot be left unstaffed when not everyone goes on the trip. The manager said that one person is booked for the driving test that has to be completed before anyone can drive the car and two are completing the necessary forms. Meetings for those who live in the home are encouraged and arranged the last being 30/11/08 when all those living in the home attended. Paper, pens, crayons, signs and symbols are provided by staff so that people can express their views in a variety of ways. Staff do put together the minutes in picture and word format to ensure a record is kept. The manager said there had been a more recent meeting but the minutes had not been completed. The homes theme nights had been discussed and a Chinese night and Jamaican night have been planned. The staff keep photographic records of trips and activities and this proved a great talking point during the inspection. People choose what is on the menu and this was pork, roast potatoes and steamed vegetables Sunday teatime. Staff told us how they provided choices to different people living in the home and these were appropriate for the individuals. Care Homes for Adults (18-65 years) Page 14 of 26 Care Homes for Adults (18-65 years) Page 15 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Medication is administered,recorded and checked to ensure people living in the home are kept safe. Evidence: Staff said they are fully trained in administering medication and there are detailed notes in each persons file that shows exactly how they like to take the medication, what it is and any side effects it may have. The medical administration record (MAR) sheets were seen and had been completed. Staff said that one of the daily checks is about recording meds adminstration and indicating any reasons for ommissions. There was evidence on file that where people had not taken their medication the reason was specified e.g. spat it out. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure is written in a format that people in the home will understand and use. Evidence: Details of the complaints process is in picture format and copies are in bedrooms and in the dining area of the home. There has been one complaint by a person living at the home about another person there. The details were in picture format and on file and the outcome agreed by the complainant. There has been one strategy meeting about an incident between two people living in the home and all the necessary details were provided. A Regulation 37 form had been completed in relation to this incident. There have been no complaints recevied by the Commission. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Furniture is replaced quickly so that people cannot injure themselves. Evidence: There was no evidence of broken furniture in the home during this inspection. There was one broken chest of drawers in the garden waiting to be collected by the bin men. The manager said that the housing association is providing more robust furniture due to the level of breakages in the past. There are paper towels available for people to dry their hands after using the toilet. The home was clean and there were no offensive odours. There are currently no arrangements for sluicing as no-one needs that facility. The manager stated that the Association is intending to update the laundry area and provide new machines that will have that facility as standard. Details in the AQAA showed that bedrooms had been personalised and some areas redecorated. The garden is being worked on to create a sensory area and another to plant vegetables. Staff and people who live there are getting involved and the manager hopes this will move forward once the better weather arrives. Staff said they Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: were keen to grow things with help from those living there. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff receive specialist training that helps them meet the needs of people living in the home. Evidence: Three surveys were returned by health professionals and they indicated a concern at the changes of staff and use of agency staff meaning lifestyle choices cannot be made and staff turnover affects the skill mix and experience of the staff group. The manager and other staff seen during the inspection said that there have been new staff taken on which has stabilised the group and agency staff are not used. Although some new staff do not have direct experience of dealing with people with behavioural problems it was evident they had completed courses and were aware of the needs of people and how to meet them in a safe and caring way. The manager stated that staff remain supernumerary until she deems them competent. It does concern the Commission that the manager does not directly interview staff who are to work in her home; since the issues for the group of people who live there are considerable and specialised. The personnel records for staff are kept at the human resources of the Nottingham Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: Community Housing Association. Three staff files were seen and they contained basic details and showed that people had undertaken an induction and this was confirmed with staff spoken to during the inspection. Staff said courses were available in challenging behaviour, medication administration and the manager confirmed staff attended courses. Records were seen and five staff are to complete a challenging behaviour course, three to complete the homes computer course, one First Aid and the manager the manual handling course. There are two staff on duty during the day and evening; and one waking and one sleeping staff at night. The rotas were seen and they reflected this ratio. The manager was reminded that the rota should include a workers surname and that where corrections have been made they should just be crossed through but remain legible. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The reporting of incidents has improved to ensure the protection of people living in the home. Evidence: The manager has NVQ Level 4 Registered Managers Award. The manager has been sending Regulation 37 reports through of incidents that have occured in the home. This means the requirment from the last inspection has been met. There was an assistant manager on site on the second day of our visit. Staff said they received supervision and there were records to evidence this in the office. The two staff surveys returned showed that they felt supported and that lines of communication between staff, service users, manager and health professionals are open and fluid enabling staff to meet needs and fulfill the wishes of residents. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: The fire alarm has been activited twice since the last inspection, once by someone in the home and the other by toast burning. The manager must ensure a record of those in the home at the time of any fire drill is kept so that it can be seen that all staff have taken part. The manager said that night staff also work days and have taken part in drills. Other required checks have been completed and records seen. The quality assurance system includes Regulation 26 visits but we were unable to see copies as they were at head office, surveys to families, staff and service users. The information is gathered and the findings are taken to staff and service user meetings to discuss where improvements are to be made and how to go about it. A copy of the January 2009 report was seen. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!