Inspection on 09/02/06 for Wheelwright Road, 76-78

This inspection was carried out on 9th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Wheelwright Road, 76-78 27/11/08

Wheelwright Road, 76-78 03/07/07

Wheelwright Road, 76-78 15/11/06

Wheelwright Road, 76-78 31/08/05

Wheelwright Road, 76-78 07/02/05

Wheelwright Road, 76-78 02/03/04

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

CARE HOME ADULTS 18-65 Wheelwright Road, 76-78 Erdington Birmingham West Midlands B24 8PD Lead Inspector Sarah Bennett Unannounced Inspection 9th February 2006 13:00 Wheelwright Road, 76-78 DS0000016717.V283283.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 Wheelwright Road, 76-78 DS0000016717.V283283.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. Wheelwright Road, 76-78 DS0000016717.V283283.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Wheelwright Road, 76-78 Address Erdington Birmingham West Midlands B24 8PD 0121 382 1566 0121 686 6601 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) Mrs Ann Marie Lyttle Mrs Ann Marie Lyttle Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Wheelwright Road, 76-78 DS0000016717.V283283.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Residents must be aged under 65 years Mrs Lyttle must ensure that Mr Adrian Lyttle takes no part in the day to day operation and management of the home Mrs Lyttle must satisfy the CSCI that an appropriate mechanism exists for completion of the day-to-day manager’s records of the home Mrs Lyttle must obtain NVQ level 4 in management and care at the earliest opportunity and in any event before 2005 31st August 2005 Date of last inspection Brief Description of the Service: 76 - 78 Wheelwright Road is an adapted domestic property situated in a residential area of Erdington. The two homes were previously registered separately but are now registered as one home, operated by the same owner. The home accommodates ten residents who have a learning disability in single and shared bedrooms on the ground, first and second floors. Bathrooms and toilets are available on all first and second floors and a separate toilet is provided on the ground floor in 78. Communal areas include a lounge and kitchen/dining room in each property. A separate office and a smoking room/conservatory are provided on the ground floor in 78. To the rear of the home is a pleasant garden and patio area. The home has a vehicle for transporting residents. Wheelwright Road, 76-78 DS0000016717.V283283.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 in one afternoon. Six residents, the Manager and Deputy Manager and the staff on duty were spoken to. A partial tour of the premises took place. Care, staff 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 August 2005. What the service does well: What has improved since the last inspection? Each resident has a manual handling risk assessment so that it is clear what support from staff each resident need with their mobility. Guidelines are in place for all as required medication so that staff know when this should be given to the individual. There is a new carpet on the first floor landing in number 78 and a hazard strip has been put on the step so that this can be seen easily. The toilet seat in number 76 that was worn has been replaced. One member of staff has had training in autism so that they can understand the needs of residents better. Training for all staff in this has been planned. Wheelwright Road, 76-78 DS0000016717.V283283.R01.S.doc Version 5.1 Page 6 The gas safety record is now kept in the home so it is clear that the gas equipment is safe to use. 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. Wheelwright Road, 76-78 DS0000016717.V283283.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 Wheelwright Road, 76-78 DS0000016717.V283283.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed. There have been no new residents admitted in the last year. EVIDENCE: Wheelwright Road, 76-78 DS0000016717.V283283.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): 7, 9 The arrangements for supporting residents to make decisions are not adequate. Adequate arrangements are in place to ensure that residents are supported to take risks within a risk assessment framework. EVIDENCE: Care plans were looked at during the last inspection and the standard was met. There have been no changes to the format of care plans since the last inspection and the Deputy Manager said that reviews are planned with residents, their relatives and other professionals where appropriate. The home has a vehicle that residents contribute some money to each month. Most residents contribute £10 and one resident contributes £20. A requirement was made at the last inspection for individual agreements to be in place for each resident stating what they contribute. The resident or their representative where appropriate must sign these. The Deputy Manager said that these are being set up at present. Resident’s records sampled included individual risk assessments. These were detailed and covered all the risks to the individual. Wheelwright Road, 76-78 DS0000016717.V283283.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 16, 17 Adequate arrangements are in place so that people living at the home experience a meaningful lifestyle. Residents are offered a healthy diet and enjoy their meals. EVIDENCE: Most of the residents go to the day centre or to college from Monday to Friday. Two of the residents travel independently to a drama group. One resident’s needs have changed and they no longer go to the day centre. They go to a local hydrotherapy pool and to a sensory room with staff. Some residents were going to a club in the evening. Some residents do not enjoy going to the club and staff said that they might go to the supermarket if they want to, to do some shopping and have a drink. Residents said that they are going to celebrate one of the resident’s birthdays at the weekend by having a party. Residents said that they take turns to do the washing up and setting the table and a rota is displayed in each kitchen stating this. Two residents were helping a member of staff to cook the tea. Residents spoken to knew who their key worker was and said that they helped them. Wheelwright Road, 76-78 DS0000016717.V283283.R01.S.doc Version 5.1 Page 11 Picture cards are used so that residents can choose what they want on the menu. There are two kitchens, one in 76 and one in 78. The menu was different in each kitchen. Residents in each house knew what they were having for tea and said that they had chosen this. Residents said that they prepare their own lunch and as they are trying to lose weight they sometimes make a salad and take fruit instead of chocolate. Fresh fruit and vegetables were available in each kitchen. One resident’s food diary was sampled and this included details of when the resident was given Build –Up drinks following the advice of the Dietician. Fluid intake records are also kept for this resident as recommended by the health professionals involved in their care. Wheelwright Road, 76-78 DS0000016717.V283283.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Residents receive personal support in the way they prefer and require. The health needs of residents is generally well met but developing individual Health Action Plans will help to ensure that this continues. Generally, the management of the medication protects residents from harm. EVIDENCE: Manual handling risk assessments have been completed for all residents so it is clear what support each person needs from staff with their mobility. None of the residents need to be moved using a hoist. Staff were observed appropriately supporting residents to move around the home. Residents were well dressed and their dress was appropriate to their age, the weather and the activities they were doing. Where appropriate health professionals are involved in the care of residents. These include Community Nurses, Psychiatrist, Dietician, Continence Nurse, Occupational Therapist, Psychologist and Speech and Language Therapist. One resident has a Health Action Plan, which their Community Nurse developed with them and the staff. The Deputy Manager said that they will use this template to develop them for all the residents and will use pictures so the residents will be able to understand them. All residents have health checks at the GP every six months. Wheelwright Road, 76-78 DS0000016717.V283283.R01.S.doc Version 5.1 Page 13 Residents are weighed monthly and a record of this is kept so it can be monitored. Medication is stored and administered in number 76 & 78 so that it is easily accessible to where resident’s bedrooms are situated. The medication administration and storage was looked at in number 78 only. All Medication Administration Records (MAR) had been signed for appropriately. Protocols are in place for all residents that are prescribed PRN (as required) medication stating when and why this should be given. Creams prescribed for residents had been dated when they were opened. One resident is prescribed antibiotics during the winter months, as they are prone to chest infections. The label on the antibiotics stated that they should be kept in a refrigerator. The cabinet seemed quite cool but there was not a thermometer to check the temperature. The Deputy Manager was advised to check the temperature of the cabinet, if it is the same as the fridge they can continue to keep the antibiotics in there. If it is too warm they must be kept in the fridge. Wheelwright Road, 76-78 DS0000016717.V283283.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Producing the complaints procedure in a format that is accessible to the residents will help to ensure that their views are listened to and acted on. Adequate arrangements are in place so that residents are protected from abuse and neglect. EVIDENCE: The Manager said that there have been no complaints since the last inspection. The CSCI have not received any complaints about this home. A recommendation was made at the last inspection that the complaints procedure be produced in a format that the residents would be able to understand. This has not yet been done but the Deputy Manager is looking at computer software that could be used for this. Staff records sampled included evidence that Criminal Records Bureau checks have been undertaken and references received for all staff prior to them starting work at the home. Since the last inspection staff have received training in the prevention of abuse. Wheelwright Road, 76-78 DS0000016717.V283283.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Generally adequate arrangements are in place so that residents live in a homely, clean, comfortable and safe environment that meets their individual needs. EVIDENCE: The home is decorated and maintained to a good standard. The carpet has been replaced on the first floor landing in number 78. A hazard strip has been fitted to the step so it is clear where the step is. The frames of the chairs in the lounge in number 78 were worn. The Deputy manager said these would be re- varnished when the residents are on holiday in June so that the fumes of the varnish do not affect them. The chairs have been reupholstered. The home was clean and free from offensive odours. In number 78 there is a small conservatory where staff can smoke. Staff said that this room is cleaned regularly to prevent odour. The room was free from the odour of smoke. The home was warm despite it being a cold day. Wheelwright Road, 76-78 DS0000016717.V283283.R01.S.doc Version 5.1 Page 16 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, 34, 35 An effective staff team supports residents. Staff receive the appropriate training and support to meet the needs of individual residents and protect them from harm. EVIDENCE: The Manager said that four members of staff have NVQ level 3 in Care. The Deputy Manager and Senior Care staff have recently completed NVQ level 4. One member of staff is doing NVQ level 2, the rest of the staff with the exception of two new staff and one other have level 2. Over 50 of the staff has NVQ level 2 or above, which meets this standard. Two members of staff have left since the last inspection and one member of staff has been dismissed. All three members of staff have been replaced so there are no staff vacancies. New staff that have started working at the home spend some time ‘shadowing’ other staff before they work alone with the residents. Staff records sampled included all the required recruitment records including a Criminal Records Bureau check. The potential new staff visit the home for two evenings to meet the residents. This gives the residents an opportunity to give their opinion on whether they think the staff are suitable to work with them. Wheelwright Road, 76-78 DS0000016717.V283283.R01.S.doc Version 5.1 Page 17 One member of staff is pregnant. A risk assessment for them was seen and it included all the required information to ensure that they were safe whilst working at the home during their pregnancy. The Manager said that the member of staff had completed the risk assessment to ensure that all the risks were covered. Staff have received training in dementia and communication provided by the Speech and Language Therapist. This will help them to meet the needs of individual residents. Staff said that they had found this training useful in meeting the needs of one resident. Wheelwright Road, 76-78 DS0000016717.V283283.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 A new application for registered manager must be made to ensure that residents continue to benefit from a well run home. Resident’s views do not underpin all self-monitoring, review and development by the home. Adequate arrangements are in place to ensure that the health, safety and welfare of residents are promoted and protected. EVIDENCE: A condition of the Owner/Manager’s registration is that she completes NVQ Level 4 in management and care. This condition has not been met however they have applied to the CSCI for a variation to extend the timescale on this condition. The Deputy Manager and a senior care staff have completed NVQ level 4 and are awaiting certificates. They support the Owner/Manager with the management of the home on a day-to-day basis. Therefore, a registered manager application can be made to the CSCI for one of these members of staff. Wheelwright Road, 76-78 DS0000016717.V283283.R01.S.doc Version 5.1 Page 19 The service has achieved the ‘Investors in People’ standard. A strategy is in place that looks at how they are going to improve the organisation, the learning and development of staff and equal opportunities. A development plan is in place. The Deputy Manager said that at resident’s annual reviews comment cards are given to resident’s relatives. Staff are asked their opinion of the service during their annual appraisal. Resident’s views on the service are not currently sought. The Deputy Manager said that they hope to develop a questionnaire in a picture format that residents will be able to complete. Residents are asked their views about the staff before they are employed to work at the home. Fire records showed that staff test the emergency lighting and alarm regularly to make sure that they are working properly. Regular fire drills are held to make sure that all residents and staff know what to do if there is a fire. An engineer regularly services the fire equipment. The Deputy Manager said that a Fire Officer visited in October 2005 and said that the fire risk assessment was satisfactory. However, due to changes in fire regulations they have requested that a Fire Officer visit to ensure that they are meeting the updated Regulations. A Corgi registered engineer tested the gas equipment in April 2005 and stated that it was in a satisfactory condition. Wheelwright Road, 76-78 DS0000016717.V283283.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 2 X 2 X X 3 X Wheelwright Road, 76-78 DS0000016717.V283283.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA7 Regulation Requirement Timescale for action 31/03/06 2. YA19 3. YA20 4. 5. 6. 7. YA24 YA35 YA37 YA39 12(1)(a)(3) An agreement must be in place for residents contributions to the homes vehicle. The resident or their representative must sign this. Previous timescale of 30/11/05 not met. 12(1)(a) Each resident must have a Health Action Plan in line with ‘Valuing People’. Previous timescale of 31/12/05 not met. 13 (2) Antibiotics prescribed for residents must be kept in a cool place as per the instructions on the bottle. 23 (2)(b) The lounge chair frames in number 78 must be revarnished. 18(1)(a,c) Staff must receive training in autism. 8(1)(b)(ii) A new application for registered manager must be made to the CSCI. 24 (3) Resident’s views of the service must be sought as part of the quality assurance system. 31/05/06 09/02/06 30/06/06 30/06/06 31/03/06 31/05/06 Wheelwright Road, 76-78 DS0000016717.V283283.R01.S.doc Version 5.1 Page 22 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. Refer to Standard YA22 Good Practice Recommendations The complaints procedure should be produced in an accessible format to all residents. Wheelwright Road, 76-78 DS0000016717.V283283.R01.S.doc Version 5.1 Page 23 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 Wheelwright Road, 76-78 DS0000016717.V283283.R01.S.doc Version 5.1 Page 24 - 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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