Care Home: 120 Lichfield Road

Similar services:

• Polesworth Group Friary Road
• Polesworth Group Pooley Heights
• Polesworth Group 32 Station Road
• Polesworth Group 70 Long Street
• Polesworth Group 64 Long Street
• Polesworth Group 68 Long Street
• Westmead
• 1a White Ladies Close

What the care home does well We found that 120 Lichfield Road is very comfortable and clean. People told us they are happy with their home, and the way it is furnished and decorated. People have been supported by some of the staff for a long time. We could see they had made strong friendships. We know this is important for people to be with staff they know and like. One person said in a survey,"What does the home do well....provides good staff who take careof all my needs" another person said, "Staff listen, are caring and pleasant" People get a chance most days to do things they enjoy. This could include activities out in the community like horse riding or shopping, or being at home and able to watch their favourite TV programmers or doing jigsaws. One person told us, "I have lots of choices in my day-to- day activities, this could improve by planning some day trips" People are supported to see Doctors and specialist health care workers when they need to. Staff can attend with people, and we could see staff recognise when someones needs change. People are helped to stay in touch with their family and friends. Family and friends are welcome to visit the home at any time. One staff member said this was an area the home does particularly well. "Friends and family are welcome here at any time." When new people move into the home they have lots of opportunities to come and visit the home, and see if they like it. People can come for meals and stop overnight. We spoke to a social worker who had recently supported someone move into the home, they said, " There were plenty of chances for the person to meet staff and residents here." What has improved since the last inspection? The home has been decorated in some parts and had some new furniture and equipment. This makes the home more attractive and comfortable. Work has been completed on the garden to ensure people without full mobility can get outside in their wheelchair. What the care home could do better: We found that some health and support needs were not well planned for, or that the plans were not up to date. This doesn`t ensure staff know peoples needs and how they would like or need them to be met. We did not find that medication was well managed. We couldn`t be sure that everyone had always been offered the medicines they need, or that staff had recorded this accurately. We did not see that people had been offered chances to be as involved in the planning of their life and care as they could be. This does not ensure the plans and staff actions are always what the person would want or choose. We found that staff training had not been kept up to date. This meant some staff had not had all the training they needed or it had not been updated to ensure theirknowledge was current. We found staff need more information about the specific needs of the people they support. This will ensure people are supported by well informed, knowledgeable staff. The home has some very experienced staff and some who work on an agency/casual basis. These vacancies need to be recruited to. This will ensure people are supported each day by staff they like and who they know can meet their needs. Both people living at the home and staff commented on this. When asked what the home could do better they said, "Provide more staff", "spend more 11 time with me", "lets have more staff, this would increase opportunities for people" and "Are there enough staff....never" The manager is required to let us know about events in the home. These events had not been reported to us. This means we do not have up to date information on which to base our judgement of the home. Key inspection report Care homes for adults (18-65 years) Name: Address: 120 Lichfield Road 120 Lichfield Road Sutton Coldfield W Midlands B74 2TA The quality rating for this care home is: one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Alison Ridge Date: 0 5 0 5 2 0 1 0 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. They reflect the things that people have said are important to them: 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 Care Homes for Adults (18-65 years) Page 2 of 33 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 mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 33 Information about the care home Name of care home: Address: 120 Lichfield Road 120 Lichfield Road Sutton Coldfield W Midlands B74 2TA Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Maya Parveen Masih Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 4 0 0 1 0 0 care home 5 Real Life Options learning disability mental disorder, excluding learning disability or dementia physical disability Additional conditions: Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 33 A bit about the care home This is a home for up to five people with a Learning Disability. Each person has their own bedroom, and share the bathrooms, kitchen, lounge, laundry and garden. People are supported by staff to do things they like each day. The fees for living at the home are individual to each person and can be obtained direct from the manager. Care Homes for Adults (18-65 years) Page 5 of 33 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: one star adequate 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 Care Homes for Adults (18-65 years) Page 6 of 33 How we did our inspection: This is what the inspector did when they were at the care home One inspector visited 120 Lichfield Road, for one day. The home did not know we were coming. We met and spoke with the people who live at the home. We spoke with staff and looked at the way they supported people. We looked at records about peoples care needs and how these are met, we looked at medication and records about the way they home is run including staffing and health and safety. Before we came out to the home the manager filled in a document called an Annual Quality Assurance Document. (AQAA) This tells us about the home. We also sent out surveys to people who live and work at the home to find out what they think. What the care home does well We found that 120 Lichfield Road is very comfortable and clean. People told us they are happy with their home, and the way it is furnished and decorated. People have been supported by some of the staff for a long time. We could see they had made strong friendships. We know this is important for people to be with staff they know and like. One person said in a survey,What does the home do well....provides good staff who take care Care Homes for Adults (18-65 years) Page 7 of 33 of all my needs another person said, Staff listen, are caring and pleasant People get a chance most days to do things they enjoy. This could include activities out in the community like horse riding or shopping, or being at home and able to watch their favourite TV programmers or doing jigsaws. One person told us, I have lots of choices in my day-to- day activities, this could improve by planning some day trips People are supported to see Doctors and specialist health care workers when they need to. Staff can attend with people, and we could see staff recognise when someones needs change. People are helped to stay in touch with their family and friends. Family and friends are welcome to visit the home at any time. One staff member said this was an area the home does particularly well. Friends and family are welcome here at any time. When new people move into the home they have lots of opportunities to come and visit the home, and see if they like it. People can come for meals and stop overnight. We spoke to a social worker who had recently supported someone move into the home, they said, There were plenty of chances for the person to meet staff and residents here. Care Homes for Adults (18-65 years) Page 8 of 33 What has got better from the last inspection What the care home could do better We found that some health and support needs were not well planned for, or that the plans were not up to date. This doesnt ensure staff know peoples needs and how they would like or need them to be met. We did not find that medication was well managed. We couldnt be sure that everyone had always been offered the medicines they need, or that staff had recorded this accurately. We did not see that people had been offered chances to be as involved in the planning of their life and care as they could be. This does not ensure the plans and staff actions are always what the person would want or choose. We found that staff training had not been kept up to date. This meant some staff had not had all the training they needed or it had not been updated to ensure their Care Homes for Adults (18-65 years) Page 9 of 33 knowledge was current. We found staff need more information about the specific needs of the people they support. This will ensure people are supported by well informed, knowledgeable staff. The home has some very experienced staff and some who work on an agency/casual basis. These vacancies need to be recruited to. This will ensure people are supported each day by staff they like and who they know can meet their needs. Both people living at the home and staff commented on this. When asked what the home could do better they said, Provide more staff, spend more 11 time with me, lets have more staff, this would increase opportunities for people and Are there enough staff....never The manager is required to let us know about events in the home. These events had not been reported to us. This means we do not have up to date information on which to base our judgement of the home. Care Homes for Adults (18-65 years) Page 10 of 33 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Alison Ridge 77 Paradise Circus Queensway Birmingham W Midlands B1 2DT 01216005300 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 - 0870 240 7535. Care Homes for Adults (18-65 years) Page 11 of 33 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 12 of 33 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive the information they need prior to making a decision about moving into the home. Evidence: This is an established home which has recently been taken over by a new provider. Four of the five people living here have been resident for several years so we did not track their experience of moving into the home. One person has recently moved into the home. We spoke with people who have helped the person choose where to live and to move in. They said the person had been offered Lots of tea and overnight visits and had, Plenty of chance to meet staff and other residents here, and that ,We had plenty of information about the home prior to moving in. Staff who supported the person in their former accommodation had provided the home with an assessment. This had lots of information about the persons needs, likes and dislikes. We saw the written assessment completed by the home, and did not find this had been completed in adequate detail to confirm the home could meet this persons needs. We couldnt see any written evidence of how the person had been introduced to existing people living at the home, risks relating to this area checked, or records of the trial visits made prior to being offered a place at 120 Lichfield Road. Care Homes for Adults (18-65 years) Page 13 of 33 Evidence: The home has produced two documents, a Statement of Purpose and a Service User Guide. These are written in ways which are easy to understand and have pictures and symbols which may help people understand them. We found that the arrangements for smoking at the home need to be detailed. 120 Lichfield Road does have a smoke room and the smell of smoke was evident around the home. This needs to be made clear. Each person living at the home has been given a contract. This tells them what Real Life Options will offer them and the rules of living at the home. We thought this document was easy to read and again had pictures to support the words which may help people understand it better. We said the contract should also make clear how much people will have to pay to wards the home vehicle. Care Homes for Adults (18-65 years) Page 14 of 33 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are not always asked about their individual needs and choices. These are not always known or recorded. Evidence: We looked at the needs of two people and how the home meets these, in detail. We call this case tracking. Each of the people we looked at had a plan of care. The staff are in the process of changing and updating the records to those of the new provider. We couldnt see that the people had been involved in the writing of their plans. We found some short term goal sheets. We were not sure how these goals had been agreed on, or who had set them. There was no information on how the person would be supported to reach the goal or how they would know if they had succeeded. Examples included, Have more showers and Cut down smoking, and Have more baths and cut down smoking. This all needs to be reviewed and show clear involvement with the person. People are encouraged to do as much for themselves as they can in the home. We were Care Homes for Adults (18-65 years) Page 15 of 33 Evidence: told by staff that people are supported to undertake light housework, shopping and meal preparation. We found that a meeting is held each week where people are formally asked about how they find life in the home. We could not see how the information collected here was used to develop the service offered. We found some of the entries were personal about an individual, and we said these issues should be discussed privately and not in a big meeting. This doesnt protect peoples dignity. We looked at risk assessments. We found that some risk assessments had been developed and these enable people to undertake activities as safely as possible. We also noticed some risks people take and are exposed to that had not been risk assessed. These included risks regards falling and using safety rails on someones bed, and some behavior which may have an impact on people living and working in the home. Care Homes for Adults (18-65 years) Page 16 of 33 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to live an individual lifestyle. Evidence: The AQAA told us that the home aims to ..provide an Ordinary Lifestyle Approach which aims at enabling service users to lead an independent meaningful and fulfilling life in which privacy is respected and dignity is maintained at all times. We found that people are supported to access the community and to undertake activities in the home that people not living in a care home would also do and enjoy. This is positive. One person told us in a survey that, I have lots of choices in my day to day activities the home could improve by offering full days out, day trips. People told us and care notes showed each person did something they enjoyed each day, and that each person was supported to pursue their own interests. People who live in the home and staff told us alot about activities in the surveys. We found people really enjoy what they do, but most people felt more staff were needed to support this. Comments included, I would like people to spend more one to one time with me. , and Better Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: staffing would increase the activities we could offer We did not always find that peoples privacy and dignity was respected and saw examples of shared documents where personal information had been recorded. The AQAA told us that people are encouraged to keep up contact with their friends and family. Service users are encouraged to maintain family relationships. Family can visit here or service users can go and visit them in their home with staff support if needed. We were told by staff and people living at the home that this is the case. One staff said, We get involved with the clients and support them to see their family-family are always welcome here. We saw that a range of food was available and offered in the home. People are involved in planning and shopping and preparing meals where they are able. People are offered a range of fresh fruit and vegetables. One person we spoke to was pleased at being supported to eat a more healthy diet which had resulted in some weight loss. This had enabled the person to start a hobby they were very interested in. It was positive that specialist advice had been sought where people have specific eating and drinking needs. We could not evidence that all staff had read these guidelines and in one instance the information in the homes plan of care was different to that in the Speech and Language therapy guidelines. This must be consistent to ensure the persons needs are known and met. We could not see that peoples diet was reflective of their individual nutritional needs. We saw that people vary in body size and activity levels. We could not see how this had been reflected in the plan of care and assessments undertaken to establish a healthy body weight. Care Homes for Adults (18-65 years) Page 18 of 33 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health needs are not always known or planned for. Medication is not robustly managed. Evidence: The times for getting up and going to bed are very flexible, and we saw people were not rushed to get up, and were supported with their personal hygiene during the morning, as they were ready. People were supported to wear clothes they like, and which reflected their age, gender and the weather. All the people we met had been supported with their personal care to a high standard. We saw staff sensitively prompt and ask people about their toileting needs. The people who live at 120 Lichfield Road have a wide range of different health care needs. We could see from the records and from speaking with staff that people are supported to see the GP, specialist Doctors and nurses and attend check ups with the dentist and optician. We looked at the records about peoples health and found that these needed some more development. Not all the needs we know people have were supported with a plan, and in some instances where peoples needs had changed the records had not been updated with this information. This does not ensure staff have all the information they need to support people in the way they like or need. We were especially concerned about the lack of plans for people at night. Records showed people had very specific needs at this time which sometimes impacted on other people in the home. We also Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: found some records showing one person had some difficult to manage behaviour. Again this had an impact on other people living in the home, the staff and their own safety. These needs had not been assessed or planned for. This means staff may not have the support and information they need to ensure they all respond in the same way. People need staff to support them with their medication. We found several problems when we looked at this which didnt show us that medication was being well managed. We did not find that there was information (protocols) to guide staff on when to use as required medicines. We didnt find that all the medication people had listed on the Administration record (MAR) was available to give, and we found that staff had sometimes signed the MAR wrongly. Some tablets cannot be packed in blister packs and the home needs to have systems to ensure people are being given this medicine correctly. We could not audit this accurately as records were not completed. However the records and stock available did not confirm that people had been given their tablets as prescribed. Care Homes for Adults (18-65 years) Page 20 of 33 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are appropriate procedures in place to listen to peoples concerns and complaints,but staff knowledge may not safeguard people from the risk of harm. Evidence: Real Life Options have produced a policy to guide staff in the event of someone wishing to make a complaint about the service or if they believe someone has been harmed or abused. We looked at these policies and generally thought they were detailed and would ensure people got the help and support they needed quickly. We saw that the information about when people can contact CQC needs to be changed to say they can do this at anytime. 120 Lichfield Road has received no complaints about the service, and has no safeguarding matters being investigated. We looked at training and did not find that the staff team has up to date knowledge regards Safeguarding. It is good that this has been planned, but we were concerned that not all the staff we spoke with were clear regards what abuse is and how this should be reported. This might stop something being reported when it should be. We looked at the way the home manages the money of people who live in the home. We found the money was held securely, checked at each shift change and that records were Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: detailed. It was positive that where possible people are involved in holding and spending their money. Care Homes for Adults (18-65 years) Page 22 of 33 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. People live in a clean and comfortable home, where their needs can be met. Evidence: This is a very comfortable home, which meets the needs of the people who live there well. The AQAA says, People see the home as their own which is what we observed at our visit. Each person has their own bedroom and they share bathrooms, a kitchen, lounge, laundry and the garden. Since we last visited the home, work has been undertaken to improve the environment and this has included a new specialist bath for people without full mobility, decoration, new flooring and some new furniture. The garden is on a lower level to the house, and work has been undertaken to provide ramped access so everyone can fully enjoy the garden. We saw that the home is equipped with a special washing machine that hygienically washes soiled items. Good infection control measures including hand washing facilities were observed around the home. We found that staff training regards infection control and food hygiene needs to be Care Homes for Adults (18-65 years) Page 23 of 33 Evidence: updated. This will ensure staff have the knowledge needed to promote good hygiene practices. Care Homes for Adults (18-65 years) Page 24 of 33 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are committed to meeting peoples needs but this is hindered by an inconsistent staff team. Evidence: 120 Lichfield Road has a core of staff, some of whom have been in post for many years and know the people who live there well. How ever there are four full time staff vacancies currently being covered by agency and casual staff. It is positive that the manager is working to minimise the impact of this to people as far as possible by using a regular pool of staff, however many of the shortfalls we noted during our visit relate directly to this lack of staff consistency. Lots of staff commented about this in the surveys they returned to us. Most staff said there was never enough staff on duty. Specific comments included. What could the home do better.....recruit more staffand Is there enough staff...never We were informed that Real Life Options is actively recruiting new staff. We looked at the recruitment files of three staff. We found that all the required information had been sought prior to people being offered a post. Staff are regularly supervised, and we saw that Real Life Options provide a training sheet to use in supervisions each month to help keep staff knowledge up to date. Care Homes for Adults (18-65 years) Page 25 of 33 Evidence: Staff training has been identified as a need. We saw that mandatory training has been planned in most areas for most staff. This is now urgent as many staff are untrained or require updating. We found that staff also need further skills in the specific needs of the people who live in the home. Staff knowledge about specific needs such as Epilepsy, Mental Ill health, Dementia and difficult to manage behaviour was minimal and mainly gained by experience. This does not ensure people are always supported by a well qualified staff team Care Homes for Adults (18-65 years) Page 26 of 33 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is not always run in the best interest of people living there. Evidence: The homes manager has been in post for several years and has the professional and management qualifications needed to run the home. We did however find a significant number of issues which need urgent attention to bring them up to date, or to ensure matters are fully addressed. It was of concern to us that the manager did not already know about all of these issues. An action plan looking at the priorities for the home and people living there should be completed to ensure this is all addressed. We found the manager and senior care were very knowledgeable regards peoples needs. We found the ethos of the home to be very open, and people reported the management team was very approachable and supportive. A representative from Real Life Options has been visiting the home to undertake audits and Quality Assurance. These visits were detailed and focused to a large extent on the experiences of people living in the home. It was however disappointing to establish that matters already identified in these audits remained unmet. These should be actioned to Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: improve the service offered to people. We sampled the records about Health and Safety and found these were up to date. This confirmed the information provided to us in the AQAA. The manager is required to let us know about incidents which occur in the home. We found reports of accidents and incidents which had not been reported to us. This does not ensure we have up to date information about the running of the home, which could affect our judgement about a service. Care Homes for Adults (18-65 years) Page 28 of 33 Are there any outstanding requirements from the last inspection? Yes  No  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 29 of 33 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 Description 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 Description Timescale for action 1 9 13 Risk assessments must be 30/06/2010 reflective of risks people take and are exposed to. This will enable people to live as independently and safely as possible. 2 19 15 30/06/2010 Care records must be developed which detail each persons needs and how they would like or need them to be met. To ensure staff know each persons needs and they are consistently met in the way the person prefers. 3 20 13 Medication management 30/06/2010 must ensure full records are maintained, medication is given as and when prescribed and staff have the required knowledge and information to undertake this Page 30 of 33 Care Homes for Adults (18-65 years) 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 Description Timescale for action role. To ensure people receive their medication as prescribed. 4 33 18 All staff vacancies must be recruited to. 30/07/2010 To ensure people are supported by staff they know and who know their wishes and needs. 5 35 18 Staff must receive all mandatory training and training to meet the specific needs of people they support. 30/07/2010 To ensure staff understand and know how to support people. 6 41 37 Incidents which occur in the home must be reported to CQC without unreasonable delay. 31/05/2010 To ensure CQC has up to date information on which to base its judgments about the home. Care Homes for Adults (18-65 years) Page 31 of 33 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 1 1 The Statement of Purpose and Service User guide should be further developed to fully reflect the service offered at 120 Lichfield Road. This will ensure it fully informs people using it. A full needs assessment should be completed prior to offering people a place in the home. This will ensure the home can confidently meet the persons needs. The contract should fully detail the terms and conditions of living in the home. This will ensure people understand all the responsibilities and expectations being made of them. People should be offered more involvement in developing their own records and plans of care. Staff should ensure personal confidential information is stored appropriately. This will ensure peoples privacy and dignity is respected. The complaints policy should state people can contact CQC at any time in the process Staff must receive training to ensure they can recognise signs of abuse and are able to report it as required. Staff should receive training to ensure they have up to date knowledge regards infection control and food hygiene practices. An action plan identifying how and when issues identified will be rectified should be considered to drive the homes development. 2 2 3 5 4 5 8 10 6 7 8 22 23 29 9 39 Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 33 of 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!