Care Home: 122 Carol Avenue

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What the care home does well Information is available to help people decide if the service provides what they want and trial visits can be arranged. People`s needs are thoroughly assessed so that their care and support can be planned properly. This process also makes certain the person moving into the home is able to ``fit in`` with others that are already living there. Good use is made of ``person centred`` approaches in people`s care planning. This helps to ensure that people get their support in ways that suit them best. Careful risk assessing helps to ensure individuals get the support they need to stay safe without unnecessary restrictions being placed upon people. Consideration is given to people`s interests, hobbies, and leisure pursuits when planning activities. The involvement of relatives/families and friends is encouraged by the home. People`s personal and healthcare needs are generally well met. They get the support they need from staff and a range of other professionals to help them stay healthy and well. Staff work hard to ensure that people enjoy the benefits of living in an environment that is comfortable, homely, safe and clean. Staff are generally well trained and supervised to ensure that they have the knowledge and skills and get the support they need to do their jobs well. The home is generally well run for the benefit of people using the service. Regular maintenance and checking of important equipment helps to ensure that people living and working at the home stay safe. What the care home could do better: No requirements were made following this inspection. One good practice recommendation was made, and this can be found at the end of this report. The AQAA dated tells us that the manager has recognised the areas which they are looking to improve upon in the next twelve months and some of these are:- All support files to be signed by all staff to say that they have been read. - To further progress our ``person centred`` approach in all areas of support. To access further communication training for staff who still need it. To have a more flexible rota to further meet the needs of the people we support. - To explore and develop a symbolised/photographic shopping list to help the people supported to purchase needed items from local shops. - Continue to improve recording and support systems and to continue to facilitate staff development as and where appropriate. Random inspection report Care homes for adults (18-65 years) Name: Address: 122 Carol Avenue 122 Carol Avenue Bromsgrove Worcestershire B61 8RH two star good service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Sally Seel Date: 2 8 0 6 2 0 1 0 Information about the care home Name of care home: Address: 122 Carol Avenue 122 Carol Avenue Bromsgrove Worcestershire B61 8RH 01527872692 Telephone number: Fax number: Email address: Provider web address: www.dimensions-uk.org Name of registered provider(s): Name of registered manager (if applicable) Mr David Sampson Round Type of registration: Number of places registered: Conditions of registration: Category(ies) : Dimensions (UK) Ltd care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 4 The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 4 Date of last inspection Brief description of the care home 122 Carol Avenue is a traditional detached house in a residential setting providing a home for four people who have learning disabilities. The home includes a ground floor bedroom and bathroom facilities. The bedrooms of people who live at the home are individually decorated and furnished with a lounge, dining room and kitchen shared by Care Homes for Adults (18-65 years) Page 2 of 13 Brief description of the care home the household. There is easy access to public transport and the town centre. The house has its own vehicle for people to use. The home aims to provide a homely environment promoting independence and dignity. Each person receives care and support to live as ordinary a life as possible in the community. This involves teaching skills and creating opportunities on behalf of each person. All individuals are encouraged to participate in the running of the home and share in the general household activities within their capabilities recognising and promoting the independence of each person. Care Homes for Adults (18-65 years) Page 3 of 13 What we found: The purpose of the visit to the home was to complete a random inspection as the last key inspection of the home was undertaken on the 20th August 2007. Good outcomes for people were reported at this key inspection and this random inspection was to review the standards of care being provided to ensure that the health and welfare of people who live in the home continues to be actively promoted. This random inspection was undertaken by one inspector who visited the home over a half day period with no prior notice being given to the manager or staff at the home. We did not look at all the standards at the time of this random inspection. On the day we visited the home four people were living there. The home provides care and support for people by the reason of a learning disability. Discussions with all the people living at the home were not appropriate on the day we visited due to the short amount of time we spent at the home and being unfamiliar to people who have various communication needs. However, we did see that staff interacted with people in a positive and reassuring manner. Also people looked comfortable in their surroundings. The care of two people living in the home was identified for close examination by reading their care plans, risk assessments, daily records and other relevant information. This is part of a process known as case tracking where evidence of the care provided is matched to outcomes for the people using the service. Before the inspection we looked at all the information about the home that is held on file by us such as notifications of accidents, allegations, incidents and complaints. We also sent an Annual Quality Assurance Assessment (AQAA) to the manager to complete. The manager completed and returned the AQAA which contained helpful information about the home in time for the inspection. We received two surveys that had been completed by staff who work at the home and these will be appropriately reflected within this report. A number of records such as support plans, complaints records, staff training information, visits made by the providers representative and staff rotas. Resident and staff meetings were also sampled for information as part of this inspection. We acknowledge that the manager and assistant manager were not at the home on the day we visited. Therefore we provided a member of staff with some feedback at the time of our visit and have summarised below what the home does well together with what they could do better. We have also made one good practice recommendation at the end of this report which should be strongly considered to make sure people who live in this home are continuing to receive good outcomes. The outcome of this inspection visits is as follows: We established that one new person has moved into the home since we last inspected it in August 2007. Therefore we looked at the information that is given to people who may be considering living at the home to ensure that this was relevant and contained up to date details. We were shown the statement of purpose and service user guide. These are information guides that tell people what it would be like to live at the home, admission Care Homes for Adults (18-65 years) Page 4 of 13 criteria, staffing and management structures and what facilities are offered. Both the statement of purpose and service user guide needs some updating in relation to the Care Quality Commissions (CQC) contact details. These details are given to people in case they wish to raise a complaint and or concern about the home so it is important that these are now updated. We saw that the person who had moved into the home came from one of the providers other homes. Their care records told us that the move was a planned one where it was good to see that the staff from the persons previous home helped in the transition period of the move. We also saw that a review had been held whereby the person said that they liked living at the home and we were told that their family feel that the move was a positive one. It was particularly good to hear that the family members of other people who live at the home and people themselves were part of the process of the move. This point was confirmed in the AQAA and advised us, Families of the other people living at Carol Avenue are pleased about the compatibility of the new lady. Two people were case tracked and in each of the care records there were a variety of support plans that enable staff to determine the needs of each person. Each care plan is an individualised description of what a persons needs are and how staff are able to support individuals in achieving these on a daily basis. Each person has a key worker and we saw records that showed that the key workers play an important part in supporting people. Positively support plans celebrated what a person could do and reminded staff of this so that individuals are able to retain their levels of independence. For example, it was identified where people are able to dress themselves with guidance to support individuals in communicating to staff what clothes they choose to wear on any particular day. Also where people are able to place their own clothes in the washing machine but cannot always operate this. There are support plans that cover peoples, mobility, personal hygiene, eating and drinking, contact with family and friends and activities. In one persons support plans we saw that these had been particularly well developed using pictures so that the person themselves can be part of this process. It was good to see that peoples preferences had been recorded in relation to the times they like to get up and go to bed. We also saw the personal PATHS which are colourful and add another dimension to a person centred approach to planning particularly in enabling individuals to fulfil their aspirations within their lives. We saw that they are developed with people and are an aid that help people to put down on paper their desired aims and goals. There are time limits for these to be reached and who would be supporting the person to reach these milestones. It was also good to see communication plans so that people are able to take part in their care planning and make relevant choices and decisions within their daily lives. We saw photographs and pictures that are used as aids so that individual choices and decisions can be made. The AQAA advises us, Family surveys confirm that the care that we give is what is expected or agreed with the home. Survey comments include staff always give good care and staff seem very caring. Staff surveys told us what the home does well: There are regular reviews and healthcare needs are met. We try to fulfil the wishes and Care Homes for Adults (18-65 years) Page 5 of 13 aspirations of people in our care. Staff are motivated and organise activities, social outings and other areas that are of interest as much as possible. They (staff) work flexibly and rota reflects this. Relevant risk assessments are carried out to promote each persons safety, such as, fire and heat, animals, sharp objects, road traffic and so on. Risk assessments seen in care records sampled are recorded in formats that are personalised and comprehensive. When necessary, specific plans had also been put in place to manage particular behaviours in the best way and to keep individuals and other people as safe as possible whilst promoting their independence. Entries in peoples health records show that they are being supported to attend health care appointments to monitor and treat diagnosed health needs. Peoples records show that they are being supported to attend routine health appointments such as annual health checks, dental check ups, chiropody support, and eye tests. One area that we strongly recommend is improved upon is that of regular weight checks as we saw in one persons care records that they had lost some weight but the last time they were weighed was in December 2009. In another persons records we noticed that they were last weighed in February 2010. We pointed this out to the member of staff that was assisting us with this inspection at the time of our visit. It is important that people are weighed on a regular basis, on both peoples records it stated at monthly intervals. This will ensure individuals are not losing or gaining a significant amount of weight that could be an indicator of underlying health needs. The staff member assured us that peoples weights would be completed and recorded. We did not fully inspect the standards relating to daily life but were told that people enjoy a varied range of activities, such as, bowling, attending social evenings, church, foot massage, hand and nail care, visiting the hairdressers, college courses, day trips to places of interest, holidays and short breaks, garden centre visits, swimming, crafts, shopping, safari park and so on. The AQAA also told us what the home does well in reference to meeting peoples social stimulation and interests: Holidays are regularly planned and taken throughout the year reflecting individual choices and interests. Two people have been on a coach holiday to Butlins, two are going to a caravan in Wales and two will be going on a Turkey and Tinsel holiday in November. There is evidence to show that contact with family and friends is positively promoted and supported. Surveys show that families visit their relative at home on a regular basis. All the people in the individuals circle of support are identified to enable us to support and encourage these important relationships. We have one person we support in employment and want to further explore opportunities for others. Individual paths are a very valuable tool to enable the individual to choose how they want to live their lives and how to achieve their goals. There are medication plans for as required medications which ensure staff have the necessary guidelines for people who take these particular medications. Although we did not inspect the administration and handling of medicines at this visit we can see that staff Care Homes for Adults (18-65 years) Page 6 of 13 are provided with clear and effective guidelines to promote peoples health and wellbeing. Also we were told that regular audits of medications are completed to ensure any errors and or oversights are picked up in a timely manner so that people living in the home are fully protected by robust medication procedures. In the AQAA we are told We see people as people first, respecting the culture and beliefs of everyone, valuing everyones unique contribution. We believe in equality and opportunity should be for everyone and that discriminatory behaviour is not acceptable. There is a regional Diversity lead person who meets with other regions quarterly to look at what can be done to progress the Diversity agenda across the organisation. We have information within the home on discrimination, religious key beliefs, a list of important issues for the principal minority groups. Staff have access on Dimensions intranet to Diversity information that can be downloaded and used in individual support planning. There are links from Dimensions sight to Ethnicity Training Network. The home has a clear complaints policy and process which we saw in the statement of purpose and service user guide. As mentioned earlier the CQCs contact details need to be amended. We were told that there have been no complaints which were also acknowledged in the AQAA. However, there is a book solely for recording these. Completed surveys from two staff indicated that staff knew what to do if someone has concerns about the home. Also the AQAA states, Staff are reminded how to deal with complaints and compliments during supervisions. There have not been any referrals made about matters that could affect the safety and welfare of the people living at the home since the last inspection. Required policies and procedures are provided to promote individuals welfare and protect them which include multi agency procedures for the Protection of Vulnerable Adults (POVA) recognising abuse and whistle blowing. An area that has been highlighted in the AQAA in relation to improvements planned for the next twelve months, Although all staff have heard about the deprivation of liberties and there is information stored in the home all staff would benefit from further training on The Mental Capacity Act deprivation of liberty safeguards, at the moment one of the support staff has received training. This is important for staff practices as this legislation examines how risk assessments and decisions to restrict someones liberty such as movement, leaving the home or making decisions for themselves should be done to ensure that their liberty is not denied. It is an area that we will look at again when we next inspect the home. We are aware from the AQAA that, Staff roles are clarified during house meetings and supervisions, also each staff member is being assessed against a performance frame work and development plan called our way of working. We were informed that staff supervision happens every two months and a staff member confirmed that they receive their supervisions on a regular basis. The information from the two staff surveys responded to, Do you feel you have enough support, experience and knowledge to meet the different needs of people who live at the home by one stating Always and another indicated, Usually. The AQAA shows that 4 staff are trained to NVQ level 2 or above, and that training provided meets national standards and statutory guidelines. We are aware from looking at a sample of staff training files that mandatory training, such as, infection control, Care Homes for Adults (18-65 years) Page 7 of 13 health and safety, medications and first aid are being completed with the required refresher training as needed. The AQAA also informs us that 5 staff out of 8 full time care staff have received training in infection control. The AQAA states that, All staff are CRB (Criminal Record Bureau) checked before starting employment. Although we did not look at staff recruitment files this indicates that robust procedures for the recruitment of staff are in place so that people who live in the home are protected from harm. We saw that audits are being carried out at the home to ensure the quality of care delivered is monitored for example, Regulation 26 visits. Regulation 26 visits must be carried out at least once a month by a registered provider or another appropriate person of the organisation who is not directly concerned with the conduct of the care home. This is to inspect the premises of the care home, speak with people who live at the home, and with permission their representatives, to form an opinion of the standard of care provided in the care home and prepare a written report on the conduct of the care home. Copies of recent reports of the visits were seen and read informing of improvements that need to be made. The AQAA tells us that the home has made the following changes as a result of listening to people who use their service, We have purchased two computers for the people supported to use. One lady has attended a sporting event with a person from another area with the same interest and more will be arranged if they so wish. People have booked further college courses appropriate to their areas of interest e.g. cookery, music etc. People are in the process of booking holidays of their choice or have already taken them. One lady we support is now in paid employment working a few hours in the Worcester office. Various trips to places of individual interest have been taken or booked. People supported wanted to go to a club and meet people, near their home. We researched this and have managed to find one which they will soon start attending. All the people supported are encouraged to engage in a wide range of activities and try new things. At meal times people supported are encouraged to eat a well balanced diet with five fruit and Veg a day, there are new menu recording sheets which show choices offered or declined these are done for each individual. People choose where and when they eat. We did not inspect the homes environment at this visit but the areas that we did see looked clean and well maintained with no apparent malodours. The AQAA also, tells us People who live at Carol Avenue enjoy a comfortable and homely environment. The home is kept clean and is well maintained, there is a cleaning schedule to insure that the environment is kept hygienically clean. People supported choose the decor for their own bedrooms and furnish it if they so wish with their own furniture. All electrical items are PAT tested every year and the gas is also serviced annually. Water temperatures are checked daily to ensure they are kept at safe levels, there is also a water safe management program. Fire equipment is regularly tested and maintained. We were made aware that some of the outstanding improvements to the home have now been completed and these included, the relaying of slabs in the back garden area and the front area of the home has been resurfaced. We are also aware that work needs to be done in relation to getting the summerhouse into the back garden area. It is suggested that the manager ensures that this is not blocking any of the windows in peoples rooms whilst suitable methods are employed to move it into the back garden. Accident and incident records are kept and notified appropriately to the Commission and relevant other agencies. Care Homes for Adults (18-65 years) Page 8 of 13 These are some of the things staff surveys told us what the home could do better: Everyone needs to take more exercise and staff included. Less paperwork. There is a lot of paperwork and sometimes we are repeating ourselves on different paper. Doing courses in the house e-learning, courses should be done on a day release. While we are working in the house, our main concern is the people we support. It is suggested that the manager looks at the issues above and that these are placed upon the agenda for staff meetings. We saw that staff meetings are taking place where staff are able to share any concerns and or complaints they have within a collective forum if they wish. These processes enable staff to share any issues they may have to ensure that the home is run in the best interests of people who live there. What the care home does well: What they could do better: Care Homes for Adults (18-65 years) Page 9 of 13 No requirements were made following this inspection. One good practice recommendation was made, and this can be found at the end of this report. The AQAA dated tells us that the manager has recognised the areas which they are looking to improve upon in the next twelve months and some of these are:- All support files to be signed by all staff to say that they have been read. - To further progress our person centred approach in all areas of support. To access further communication training for staff who still need it. To have a more flexible rota to further meet the needs of the people we support. - To explore and develop a symbolised/photographic shopping list to help the people supported to purchase needed items from local shops. - Continue to improve recording and support systems and to continue to facilitate staff development as and where appropriate. 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 2. Care Homes for Adults (18-65 years) Page 10 of 13 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 11 of 13 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, 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 1 19 The recording of individuals weights needs to be completed in a consistent manner so that any losses and or gains in a persons weight is identified in a timely manner to make sure there are no underlying medical conditions which would otherwise go undetected. Care Homes for Adults (18-65 years) Page 12 of 13 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 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 noncommercial 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 13 of 13 - 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. 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