Care Home: 191 Redditch Road

Similar services:

• Polesworth Group Friary Road
• Polesworth Group Pooley Heights
• Polesworth Group 32 Station Road
• Aston Court Nursing Home
• Polesworth Group 70 Long Street
• Breme
• Ravenhurst
• Polesworth Group 64 Long Street

What the care home does well Each person has a care plan so that staff know how to support them to meet their needs. People are supported to take part in the activities that they enjoy so that they have an enjoyable lifestyle. People are provided with healthy meals that they enjoy. The health needs of the people living there are met and people get the care from other professionals they need. The home is clean and well decorated so it is a nice place to live. The staff were seen to have excellent relationships with the people living there and spoke to them naturally, with empathy and supporting them as they wish. This gives people a sense of wellbeing. Checks are done on equipment and the fire alarms to make sure people are kept safe. The Home is generally well run, and the style of management is relaxed, open and inclusive. What has improved since the last inspection? People now have their own health action plans to help make sure they receive the care they need to stay healthy. Staff have been told about the Mental Capacity Act so they can ensure that people are supported appropriately to make decisions about their welfare if they are not able to. Parts of the home have been redecorated and new furniture bought so that it is homely and comfortable for people to live in. The home have employed a part time housekeeper and this helps to keep the home clean as well as freeing up care staff time to spend more time supporting people. A new wash hand basin has been fitted in the laundry so that infection control arrangements are improved and people are less at risk from infection. Quality monitoring systems have improved and are based on seeking the views of the people living there so they decide how improvements are made. What the care home could do better: Information about the home should be updated so that people have all the information they need. Minor improvement is needed to some risk assessments to ensure they are accurateand reflect all the control measure in place to help keep people safe from harm. Medication procedures need minor improvement. This will make sure that staff consult with the GP about medication changes to make sure people get the medication they need safely. An audit needs to be completed of staff recruitment records to make sure they contain all the required information to make sure people have suitable staff working with them. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Redditch Road (191) Redditch Road (191) Kings Norton Birmingham West Midlands B38 8RH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kerry Coulter     Date: 2 0 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 33 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 33 Information about the care home Name of care home: Address: Redditch Road (191) Redditch Road (191) Kings Norton Birmingham West Midlands B38 8RH 01216802669 F/P01216802669 michelledwyer@bvt.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Bournville Village Trust care home 5 Number of places (if applicable): Under 65 Over 65 0 0 learning disability physical disability Additional conditions: Residents must be aged under 65 years Date of last inspection Brief description of the care home 5 5 191 Redditch Road provides personal care and accommodation for five people with a learning disability. The home is located on a bus route and has space for parking for several cars to the front of the home. Local shops are within walking distance. The home operates a home for life as long as they can meet peoples needs, and operates a needs led approach, which aims to provide a high quality, residential service. Care is offered with normal lifestyle principles and people are encouraged to bring personal possessions to the home. There no rigid visiting hours or set mealtimes. People who live there are able to retire and rise when they prefer. They can also shop for, prepare and cook their own meals if they wish, and are offered a choice of leisure time activities geared to their individual needs and abilities. All people who live at the home have their own bedroom. The home is fully equipped with hoists, changing facilities, an Arjo bath, with some bedrooms being fitted with ceiling hoists. The gardens to the Care Homes for Adults (18-65 years) Page 4 of 33 Brief description of the care home front and rear have been designed for wheelchair users. Visitors to the home can request to see a copy of our reports from staff as reports are located in the homes office. The range of fees to live at the home was not included in the service user guide, people therefore need to speak to the manager to request this information. 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The visit was carried out over two days, the home did not know we were going to visit. This was the homes key inspection for the inspection year 2009 to 2010. The focus of inspections we, the commission, undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home. The Annual Quality Assurance Assessment (AQAA) that provides information about how they think they are meeting the Care Homes for Adults (18-65 years) Page 6 of 33 regulations was returned to us before we visited the home. We also sent surveys to people who live at the home, staff and care professionals. Two people who live in the home were case tracked this involves establishing individuals experience of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. During our visit we spoke with everyone who lives there, the manager and staff. Time was spent observing care practices, interactions and support from staff. We looked around some parts of the home. Care, staff and health and safety records were looked at. What the care home does well: What has improved since the last inspection? What they could do better: Information about the home should be updated so that people have all the information they need. Minor improvement is needed to some risk assessments to ensure they are accurate Care Homes for Adults (18-65 years) Page 8 of 33 and reflect all the control measure in place to help keep people safe from harm. Medication procedures need minor improvement. This will make sure that staff consult with the GP about medication changes to make sure people get the medication they need safely. An audit needs to be completed of staff recruitment records to make sure they contain all the required information to make sure people have suitable staff working with them. 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 9 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 10 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have most of the information they need to ensure they can make a choice about whether or not they want to live at the home. Evidence: Each service user has their own copy of the service user guide. This is in both a written and picture format and contains most of the required information. The guide needs to be updated to reflect the current management arrangements in the home and the range of fees charged to live there. People thinking of moving to the home will then have more information to help them decide if they would like to live there. There have been no new admissions to the home for some years and so this made it difficult to fully assess practice. The admissions procedure was sampled and was observed to be satisfactory. The annual quality assurance assessment completed by the manager told us We have clear guidelines detailing the procedure for assessing a prospective resident and for introducing them to the home. Proposed residents are encouraged to visit the home on an introductory basis and new residents are Care Homes for Adults (18-65 years) Page 11 of 33 Evidence: encouraged to visit the home over several weeks prior to moving in, for varying lengths of time. Information from surveys we received from people at the home indicate they were asked if they wanted to move to the home and had received enough information. Care Homes for Adults (18-65 years) Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have most of the information they need so they can support people in the way that the individual chooses so ensuring their safety and well being. Evidence: The home has a care plan for each individual, which includes detailed profiles, activity plans, and daily recording. We looked at the care provided to two people. Each person had an assessment of need and a plan to meet those needs that had been regularly reviewed. Staff meet monthly with people to review their care and find out what things they would like to be doing in future months. We saw that one person had previously requested to go to the seaside and that this had been scheduled in line with their wishes. For one person who was unable to contribute fully to their review meeting staff had invited one of his friends as an informal advocate. Where appropriate peoples Care Homes for Adults (18-65 years) Page 13 of 33 Evidence: relatives are also invited to participate in the meeting. One healthcare professional told us that staff at the home work in a person centred way. Members of staff were observed encouraging people to make choices about day to day matters, such as what to drink and what they wanted to do on that day. Peoples ability to exercise choice and to make informed decisions is variable, according to their degree of learning disability. Staff asked permission from people before they went in their rooms. Peoples care plans contained information about how choice should be offered to them. Staff spoken with were able to describe how peoples views are sought and choices are offered to people. Minutes available show monthly meetings take place for people who live at the home where they are consulted about what goes on and things they would like to do. There is evidence that people are supported to take manageable risks, and staff encourage individuals to have an independent lifestyle as possible. Risk assessments were noted to be in place for things such as fire evacuation, bathing, moving and handling, going on holiday and use of bed rails. These were up to date with evidence of evaluation available. One person has recently been swimming for the first time and a risk assessment was seen to have been completed for this. This was generally satisfactory but we discussed with the manager that it would benefit from some minor improvement to enhance the control measures to make sure the activity is as safe as possible. For both care files sampled risk assessments completed identified they were at risk of developing pressure sores. One person had a detailed care plan in place so that staff know what support the person needs to reduce the risk of sores happening. However for the other person there was no care plan in place. Discussions with staff indicate they did not think this person was at risk of developing pressure sores and other records we sampled appeared to support these views. During our visit the person was quite mobile and this was not reflected in their assessment. We discussed with the manager that the risk assessment should be reviewed and if it still identified the person was at risk then a care plan would need to be completed. Care Homes for Adults (18-65 years) Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place so that people who live at the home experience a meaningful lifestyle. People who use services have good quality food and their diverse needs are well supported. Evidence: Discussion with people who live at the home, staff, sampling of records and observation of practice indicate that people undertake a wide range of activities, to include in house, day centres and in the community. Each person has an individual activity plan. Activities on offer include aromatherapy, snoozlum, disco, visits to parks, swimming, shopping, Church, Kennedy House, pub, library, walks and bowling. The home has referred one person to a community options scheme to look at activities available. Care Homes for Adults (18-65 years) Page 15 of 33 Evidence: During our visit we saw staff looking through magazines with people and playing board games, some people went out shopping, one person went to a lunch club. One person told us I go to church, I like going, going to a disco tomorrow, Im happy here, its a nice place. Another person told us they had been to the garden centre recently to choose some hanging baskets and plants for the front garden, they were very pleased with them. One person has a visual impairment and so the home has arranged for him to receive talking newspapers. Individual needs and wishes are taken into consideration and people are consulted every month about activities they wish to do for the month ahead. Minutes of peoples meetings show consultation regarding activities and holidays. One person was due to go on holiday to Cornwall the day after our visit. Another person told us they were going on holiday in July to Devon , they said they had chosen where to go and were looking forward to it. Sampling of records and discussion with people who live at the home and staff indicates that people are supported to maintain contact with relatives and friends. It is good that staff have arranged for one person to have a holiday close to where a relative lives so that they can visit them during the holiday. The AQAA told us One person invites a friend to lunch each Saturday and staff ensure a long standing friendship is maintained by providing transport for this individual when she has transport difficulties. There was no evidence of strict house rules. Staff were observed sitting and socialising with individuals. People who live at the home are able to choose whether or not to spend time with others, or to have private time in their own rooms. There was lots of evidence that people are able to choose what food they would like and have a healthy balanced diet. Some individuals are on special diets and see the dietician regularly. Two people at the home are at risk of choking and so have to have a soft diet. Staff spoken with were aware of their needs and the types of food they should avoid. We observed people having breakfast and lunch. Staff gave appropriate support in line with care plans in a friendly tone of voice. One person told us that their lunch was nice. Lots of fresh fruit was observed to be readily available in the kitchen and was not stored out of peoples reach. Food records are kept for all people so staff can monitor that people have a healthy diet. Care Homes for Adults (18-65 years) Page 16 of 33 Care Homes for Adults (18-65 years) Page 17 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of the people living there are met so ensuring their well being. Evidence: Care plans sampled around personal care needs are detailed and include individual preferences. This includes the gender of staff who support people and when they prefer a bath or shower. However preferences cannot always be met due to the gender balance of the staff team but the home has tried to improve this by recently recruiting a male staff to the home. People met with had been supported by staff to look well groomed and were dressed appropriately to their age, culture, gender and the weather. All staff gave appropriate support in a friendly tone of voice. Where people need support from staff in moving and handling there were satisfactory assessments in place so that staff knew how to support the person safely. We have previously recommended that Health Action Plans should be implemented. Care Homes for Adults (18-65 years) Page 18 of 33 Evidence: This is something that the Government paper, Valuing People recommended that each person with a learning disability had by 2005. This is to ensure individuals receive all the care they need to stay healthy. These are now in place and people have a copy of their plan. Records sampled showed that health professionals are involved in peoples care where needed. Records showed and staff said that they work with other professionals to ensure individuals well being. People attend health check ups as needed, for example with the dentist, optician, dietician and chiropodist to ensure their health needs are met. Where people have been unwell discussion with staff and observation of records shows that staff ensure they see the relevant health professional and that appointments are followed up if the person remains unwell. We received a survey from one healthcare professional, they were positive in their comments about the home, they thought that the care staff were knowledgeable about peoples needs and contacted them when healthcare advice was needed. Some people have fluid balance charts that staff complete to monitor that they are having enough to drink each day. Observation of the charts shows that people are getting enough to drink. One person attends the weight clinic regularly in line with their care plan and has recently been referred to the dietician. Since our last visit to the home they have introduced nutritional assessments to make sure people are at a healthy weight and have the diet they need to stay healthy. We looked at the systems for the safe handling and administration of medication. Medication storage was observed to be satisfactory. At the front of each persons Medication Administration Record (MAR) there is a photo of the person so that unfamiliar staff would know who to give the medication to. Where people are prescribed medication on an as required basis there is a written protocol in place so that they know when it should be given. Medication administration records sampled had been appropriately signed and indicate that people had the medication they needed. However, there was one exception. One person is prescribed ear drops on a month on, month off basis. Records showed that the persons ear had become sore and so staff had made a decision to stop the drops. Discussions indicate staff thought they were acting in the persons best interests, however they had not consulted the persons GP. Due to the type of ear drops prescribed there was not a very high risk of any detrimental effects to the person. However, the manager needs to ensure that in future any clinical decisions are discussed with the GP. Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: The home retains copies of prescriptions, and internal audits are regularly undertaken of medication practice. The homes pharmacist also completed an audit of medication practice in March and did not raise any concerns. Staff have completed satisfactory medication training and have an annual assessment to ensure they are competent when administering medication. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how to make a complaint and that their views will be listened to and acted on. Arrangements are sufficient to ensure that people are protected from abuse, neglect and self-harm. Evidence: The annual quality assurance assessment (AQAA) completed by the manager and the homes log of complaints indicates they have not received any complaints in the last twelve months. We have not received any complaints or concerns about the home either. We saw that the home has a satisfactory complaints procedure. A summary of this is on display in the hallway. People who live at the home have a copy of the procedure in the service users guide. This is available in a format that includes pictures. Minutes of meetings show that the procedure has also been verbally explained to people and they are regularly asked if they are happy or have any concerns. Surveys returned by people who live at the home indicated they knew who to speak to if they were not happy. The AQAA told us It is clearly stated in the service users guide that it is the service users right to make a complaint or raise any concerns and they will not be victimised if Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: this right is carried out. As an organisation we monitor complaints and effectiveness in dealing with them. This is co-ordinated by our Business Improvement Unit. The AQAA told us We have a clear whistle blowing policy and ensure that staff are aware of their responsibility regarding this, to ensure the safeguarding and well being of residents and staff. Records showed and staff said that they have had training on safeguarding adults who are vulnerable so they know how to recognises signs of abuse and report this so that the people living there can be safe. Discussion with a member of staff shows they knew what to do to keep people safe if an allegation of abuse was made. Records and discussion with staff show that they receive training about the Mental Capacity Act. This legislation came into force in April 2007 and requires an assessment of a persons capacity to be done if there is any doubt that they may not have the capacity to make a decision. Where a person has been assessed as not having the capacity an Independent Mental Capacity Advocate (IMCA) can be appointed to act on their behalf. The financial records of two people who live in the home were sampled and robust procedures were in place to safeguard their money. Receipts of all expenditure were available and two staff sign the record of each transaction. Inventories are available to show the personal belongings of each person, these were observed to be up to date and track when new items are bought and old ones discarded. 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 homely, comfortable, safe and clean environment that meets their individual needs. Evidence: The home was seen to be well maintained, comfortable, and free from odour. Since we last visited there has been lots of improvement with many rooms being redecorated making it a nicer place to live. In addition to redecorating the lounge there were new leather settees, new flooring and a new fireplace. The room is now contemporary in style but homely with lots of pictures, ornaments and photos of the people who live there. Recently the kitchen has been refurbished to a high standard, to include new flooring, cupboards, worktops and appliances. We looked at three peoples bedrooms, these were all observed to be personalised and decorated to a satisfactory standard. The rooms were very personalised and met peoples diverse needs. People told us they were happy with their bedrooms and had been involved in choosing the decor. The home has the necessary equipment and adaptations to meet peoples individual needs, to include mobility issues. The home has an assisted bathroom, where grab Care Homes for Adults (18-65 years) Page 23 of 33 Evidence: rails and a hoist are provided. One person has an overhead ceiling tracking system in their bedroom. There is ramped access to the garden where there are raised beds to improve accessibility for the people who live there. Infection control procedures in the home are good. All areas of the home that we looked at were clean. Since we last visited the home they have employed a part time housekeeper and this helps to keep the home clean as well as freeing up care staff time to spend more time supporting people. As recommended from our last inspection new hand washing facilities have been installed in the homes laundry. Recently the home has had a visit from the Environmental Health Officer to look at the food hygiene arrangements in the home. Following the visit the arrangements were rated as very good. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home benefit from a well trained and supported staff team that can support them to meet their individual needs. Improvement is needed to ensure people are protected by the homes recruitment practices. Evidence: Support to people who live at the home is given in a warm and friendly manner, and staff were seen to be polite, considerate and patient. Staff spoken with had a good awareness of individual needs and how to meet them. The annual quality assurance assessment indicates that eleven of the thirteen staff have achieved a National Vocational Qualification at level 2 or above in care. This means that people are usually supported by well qualified staff. People told us that staff usually treat them well and listen to them. The home have a very stable staff team. The only new staff who have started since our last visit have transferred from another of the providers care homes. This means that staff know the people who live at the home well. There are generally three staff on duty during the day. At night there is one waking night staff and one member of staff sleeping in. The hours worked by the manager of the home and the housekeeper were not recorded on the staff rotas we looked at. This information should be recorded Care Homes for Adults (18-65 years) Page 25 of 33 Evidence: to show all the staff who are working in the home. Information from staff surveys and observation of practice shows this is enough staff to meet peoples needs. There is some use of bank staff and occasional agency staff but this is not excessive. We looked at the recruitment records of three permanent staff. These showed that usually robust recruitment procedures are followed for the protection of people who live at the home. However for one member of staff who had been employed by the provider for several years one of their references was missing from their file. An audit should be completed of all the staff files to make sure all the required information is available and where possible the missing information obtained. Where information is missing a risk assessment should be undertaken to make sure people are not being put at risk. The AQAA states We have done much, developing a training database within the department and have a more structured approach to training. There are also more opportunities for in-house training. Staff surveys showed, and those spoken with said they were generally happy with the training on offer, they said they get the training they need to meet peoples needs. Discussions with staff and sampling of training records show that regular training is on offer to staff. Staff have completed mandatory training in areas such as fire, health and safety, first aid, moving and handling and safeguarding people from abuse. Additionally staff have had training to help them meet the specific needs of people at the home. This has included sight loss awareness, dementia, menu planning and person centred planning. Evidence shows that staff are well supported. Formal supervision for care staff is regular, and annual appraisals are also completed. Staff meeting minutes show these usually happen regularly. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management arrangements ensure that the home is safe and well run in the way that the people living there want. Evidence: Since our last inspection the home has had a new manager. They were previously the registered manager for another of the providers homes but are not yet registered with us to manage this home. The manager has started the registration process by having a criminal record bureau check completed through us. The manager said they had sent their application to us for registration but unfortunately we did not receive this. The manager has agreed to resend this as soon as possible. The manager has a significant amount of experience in working with people with a learning disability and has a management qualification. The homes annual quality assurance assessment was completed by the manager to a satisfactory standard and sent to us when we asked for it. Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: The manager was on holiday on the first day of our visit and so we had to return for a second day to look at staff recruitment and training records as the staff on duty did not have access to these. The deputy manager had also been on holiday and on training the previous week. As the home does not have any senior staff this meant that there had been no one at the home in overall charge. However each day a shift leader had been designated to make sure things got done that needed to be. It is recommended that both the manager and deputy are both not away from the home for extended periods unless there is someone else designated to run the home in their absence. There are systems in place to assure quality and the views of people who live at the home are listened to and the home is working to further improve these. The providers representative visits the home monthly to make sure it is being well run, reports of the visits are available. Regular meeting are held with people at the home to seek their views and a number of internal audits are completed, for example for medication and health and safety. Surveys have recently been sent by the home to care professionals and relatives. Those received so far indicate people are satisfied with the service provided. The manager is part of a working group looking at improving quality assurance, minutes of the last meeting show that surveys are being developed for people who live at the home. The home has recently implemented the use of monthly performance indicators. This means that on a monthly basis information about things such as staff training, supervision, peoples reviews and any complaints received are sent to the director of care. Health and safety at the home was well managed. Monthly health and safety audits are completed. An examination of the homes fire safety records indicate that routine testing of alarms and lights is being carried out. The records also show that fire drills are being routinely carried out and staff have fire training so that they know how to keep people safe should a fire occur. Service certificates were available for fire alarms and manual handling equipment, eg hoist, bath and ceiling tracking, to show they are well maintained. Records showed that a qualified person had tested the electrical installations to ensure that they are safe to use. The gas safety certificate expired the day of our visit, however we saw evidence that the gas engineers had visited a few days before our visit. The manager said that she had not yet received the new gas safety certificate but would forward it to us when received. Care Homes for Adults (18-65 years) Page 28 of 33 Evidence: Care Homes for Adults (18-65 years) Page 29 of 33 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 30 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 Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 Medication procedures need improvement to make sure that staff consult with the GP before making clinical decisions about medication. To make sure people get the medication they need safely. 22/05/2009 2 34 19 An audit needs to be 22/05/2009 completed of staff recruitment records to make sure they contain all the required information. To make sure people have suitable staff working with them. 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 service user guide needs to be updated to reflect the current management arrangements in the home and the range of fees charged to live there. People thinking of moving to the home will then have more information to Page 31 of 33 Care Homes for Adults (18-65 years) help them decide if they would like to live there. 2 9 Review peoples pressure care risk assessment to make sure they are accurate. If the person is still assessed as being at risk then a care plan should then be completed to ensure they get the pressure care they need. The manager needs to submit an application to us for registration as soon as possible so that we can assess if she is suitable to be registered to manage the home. It is recommended that both the manager and deputy are both not away from the home for extended periods unless there is someone else designated to run the home in their absence. This will ensure the home is well run at all times. 3 37 4 37 Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 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!