Care Home: 2 Kettlewell Way

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What the care home does well There is a procedure for assessing people’s needs before they move in so they can be confident the home is suitable for them. People are supported to keep in touch with friends and relatives so that they do not lose relationships that are important to them. There are lots of opportunities for people to go out and do things they enjoy so that they experience a meaningful lifestyle. The staff team work hard to make sure that the way people communicate is understood and respected. People enjoy their meals and mealtimes. We were told that (the food) is “very good”. The home operates a thorough system of recruitment for the protection of the people who live there. Information is shared with people at house meetings and weekly activity planning meetings so that people are included in the day to day running of the home. There are procedures in place to listen to complaints should they arise and to protect vulnerable people from possible harm. We were told, “I would talk to the staff if I had (any complaints). They would listen”. People live in a clean and comfortable home which meets their needs and promotes their independence. The home is being managed in a way that promotes people’s well being and listens to their views and opinions. What has improved since the last inspection? Medicines are being well managed so that people receive their medication in a planned and safe manner. Staff have been given guidance to ensure that people are supported to answer their own front door, without being placed at unreasonable risk of harm. (When we last visited in August 2008, this was an area of concern).DS0000072294.V377226.R01.S.docVersion 5.2 What the care home could do better: Some records of staff training are not well organised which could lead to staff missing important training that benefit the people who live in the home. The home does not have a computer. This means that staff cannot take part in valuable training that is available of the intranet. Key inspection report CARE HOME ADULTS 18-65 2 Kettlewell Way 2 Kettlewell Way Chelmsley Wood Birmingham West Midlands B37 5JG Lead Inspector Julie Preston Unannounced Inspection 29th July 2009 11:00 DS0000072294.V377226.R01.S.doc Version 5.2 Page 1 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. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 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. DS0000072294.V377226.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address DS0000072294.V377226.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 2 Kettlewell Way Address 2 Kettlewell Way Chelmsley Wood Birmingham West Midlands B37 5JG 0121 770 4513 0121 770 4513 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Solihull Care Trust Manager post vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places DS0000072294.V377226.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care Home only - Code PC. The service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: - Learning Disabilities - Code LD. The maximum number of service users who can be accommodated is: 3. 5th August 2008 2. Date of last inspection Brief Description of the Service: 2 Kettlewell Way is a small home providing permanent accommodation for three adults with a learning disability. The service is part of a scheme linked to other similar services in the Chelmsley Wood area. The Registered Provider is Solihull Care Trust. The service is located in a residential neighbourhood within a bus ride from Chelmsley Wood shopping centre and is in reasonable distance to local amenities. 2 Kettlewell Way provides a full range of residential care service to individuals that minimises institutionalisation and combines this with an integrated day service to enable people to be engaged in meaningful activities, education and personal development. There are three bedrooms one of which is located on the ground floor as part of a garage conversion. None of the bedrooms have wash hand basins. Bathing facilities include a bathroom with bath and overhead shower unit and wash hand basin. A single toilet is located on the ground floor. Shared space includes a separate lounge and there is a kitchen/dining area. There is a laundry facility with washing machine and tumble dryer. A private garden is located at the rear of the home. Parking is at the road side as there is only enough room for one car on the drive. The fees charged each week are varied according to people’s needs. More details can be obtained from the home. People pay a contribution according to their individual welfare benefit. There are extra charges made for using the home’s vehicle. At this visit charges were made at 40p per mile. DS0000072294.V377226.R01.S.doc Version 5.2 Page 5 DS0000072294.V377226.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use the service experience good quality outcomes. The focus of inspections undertaken by the Care Quality Commission (CQC) 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 which included, • • • notifications received from the home that tell us about events that have affected the well being of people information about complaints information about safeguarding An annual quality assurance assessment (AQAA) was completed and returned to the Commission in time for this inspection, providing the manager’s views of the home’s performance during the last year and plans for further improvements. This visit took place over six hours and staff and the people who live at the home did not know that we were coming. Two people were “case tracked” and this involves discovering individual experiences of living at the home by meeting or observing them, discussing their care with staff, looking at medication and care files and reviewing areas of the home relevant to these people, in order to focus on outcomes. Case tracking helps us to understand the experiences of people who use the service. Staff files, quality assurance systems and health and safety records were reviewed. We looked around the building to make sure that it was warm, clean and comfortable. We spoke or spent time with all of the people who live at the home and three staff as well as the manager to gather more information about the running of the home and the way in which people make decisions and choices about their lifestyles. DS0000072294.V377226.R01.S.doc Version 5.2 Page 7 There were no immediate requirements made as a result of this visit. This means that there was nothing the home needed to do urgently to protect the people who live there. What the service does well: What has improved since the last inspection? Medicines are being well managed so that people receive their medication in a planned and safe manner. Staff have been given guidance to ensure that people are supported to answer their own front door, without being placed at unreasonable risk of harm. (When we last visited in August 2008, this was an area of concern). DS0000072294.V377226.R01.S.doc Version 5.2 Page 8 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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. DS0000072294.V377226.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000072294.V377226.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 2. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a procedure for assessing people’s needs prior to admission so they can be confident the home is suitable for them. EVIDENCE: There have been no new people admitted to the home since we last visited in August 2008. All of the people who live at Kettlewell Way have done so for a considerable period of time and there are currently no vacancies. It was evident from looking at two people’s files that assessments of their needs had been completed before they were offered a place at the home. We were told that Solihull Care Trust has standard procedures for assessing people’s needs and that this information is made available in the home’s service user guide. One person told us, “I love living here, I am very, very happy”. DS0000072294.V377226.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9. People using the 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 the information they need and a good understanding of how to offer care and support to each person. This should make sure that people are supported according to their individual needs and preferences. People receive good support to make choices and decisions as part of their everyday lives. EVIDENCE: We looked at two care plans and risk assessments. These documents explain people’s needs and describe the care and support they require to make sure these needs are met. DS0000072294.V377226.R01.S.doc Version 5.2 Page 12 The files we looked at gave detailed information about how staff should support people in order to meet their individual needs in relation to health, personal care, communication, culture and social and leisure preferences. Care plans had been linked to risk assessments so that the person could take responsible risks according to their individual needs. People told us that they make choices and decisions as part of their day to day lives. One person said, “I decide what I want to do and when I want to do it”. Staff at the home have engaged the support of Speech and Language Therapists to ensure that each person’s communication needs are understood and met. We saw people using objects of reference, pictures and Makaton symbols to make choices about activities and meals. Makaton is a system of signs and symbols that helps people with communication. Staff told us that some people use Makaton signs to communicate. A poster in the kitchen displayed a “sign of the week” which indicates an awareness of the importance of using signs; however we did not see staff signing to people during our visit. This could lead to people’s needs not being fully met and restrict communication. “Me and My Life” books were seen in people’s bedrooms. The books, which had been completed by each person with the assistance of staff, show how people had been supported to achieve their individual goals and aspirations. Photographs were included to give people a visual image of their achievements such as cooking, going to college, visiting places of interest and taking holidays. One person told us, “I am proud of my college certificates”. We spoke to staff on duty throughout our visit. They answered our questions about the people whose records we looked at and clearly know them well. People who live at Kettlewell Way need assistance to manage their money. There are systems in place to record individuals’ income and expenditure, which are audited each month for their ongoing protection. We have not been advised of any financial errors and the records we looked at during this visit showed no anomalies. This indicates that financial systems are working for the ongoing protection of people who live at the home. DS0000072294.V377226.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 12, 13, 15, 16, 17. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to live an active life and have opportunities to go out and do things they enjoy on a regular basis. People are consulted about the food they eat so that they receive meals they enjoy. EVIDENCE: In addition to staff who work a range of shift patterns at the home, Solihull Care Trust provides one staff member during weekdays to assist in the planning and implementation of activities. We spent time talking to this person during our visit. DS0000072294.V377226.R01.S.doc Version 5.2 Page 14 We were shown records which confirmed that people are actively involved in planning what they do each day and that there are opportunities for them to have time alone with staff so that they can pursue their individual interests. Meetings are held each week so that people can plan for the following week. A timetable is displayed in the kitchen so that people know what has been planned. There are also monthly house meetings, when activities are discussed and group trips to places of interest are considered. These meetings are recorded in plain language with added pictures and symbols so that they are more accessible to people who live in the home. One person told us, “I wanted to go to Warwick Castle and now I have”. There is a system of evaluating activities so that staff can be sure that people are enjoying those that have taken place and as an aid to future planning. A member of staff stated that the plan is flexible, which we saw when we visited. One person made it clear that he did not wish to take part in a proposed activity and staff quickly offered an alternative, which was accepted. The home has a car available for longer journeys and people have bus and rail passes, which they regularly use. People make good use of community based facilities and walk to the nearby pub and to watch the local football team. Activity plans and daily records showed that people had taken part in a variety of activities within the last few weeks, such as attendance at college, shopping, swimming, cinema and Snoozelan trips as well as day trips to Coventry Cathedral and Warwick Castle. One person showed us the flowers and vegetables he had planted in the garden and commented that he and his friends had enjoyed eating the strawberries, carrots and herbs. People are supported to keep in touch with their friends and relatives. Some visit their families and spend regular time with them whilst others keep in telephone contact. One person told us that he had made many friends at college and had photographs of them in his bedroom, which was important to him. Menus and records of food eaten by individuals were sampled to establish that a balanced and varied diet is provided that meets peoples’ needs and preferences. We saw that people had a choice of food at each meal and that menus had been planned in advance to incorporate individual preferences. Staff and people who live in the home told us that food shopping is done weekly and that people have opportunities to go to the local supermarket to buy their food. DS0000072294.V377226.R01.S.doc Version 5.2 Page 15 One person said that he enjoyed cooking snacks and making drinks at home and that staff would help him with main meals. This person told us that the food was very good. DS0000072294.V377226.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are effective systems in place to meet people’s personal and health care needs and to manage medicines safely for their ongoing well being and protection. EVIDENCE: We looked at personal and health care plans for two people. There was some comprehensive information to describe how people should be supported in these areas so that their needs would be met. We met all of the people who live in the home, who had clearly been assisted with personal care during our visit. Everyone was well dressed and wearing clothes suitable for the time of year. Preferred personal care routines had been incorporated into care plans which should make sure that people receive support in a way that they like and need. DS0000072294.V377226.R01.S.doc Version 5.2 Page 17 One personal care plan contained information that did not accurately reflect the person’s needs. This was discussed with staff during our visit and we were assured that the plan would be reviewed. The home has implemented a system of health action planning. A health action plan describes what a person needs to do to stay healthy and the services they should access to do so. The plans we looked at showed that the staff team had contacted health care professionals such as Speech and Language Therapists and psychologists to help them meet people’s needs. Guidelines were in place which explained how staff should support people with their communication and in the management of behaviour which may be challenging. The staff we spoke to were able to describe how they offer care and support to people, which was consistent with the guidelines on file. This indicates that the staff team understand the importance of following professional advice for the ongoing benefit of people living at Kettlewell Way. The home implements a range of monitoring measures to make sure that people stay healthy and well. Weight records were seen as well as records of chiropody treatment. The outcomes of appointments with doctors, dentists and psychiatrists had been recorded and we were told that this information is handed over at each shift change so that staff have accurate information about people’s health. We looked at the management of medicines to make sure that a robust system was in place for people’s ongoing protection. Medicines are stored securely in a locked cabinet. We spoke to three members of staff and looked at records of training, which showed that all but one had received accredited training in the safe handling of medicines. The house leader told us that the person who has not completed the training had been assessed as competent by a registered nurse and re assessed every six months. The Commission has not been advised of any medication errors since the home’s last inspection in August 2008 and a Solihull Care Trust audit in May 2009 identified no areas of concern. This indicates that medicines are being well managed for people’s ongoing health and protection. Medication is received into the home using the monitored dosage system in blister packs. The Medication Administration records (MAR) cross-referenced with the blister packs sampled indicating that medication had been given as prescribed. DS0000072294.V377226.R01.S.doc Version 5.2 Page 18 There were protocols in place which described the circumstances under which people should be offered medication they take on an “as required” basis. The staff that we spoke to were able to explain the content which suggests that protocols had been read and understood. DS0000072294.V377226.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are effective systems in place to listen to and respond to complaints made about the service and to safeguard vulnerable people from harm. EVIDENCE: The home has a complaints procedure which is displayed in the kitchen and forms part of the service user guide. There have been no formal complaints made to the Commission or directly to the home since our last visit in 2008. The manager confirmed that he has regular telephone contact with relatives which means that any concerns are dealt with promptly and as they occur. We looked at the results of recent surveys sent out to relatives which stated that they knew how to raise concerns and complaints should they have any. One person told us that he had no complaints and that “I would talk to the staff if I had. They would listen”. Monthly house meetings are held between staff and people living at the home. We looked at records for the three most recent which showed that people had been invited to talk about any problems or concerns they may have. None had been recorded. DS0000072294.V377226.R01.S.doc Version 5.2 Page 20 Some people demonstrate behaviour that means staff must work with them in a particular way to help them stay safe and well. We were shown guidelines, which had been recently reviewed by psychology services to explain how staff should support people with these needs. We observed staff following the guidelines during this visit, which indicated that the team had read and understood the importance of their role in helping people to stay safe and well. The manager told us that all staff had received training in the safeguarding of vulnerable adults. Staff were able to explain that the training provided them with information about the types of abuse that may be experienced and what to do to protect people and who to report to if abuse is disclosed or suspected. There have been no safeguarding issues referred to Solihull Care Trust since our last inspection. DS0000072294.V377226.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 30. People using the 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 which meets their needs and promotes their independence. EVIDENCE: 2 Kettlewell Way is situated within easy reach of Chelmsley Wood town centre with good access to public transport routes. This is important to the people who live there as they make regular use of these facilities. The home is domestic in style, looking no different to others in the area and is not identifiable as a care home. We looked around the building to make sure that it was warm, clean and comfortable. DS0000072294.V377226.R01.S.doc Version 5.2 Page 22 Bedrooms are single and there are no en suite facilities. None of the bedrooms have hand basins, instead people share a first floor bathroom which has a toilet, bath with shower and hand basin. There is an additional toilet on the ground floor. The bedrooms we looked at had clearly been furnished and decorated according to people’s personal tastes and were all clean and warm. Lockable cabinets are available in bedrooms so that people can keep their belongings securely. There were no unpleasant odours which may indicate poor cleansing routines. Shared space consists of a lounge which leads into the kitchen/dining area. Both rooms were well decorated and furnished. There is sufficient space for people to relax in the lounge and to take their meals together in the kitchen. There is a bedroom upstairs which staff use when they sleep in overnight. This room also provides some storage for people’s records so that confidential information is stored securely. There is space for staff to store their personal belongings so that this does not impact on the space used by people living in the home. A separate laundry room is located off the kitchen with a washing machine and tumble dryer. This room leads directly into the garden so that clothing can be dried on the line outside. The garden has a vegetable patch, flowers and lawned areas with seating that it used during the summer months. People told us they enjoyed spending time in the garden. We were shown an Infection Control report made by the Care Trust in February 2009 which stated that the home demonstrated excellent compliance in this area. Bromford and Carinthia maintain the premises and we saw records which evidenced that requests for repairs and/or maintenance were responded to promptly. This should ensure that the home remains safe and comfortable for people to live in. DS0000072294.V377226.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are supported by a well trained, competent team of staff, who know them well and understand their needs. The home operates a robust system of recruitment for the protection of the people who live there. EVIDENCE: There are photographs of the staff on duty each day displayed in the kitchen so that people know who will be working in their home. All current staff are permanently employed and no agency staff are used. There are no staff vacancies. The home’s rota showed that for the week we visited there were three staff on duty during the day and a member of staff sleeping in at night. Typically there is only one member of staff on duty from 4pm until 7am the following morning. We were told however, that should an evening activity be arranged there were DS0000072294.V377226.R01.S.doc Version 5.2 Page 24 staff available to support this. For example, people had been invited to attend an evening barbecue and staff had planned to be on duty so that they could go. One person told us, “If I want to go out at night I can”. The staff we spoke to demonstrated good understanding of people’s individual needs and have formed positive relationships with them. One person said (of the staff team), “they are very good”. Some people were not able to tell us what they thought, due to their complex communication needs, so we watched how they related to those on duty at various times during the day. People sought out staff and sat next to them and smiled when staff members spoke to them. This indicates that people were comfortable with the staff on duty. There have been no new staff recruited since our last visit. We looked at records for the recruitment of a person employed in 2007. Checks had been made of the person’s suitability to work in the home, including a satisfactory Criminal Records Bureau check; references had been received and an application form completed. This should make sure that people who live in the home are not placed at risk of having unsuitable staff working with them. The AQAA stated that six of the seven staff employed have achieved National Vocational (NVQ) training at Level 2 or above. NVQ training provides staff with essential core knowledge of social care which should contribute toward the deployment of a competent team of staff. The manager told us that people contribute to the process of recruitment and selection by meeting them prior to interview, although this had not happened for some time as no new staff have been appointed recently. Staff training records showed that a rolling programme is offered from Solihull Care Trust. Responsibility for arranging training falls to the manager and house leader. The records we looked at made it difficult to establish when training had last taken place and when updates were needed as some of this information was missing from the training matrix. Since our last visit, staff have taken part in equalities and diversity training as well as Mental Capacity Act and safeguarding training. There are regular opportunities for updates in health and safety, first aid, moving and handling and fire safety training. Some staff training is provided via Solihull Care Trust’s intranet facility. The home does not have a computer, so this resource is not available to staff who work at Kettlewell Way and could restrict their access to essential training opportunities. DS0000072294.V377226.R01.S.doc Version 5.2 Page 25 DS0000072294.V377226.R01.S.doc Version 5.2 Page 26 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42. People using the 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 home is being well managed for the ongoing health and protection of the people who live there. There are systems in place to measure the quality of care and service provided, which include the views of people who live in the home. EVIDENCE: The home has a registered manager who has additional responsibility for another care home in the area. There is a house leader who runs the home on a day to day basis. This person has previous management experience and both DS0000072294.V377226.R01.S.doc Version 5.2 Page 27 have many years experience in the field of social care and learning disability services. Both the manager and house leader were present at this visit and we able to answer our questions about people’s needs and the running of the home with confidence. The AQAA we received clearly stated how the home had made improvements for people over the past twelve months such as developing person centred plans and auditing medicines. There are systems in place to review the quality of care and service in the home. A representative of the registered provider visits on a regular basis and leaves a report describing how the home is meeting or attempting to meet national minimum standards in care. In May 2009 the home received a visit from an Expert By Experience, employed by the Solihull Advocacy group. An Expert By Experience is a person with a learning disability who has experience of social care services. The Expert spent time with the people who live in the home and asked a series of questions about what it is like to live at Kettlewell Way. The home have yet to receive a report of this person’s visit, however it is considered positive that such measures are in place as part of the quality assurance plan. Questionnaires had been sent to family members this year inviting them to comment on the quality of care and service provided by the home. Some of the responses received are included below:“I am very happy with everything”. “I could not have asked for anything better in the last twelve months”. Bromford and Corinthia have responsibility for maintaining the premises. A representative makes three monthly visits to check that the building is comfortable and in a good state of repair. We looked at the last report made in April 2009 and saw that there were no outstanding repairs or maintenance work necessary in the home. A number of checks are made by staff to make sure that peoples’ health and safety is maintained. We looked at some of these. Records showed that the fire alarm system had been regularly tested and serviced to make sure that it was working properly. Fire drills had been conducted on a regular basis to enable staff and people who live in the home to practice evacuation in the event of an emergency; each drill had been recorded. One person was identified as being at risk of possible harm as he may refuse to respond to the fire alarm sounding. There DS0000072294.V377226.R01.S.doc Version 5.2 Page 28 was a plan in place to instruct staff how to safeguard this person so that risks to his health and safety would be minimised. Staff have received training in health and safety, fire safety awareness and First Aid. This should minimise risks to people’s health and well being. We saw that electrical and gas appliances had been checked by professionals qualified to do so. Certificates were available showing that appliances were safe to use. DS0000072294.V377226.R01.S.doc Version 5.2 Page 29 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X DS0000072294.V377226.R01.S.doc Version 5.2 Page 30 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA7 Good Practice Recommendations The way that staff communicate with people should be reviewed to make sure that each person has the assistance they need to make decisions about their lifestyles. Personal care plans should be reviewed so that staff have accurate information about people’s needs so that individuals receive the assistance and support they require. Staff training records should include the date of the most recent training so that timely updates can be planned for in order to provide consistent care and support to people who live in the home. Consideration should be given to providing staff with access to Solihull Care Trust’s intranet facility so that they can complete essential training online for the benefit of people who live in the home. 2 YA18 3 YA35 4 YA35 DS0000072294.V377226.R01.S.doc Version 5.2 Page 31 Care Quality Commission West Midlands Region Citygate Gallowgate Newcastle upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Fax: 03000 616171 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) Care Quality Commission (CQC). 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