Care Home: 21 Elvetham Road

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What the care home does well We saw staff support people and they were kind, and respectful. Staff and people living at the home enjoyed a joke together. People have their own bedrooms. They are able to put things in there which are important to them. People are helped to stay in touch with their family and friends. Staff help people see doctors and nurses who can help them to stay healthy. Fresh food is provided which people enjoy. The home is bright and clean, and there is plenty of space for people to move about. There is equipment to help people move and bathe safely. What has improved since the last inspection? We asked staff what had improved at the home. They said, "The rapport between people and the staff. We all get on really well. This is generally a happy place to be." What the care home could do better: Care needs must be written down in a plan, so all staff know what the needs are and how the person would like them to be met. Risk assessments must be written to make sure people can live as independently and safely as possible. Staff need to be better trained and supervised to ensure they are able to support people well. Checks on staff before they start work need to improve to ensure they are suitable to work at this home. All the equipment and services provided by the home need to be checked to ensure they are safe to use, and won`t harm people. Key inspection report Care homes for adults (18-65 years) Name: Address: 21 Elvetham Road 21 Elvetham Road Birmingham W Midlands B15 2LY     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Alison Ridge     Date: 0 8 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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. Care Homes for Adults (18-65 years) Page 2 of 28 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 Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 21 Elvetham Road 21 Elvetham Road Birmingham W Midlands B15 2LY Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Michelle Marie Bisseker Type of registration: Number of places registered: care home 5 Real Life Options Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability sensory impairment Additional conditions: 1.The registered person may provide the following categories of service only Care Home only Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories Learning Disability Code LD maximum number of places 5 2. The maximum number of service users to be accommodated is 5 Date of last inspection Brief description of the care home Upto five people can live in this home. Each person has their own bedroom, and shares the lounge, kitchen, laundry and bathrooms provided. Staff are provided to support people with their care and to help them do interesting Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 5 0 0 0 Brief description of the care home things each day. Fees are calculated for each person and can be obtained direct from the home. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: One inspector visited the home and did the inspection in one day. The home did not know we were going to visit. We spoke to people who live at the home, the staff and manager. We looked at the way staff supported people with their care and activities. We looked at records about care and support. We looked at paperwork the home has to keep. This is about staff and keeping the home safe. We looked around some parts of the home. Care Homes for Adults (18-65 years) Page 6 of 28 What the care home does well: What has improved since the last inspection? 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. Care Homes for Adults (18-65 years) Page 7 of 28 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 8 of 28 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 the information they need prior to deciding if the home is right for them. Evidence: This is an established home, which has recently been taken over by a new provider. The people living here have been resident for several years, so we did not track their experience of moving into the home. There are currently two vacancies for people to move into, and Real Life Options and the staff team are looking for the right people to move into this home. We saw that the procedure to under pin this should ensure that the existing people living at the home will get chance to meet the new people, and the staff team will be able to get to know the people, and be confident they and the home can meet their needs. The manager of the home told us how they will check they can meet the persons needs, before anyone is offered a place. The home has produced two documents, a Statement of Purpose and a Service User Guide. These are written in ways which are easy to understand, and have pictures and Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: symbols to help people understand what has been written. Each person living at the home has been given a contract. This tells them what Real Life Options will offer them, and the rules of living at the home. We though this document was easy to read, and again had pictures to support the words. It was good that staff had read these documents to people living at the home. We said the contract should also make clear how much people will have to pay to wards the home vehicle. Care Homes for Adults (18-65 years) Page 10 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples choices are respected,and they are helped to live their life in the way they prefer. Evidence: We case tracked one person. We found that they were very involved in the running of the home, and were supported to clean their room, and around the home as well as to bake and to prepare light meals. The home has been recently decorated, and when we commented on this, the person smiled and said of the wall paper, I chose this myself. They were also pleased to show us their bedroom, and the decor and soft furnishings they had chosen for it. The person we case tracked was supported to manage their own money, and staff helped them to access a local bank. We thought it was positive that people are asked formally each week about things they would like to do, but we also saw during the day people being asked and involved Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: in the organisation of the day, activities and meals. The manager and one person living at the home informed us that Real Life Options involved them in the running of the organisation. They had attended meetings and been asked questions about which things are going well and how things could improve. It is hoped people will also be active in recruiting new staff. The staff team are developing new care and support plans for each person. It was positive to see that people are being involved in this. We could see and one person told us that staff read the plans to them, and ask them what they would like to be written in them. We looked at risk assessments. These were mainly available for the risks people regularly face. We did not find that they had been kept under review when peoples needs change, or every few months to check they remain relevant. We looked at one person who had lots of falls. There was no risk assessment available for this. We could not see that staff had done everything possible to reduce the impact of falls. Doing this would promote the persons safety, while enabling them to live as independently as possible. Care Homes for Adults (18-65 years) Page 12 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live an interesting lifestyle, doing things important to them. Evidence: We were pleased to see that each of the people living in this home were supported to do things they like during the day of our visit. We spoke with all the people who live in the home, who told us the sort of things they like to do. We were pleased when they told us that they are able to do these things most days, and records and staff also showed us this was the case. Two of the people we spoke to like knitting It was positive they had been supported with this, they had plentiful supplies of wool, and had been supported to find places which would benefit from their work. One person told us they like parks, cafes and libraries. We saw them be supported out of the home in both the morning and afternoon of our inspection to visit these places. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: We were pleased to see that people are supported to stay in touch with people who are important to them. This includes by phone, to have visitors to their home, and being supported by staff to meet people in the community. We found that the menu offered was very flexible. A menu is planned but people can change this if they would like something different. We saw the menu had food on it which people had requested in their weekly meetings, and which they told us they like during our visit. Some people need their food preparing in a special way to help them eat it. This was done very sensitively, and the appearance of the food made as nice as possible. Care Homes for Adults (18-65 years) Page 14 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People cannot be confident their health needs will always be known or met. Evidence: Each person has a plan of care, and these are currently being updated. We were pleased to see how much each person had been involved in writing their plan, and that they were very individual to each person. The style in which the plan is written helps the person understand it, and the words are supported by pictures and symbols. We saw the early draft of a new care plan on the computer, and found the way this had been written again would help people understand what it was about. We sat in the lounge and watched how staff supported people and helped them to move. We saw that this was very kind and respectful, and it was in the way the person preffered. We looked in detail at one persons plan, and found that some areas of care were not well planned for. We were concerned that this person currently needs some extra support due to a injured leg, and this had not been written down in the plan. We saw that one person has epilepsy and the plan did not tell staff how the person needs to be Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: supported if they have a seizure. We saw that staff check peoples weight each month, but we could not see any guidance on what the goal weight for the person was. We could not judge if this was effective. It was good an assessment had been done regards the person getting sore skin. The chance of this occurring now the person has an injured leg is increased but this had not been identified or prompted a review of the assessment. It was good that people are supported to see health care staff. We could see that appointments had been made with the dentist, optician, podiatrist, specialist doctors and for well woman checks. We checked the medication management and found this to be very good. There are systems in place which should quickly identify any medication mistakes. All the medication people needed was available. We could see that staff had checked the medication when it had arrived into the home, they had stored it properly, and recorded each time it was given. Staff had found out how each person likes to have their medicine and recorded this, to ensure all staff give it in the way the person has chosen. Care Homes for Adults (18-65 years) Page 16 of 28 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. Peoples concerns are listened to, and they are protected by practices that keep them safe from harm. Evidence: We looked at the proceedure for dealing with complaints and safeguarding matters. We found these were generally very good and would ensure that the right people are informed of any matters of concern. We noticed that the complaints policy needs to make clear that people can contact CQC at any time, and not only when they have followed the internal proceedure. We found that people are given chance to raise concerns each week at the residents meeting. One person we spoke with said they couldnt imagaine needing to make a complaint, but they would feel able to talk to the staff. It is good that the complaints policy is written in a way that is easy to read and understand. A computer programme which assesses if peoples are having their Liberty Deprived (DOLS) has been obtained, and this is being used to assess if anyone is affected by this. It was positive that two of the three staff we looked at have been trained in the Mental Capacity Act and DOLS. We looked at staff training for three staff. We found that two staff needed to have training on safeguarding. We spoke to one member of staff about what they would do Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: if they saw or thought someone was being harmed. It was good that this person knew about types of abuse, but we found they needed more information about who they should refer the concerns onto. We looked at the way peoples money is managed by the home. We found this was securely stored, and good records with receipts were being kept. This was all done in a way that still allowed the person to have access and control over their money which is important to them. Care Homes for Adults (18-65 years) Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean comfortable home which meets their needs well. Evidence: The bungalow very much feels the home of the people who live there. Some decoration has been undertaken recently and all the areas we looked at were presented to a high standard. Two people showed us their bedrooms. These were extremely comfortable, and reflected the individual tastes, age and gender of the people very well. People looked very comfortable sitting in lounge chairs. Side tables and foot stools were provided. People were able to move freely around the home, and it was good to hear that people take an active role in keeping the home clean, and choosing decor and items to furnish it. There is a walk in shower room, and assisted bath facility, which meets the needs of the people accommodated. The home was clean throughout, there were no unpleasant smells. Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: There were hand washing facilities in bathrooms and the kitchen. This helps to stop the spread of germs and infection. Care Homes for Adults (18-65 years) Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by staff they know and like. Staff do not have all the skills required to support people safely. Evidence: People are supported by an established staff team who know them well. We saw during our visit that people feel comfortable around staff, and an easy relaxed atmosphere was in the home all day. We observed staff to support people in a way which was respectful and kind. We saw staff and people living in the home laughing together, and having fun. We looked at the records held about three staff. One person had worked in the home for several years and was recruited by the previous home owners. We could not see that for this person all the checks required had been completed before the person started work in the home. We could not see that checks on people (The CRB) had been updated regularly. This does not ensure people are supported by staff suitable to work in care. The staff we looked at had worked in the home for many years, and over that time had received alot of training. We could not see that this had been kept up to date and renewed when needed. The staff need some specific skills in supporting people who Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: cannot hear well, who have epilepsy, and who need special help to eat and drink. We could not see that all staff had this training, or that it had been kept up to date. This means staff do not have up to date specialist knowledge. It was positive that the home had recognised this, and significant training was booked for the next few months. An audit should be undertaken to ensure that all staff will have up to date training following this. Staff had been supervised. This ensures they feel supported and are able to do their job. Recently, since the home has been operated by Real Life Options this has been done monthly, but some people have gone up to seven months in the past year between supervisions. We thought it was positive that a topic and work sheet is provided for staff each month. This ensures they stay up to date with changes, and will enable them to support people more effectively. Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a mainly well run home. Evidence: The manager has been in post for several years, and has the training needed to run the home. We saw during our visit that the manager was approachable and friendly and people and staff found it easy to talk with her. One staff said, She is friendly and approachable, all the senior team are. The new providers have undertaken one Regulation 26 audit of the home. This identified that work needs to be completed to transfer documents to the new providers paper work, and to ensure things are up to date. An action plan to do this was completed with the audit. We looked at some of the records to show that equipment and services provided at the home are safe to use. We found a lot of the things we looked at were out of date and needed attention. The fire risk assessment had not been reviewed since Feb 2009. This was a detailed Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: document, but it was identified as needing an annual review. Staff had checked the fire alarm and emergency lights, to ensure these would work in event of a fire. We thought it was good that a sign to show people when a fire alarm test or a real fire alarm was occurring had been developed. Records showed that not all fire doors had closed properly, and that a request to repair these had been made. This needs to be done, and it confirmed they now close fully. The gas had been checked and was safe to use. A fire lecture had not been delivered since February 2009, and not all staff had attended. This means some staff had no recent fire training, and may not be able to support people effectively in event of a fire. A new bath had been fitted recently, we could not see that it had been load tested prior to being used. The electrical hard wiring was overdue for inspection. This should have been done by January 2009, and we need to be certain the electricity is safe to use. The hot water temperatures are checked weekly by staff at the home. We noticed the shower was running at 47 degrees and asked this be checked and if needs be reduced slightly to reduce the risk of scalding. Care Homes for Adults (18-65 years) Page 24 of 28 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 25 of 28 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 9 13 Risks people take must be assessed and the assessment kept under review. To ensure the impact of risks are reduced as far as possible, while people are supported to be independent. 31/05/2010 2 18 12 People must have an upto date careplan that details their needs and how they are to be met. To ensure staff know their needs and how the person prefers them to be met. 31/05/2010 3 34 19 All staff must be checked prior to being offered work at the home, and checks updated as required. To ensure people are supported by staff suitable to work in care. 31/05/2010 Care Homes for Adults (18-65 years) Page 26 of 28 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 4 35 18 All staff must have training specific to the needs of people they support. To ensure they are knowledgeable and able to meet peoples assessed needs. 30/06/2010 5 41 23 All services and equipment must be serviced and maintained in a fit to use condition. To ensure people live in a safe environment. 31/05/2010 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 5 It is recommended that the amount each person must pay to wards the homes vehicle be clearly stated in the contract. Care Homes for Adults (18-65 years) Page 27 of 28 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. 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. 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