Care Home: 24 Main Road

What the care home does well The staff try to find out what people like to do.They try to find out what they like to eat and try to make sure that is what they get for their meals.They have written down what help people need.If someone is ill they make sure that they get the right treatment. If someone needs medicines or creams they will make sure they get them.If a person doesn`t like something they can tell the staff. If someone is upset and unhappy the managers and the staff will try to find out why.The home is clean and well decorated.Each person can keep their own belongings in their room and those rooms can be decorated how they would like them to be.The home has a pleasant garden for people to sit and walk in.The staff are cheerful friendly and helpful and encourage people to enjoy themselves but also try to make sure that they are safe and well looked after. What has improved since the last inspection? This is the first time that this home has had a full inspection. What the care home could do better: We have made no formal requirements or recommendations as a result of this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: 24 Main Road Main Road Main Road Dorrington Shrewsbury SY5 7JR The quality rating for this care home is: two star good 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: Michael Moloney Date: 1 0 0 5 2 0 1 0 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 31 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 31 Information about the care home Name of care home: Address: 24 Main Road Main Road Main Road Dorrington Shrewsbury SY5 7JR 01743719950 01743719000 manager.mainrd@consensussupport.com www.consensussupport.com Consensus Support Services Limited Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Rosemary Anne Bullimore Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 9 0 0 0 care home 9 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is: 9 The registered person may provide the following category of service only: Care Home Only (Code PC) to service users of the following gender: Both whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 9 Date of last inspection 1 7 1 2 2 0 0 9 Care Homes for Adults (18-65 years) Page 4 of 31 A bit about the care home This is a service that has been registered to provide a home for up to nine people with a learning disability. It is situated in the Shropshire village of Dorrington just a few miles to the south of the county town of Shrewsbury. It is owned by Consensus Support Services Limited and is managed on their behalf by Rosemary Bullimore. There is easy access to this home as it is just off the main A49 and has plenty of parking for visitors. Care Homes for Adults (18-65 years) Page 5 of 31 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 Care Homes for Adults (18-65 years) Page 6 of 31 How we did our inspection: This is what the inspector did when they were at the care home Before we went to the home we looked at the information that the manager had sent us. We often ask for this before an inspection and always ask the same questions. This tells us how the home thinks they are doing. We also look at the information that the home has sent us about accidents that have happened to people who live and work in the home. We did not tell them that we were coming. One inspector visited the home. His name was Mike Moloney. He was there for four hours. Care Homes for Adults (18-65 years) Page 7 of 31 We looked at how two of the people who live in the home are looked after and what had been written down about them. We talked to and we watched how the staff looked after them and talked to them about what they did. At the time of our visit there was only one of the people who live there in the building. She chose to stay in her room while we were there and so we were unable to talk to her to get her views. What the care home does well The staff try to find out what people like to do. Care Homes for Adults (18-65 years) Page 8 of 31 They try to find out what they like to eat and try to make sure that is what they get for their meals. They have written down what help people need. If someone is ill they make sure that they get the right treatment. If someone needs medicines or creams they will make sure they get them. If a person doesnt like something they can tell the staff. If someone is upset and unhappy the managers and the staff will try to find out why. Care Homes for Adults (18-65 years) Page 9 of 31 The home is clean and well decorated. Each person can keep their own belongings in their room and those rooms can be decorated how they would like them to be. The home has a pleasant garden for people to sit and walk in. The staff are cheerful friendly and helpful and encourage people to enjoy themselves but also try to make sure that they are safe and well looked after. What has got better from the last inspection Care Homes for Adults (18-65 years) Page 10 of 31 This is the first time that this home has had a full inspection. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Michael Moloney 77 Paradise Circus Queensway Birmingham W Midlands B1 2DT Care Homes for Adults (18-65 years) Page 11 of 31 01216005300 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. Care Homes for Adults (18-65 years) Page 12 of 31 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 13 of 31 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 who may want to live in this home and their representatives have the information needed to choose a home, which will meet their needs. They have their needs fully assessed and, when possible, the chance to visit the home before they decide to stay there. Evidence: Four new people had come to live at this home since it opened as well as a small number who had stayed there for respite care. We looked at how the home had managed their admission and found that they had obtained as much background information as possible from their families, schools and other carers. They had obtained the advice of not only those people but other professionals such as psychologists as well. The staff also talked about a person who was being considered for admission who was also able to visit before it was decided that this home would be a suitable place for him to live. We saw that the home had a service user guide for both the full time and respite care services. These documents give people an outline of the of how the home is run, what services and support it can provide and how someone would raise an issue about it should they need to. Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: Care Homes for Adults (18-65 years) Page 15 of 31 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. People who live in this home are involved in decisions about their lives and play an active role in planning the care and support they receive. Evidence: We looked at how people who live in this home are involved in decisions a about their care and the activities that they are involved in. We saw that Person Centred Plans were being developed for each of them. These are plans that are drawn up by the home that identify what each person needs to be healthy, what they enjoy doing and what they dont like to happen to them. These are all written down and guidance is drawn up for the staff to follow that take into account all of these things. We saw written descriptions of how those plans could be put into effect safely. We talked to staff who explained peoples plans had been drawn up by talking with them. If people have difficulty expressing themselves the staff told us that they can develope the plans with specialist help. They gave the example of one person who was receiving help in expressing her wishes from a psychologist who had known her for some time. We also saw the records of reviews carried out by the local authority that check that the home is meeting the needs of the people who live there. We also saw records that showed that the home consulted Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: specialist healthcare workers about identifying and meeting the more complex healthcare needs. Care Homes for Adults (18-65 years) Page 17 of 31 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. People who live in this home are able to make choices about their life style and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individuals expectations. Evidence: We looked at how the home meets the social needs of the people living there. As previously stated we looked at peoples plans of care and saw that these showed what people liked to do and what they did not like to do. We saw records that said that they went to such things as the day services provided by local agencies, shopping, line dancing, swimming and various clubs. We saw that each person had a clearly identified weekly timetable and the staff told us that they drew these up with the individual concerned, usually on a Sunday, and these contained the activities that they wanted to take part in as well as such things as doctors appointments. We saw that the home has a people carrier style vehicle and this is used to take people to appointments and other activities such as the Gateway Club. We looked at the meals that were served in the home. We saw records that showed that the diet is varied and nutritious. The staff who Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: prepared the meals told us that they had current food hygiene certificates and we saw that the training records maintained by the home confirmed this. We also looked at the records of the meals provided to people who live in this home. Staff told us should someone not want what had been agreed for that day they would prepare an alternative for them. Examples of the meals on the menus were grilled chicken, pork chops, cottage pie and sausage beans and chips. We talked with the manager and the staff who told us that some of the people who live in this home need a special diet for either medical or cultural reasons. We saw that different ingredients had been bought to meet those needs. Throughout the inspection there was only one of the residents in the home as the other three were out at various activities. The one remaining person chose to stay in her room, however, we heard the staff talking to her in a friendly, clear and professional manner. When they talked about someone they called them by the name that had been agreed with that person and entered in their records. We saw that when a member of staff entered bedrooms or bathrooms they always knocked and called before entering the room. Care Homes for Adults (18-65 years) Page 19 of 31 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 that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: We looked at the records of two of the people who live in this home to see if their health needs are being met. We looked at peoples assessments that contained information about any medical conditions that affected each person and the records also said how each condition should be managed. Within the records we saw entries that showed when and why people saw healthcare professionals such as consultants, general practitioners, physiotherapists, dentists chiropodists. We also saw guidance to staff about how people would want to receive their personal care. We talked to the staff and they showed that they were aware of what these wishes were. There was only one resident in the home at the time of the inspection and she stayed in her room. However, we saw staff discretely talking to her from the bedroom doorway after they had politely knocked. Observing that and talking with the staff indicated that this was normal practice and behaviour within the staff team. The records that we saw also contained information about peoples weight as part of the system for monitoring their general health. We talked to the staff and they showed that they were aware of the general mood of each person and would try to pick up if someone was out of sorts and work out if they needed to contact their G.P., dentist, chiropodist or some other healthcare professional. They also told us how they Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: were working closely with a psychologist to address some areas that were an issue for one of the people who live in the home. We saw that peoples medications are reviewed on a regular basis by their doctor. We saw that there are accurate records of when the medication is administered and we saw that the medication is stored safely. We discussed the deprivation of peoples liberties and the manager and the staff told us that they had undertaken the training available locally about this and currently there were no issues in the home that needed to be referred to the local authority. Care Homes for Adults (18-65 years) Page 21 of 31 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 who live in this home are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected. Evidence: We looked at the homes complaints policy and this was seen to contain information on how and with whom issues of concern could be raised. We looked at the homes complaints book and we saw that no complaints had been made. No referrals had been made into the local procedures that deal with allegations of abuse of vulnerable people. We looked at the training records and saw that staff had received training in the identification of abuse and the procedures that they must follow if they see such an instance. They also told us that they had received training in the procedures that they must follow if they thought that it may be necessary to restrict the freedom of an individual in that persons best interest. We also spoke to a number of the staff who confirmed that those records were accurate. Care Homes for Adults (18-65 years) Page 22 of 31 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. The physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment, which encourages independence. Evidence: We looked around the building and grounds of 24 Main Road. We saw that there were three communal areas in the building that the people who live there could use. There were 2 lounges and a dining room. The dining room was next to the well equipped kitchen We saw that it was clean and well maintained and was equipped with a dishwasher to help maintain cleanliness at a safe level. We also saw that there were a satisfactory number of clean and odour free bathrooms and toilets appropriately spaced around the home so that one was always convenient for people to get to. We looked at a number of the bedrooms used by people who live in this home and they were all seen to be very spacious, well maintained, clean and each had been decorated in a different way. Each room had en suite facilities. Staff told us that the rooms had been decorated in a way that they thought the occupants would prefer. We also went into the homes laundry and found this to be equipped with the machinery necessary to cope with heavily soiled clothing and bedding. Staff told us that they had received training in infection control and we saw the training records that are maintained by the home that confirmed this. We also saw that the part of the home that would be used for respite care was separated form the rest of the building by a door with a code activated lock so that each area could Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: maintain its privacy but the staff could move between them. Each of the three bedrooms in the respite area had its own en-suite facilities and access to kitchen/lounge/dining area. We also saw that the part of the rear garden nearest to the kitchen was decked and level. The manager and the staff also told us that the larger area outside the main lounge was being developed with the involvement of the people who live in the home. A level lawn is already in place. We also saw that there was plenty of car parking for people who wanted to visit anybody living in this home. Care Homes for Adults (18-65 years) Page 24 of 31 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. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions and to support the smooth running of the service. Evidence: We looked at the employment records of four of the staff and saw that background checks had been carried out before they were allowed access to people living in this home as part of the procedure that ensures that they are fit do so. The records for each stage in the recruitment process were seen to be clear and easily accessed by those people who need to check them. Looking at the staff rota as well as talking with the manager and staff showed that there were enough staff on duty to make sure that the care needs of the people living there are met. During the inspection few conversations between people who live in the home and staff were seen and heard as most of the residents were out and the one who remained stayed in her bedroom. The staff were always professional, clear and polite when they spoke. We talked with a number of the staff who confirmed that they have received or were about to go on the training that would ensure that they are able to meet the needs of the Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: people living at the home. This included such things as manual handling training to make sure that when they are helping people to move that they do so in a safe manner and basic first aid so that they can provide support to people who are ill or hurt until more skilled assistance arrives. Infection control training was also in place. The staff also confirmed that they had undertaken food hygiene training. The manager and some of the senior members of staff explained the system that the home uses to identify what training each member of staff has had or needs. They showed this to be a systematic process that would put the staffs skills in place so that they could meet the needs of the people who live in this home. Talking with staff and looking at the training records showed that the training for care staff included National Vocational Qualification training to level 2 or above in care to help more experienced staff to develop their skills and knowledge and foundation training which gives an immediate and basic training for those who are new to this type of work. Care Homes for Adults (18-65 years) Page 26 of 31 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 and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. Evidence: We talked to the manager and she confirmed that she was a qualified nurse and had completed the National Vocational Qualification in care to level 3 and the Registered Managers Award which are all qualifications that are considered to be appropriate for someone who runs an organisation such as this. We found that the proprietor carries out regular monthly quality assurance inspections and saw the records of the result of these. The manager told us that they intend to carry out a satisfaction survey amongst the people who live in the home to try and find out how well they think the home and its staff are meeting their needs. The manager told of how the home was aware of the local procedures that are designed to protect the human rights of people who lack the capacity to do so for themselves. She Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: told us that nobody in the home had any restrictions placed upon them as a result of these. We found that the home stores small amounts of cash on behalf of some of the people who live there. We saw that these sums are kept and recorded in a clear and easily checked way. We asked for and were shown the records of the regular testing of such things as hot water temperatures, fridge/freezer and fire alarm systems. We saw that these records were clearly and regularly maintained showing that the safety of the people who live in this home is monitored on a regular basis. We looked for records of staff training. We saw that records contained comprehensive records of what training staff had received. Care Homes for Adults (18-65 years) Page 28 of 31 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 29 of 31 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 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 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. 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