Care Home: 24 Upland Road

Similar services:

• Polesworth Group Friary Road
• Polesworth Group Pooley Heights
• Polesworth Group 32 Station Road
• Polesworth Group 70 Long Street
• Breme
• Polesworth Group 64 Long Street
• Polesworth Group 68 Long Street
• 10 Whitfield Avenue

What the care home does well Care plans had a lot of information about the person`s needs and how staff were to help them. People had many risk assessments so that staff know how to help people to be safe.People help with household tasks such as making their own breakfast and tidying their rooms. This helps them to be more independent.There are individual menus so that people have a healthy diet and the foods they like.People help with cooking their own meals and go shopping with staff for food. This helps them to be more independent.When decisions have to be made for the people living there, health care professionals help to do this. This makes sure the decision is in the person’s `best interests`.People have the medication they need to help meet their health needs.The people living there have information about how to make a complaint. This has pictures so it is easier for people to understand.Each person has their own bedroom that is decorated in the way they want. People said they liked their bedroom and had their things in it.People living there said that they like the staff and they are nice.Staff had training in how to work safely so they can help people to be safe.Equipment in the home is checked often so that the people living there and the staff are safe. What has improved since the last inspection? Since we last visited there has been changes in the management of the home. There was a few months where there was little management support. This has meant that staff have not been well supported to make sure that people`s needs are met.Staff know more about how to help people with their diet so they have the diet they need.There are more staff working there so that people are supported by staff that know them well. What the care home could do better: Information about the home should be updated. This will help people to make a choice as to whether or not they want to live there.People`s goals should be reviewed when needed so that staff know how to help them.People should be able to go out more so they can enjoy their life.People should be supported in the way they want and that respects their dignity.People should have regular health check ups to make sure they are well.Staff must know how to reportthings quickly to the right people so that people are kept safe from harm.Records of people`s belongings should be updated when they buy new things so it is clear what belongs to each person.Staff should follow people`s behaviour care plans so they support them in a way that helps them.The home should be redecorated and new furniture bought so it is homely and comfortable to live in.Staff should have the equipment they need to make sure food is cooked safely and people do not get food poisoning.The manager should have enough time to do management tasks so they can run the home well to benefit the people living there. Key inspection report Care homes for adults (18-65 years) Name: Address: 24 Upland Road 24 Upland Road Selly Park Birmingham West Midlands B29 7JR one star adequate service The quality rating for this care home is: 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: Sarah Bennett Date: 2 6 0 1 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 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) Copyright © (2010) 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 Information about the care home Name of care home: Address: 24 Upland Road 24 Upland Road Selly Park Birmingham West Midlands B29 7JR 01214155389 01214155389 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.voyagecare.com Milbury Care Services Ltd Name of registered manager (if applicable) Vacant Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 care home 6 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 6 Date of last inspection 0 9 0 2 2 0 0 9 A bit about the care home Six people who have a learning disability can live at 24 Upland Road. The house is detached and is in a road with other houses in Selly Park in Birmingham. Each person has their own bedroom. Two bedrooms are down stairs. Rooms have a sink but do not have a toilet, shower or bath. There is a large kitchen, dining room and two lounges downstairs. There is a bathroom upstairs and downstairs. In each bathroom there is a bath, sink and toilet. Baths have a special chair so that it is easier for people to get in and out of them. There is another toilet and an office upstairs. There is a big garden at the back of the home. At the front there is a big drive. The home is near to shops, parks and bus stops. It costs from £1,253.17 to £1,189.22 per week to live there. Information from the home tells people how this is paid for. The people living there pay for personal items, such as clothes, toiletries and going out. 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 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. One inspector visited in one day. The home did not know we were going to visit. Before we visited we looked at information the home had sent us. This was reports about things that have happened in the home that they have to let us know about and an Annual Quality Assurance Assessment (AQAA). This tells us about the home and how they think that it meets the needs of people living there. Two people’s records were looked at. We talked to the people living there, looked at how staff help them and talked to staff. We looked around the home and at care, staff and health and safety records. What the care home does well Care plans had a lot of information about the persons needs and how staff were to help them. People had many risk assessments so that staff know how to help people to be safe. People help with household tasks such as making their own breakfast and tidying their rooms. This helps them to be more independent. There are individual menus so that people have a healthy diet and the foods they like. People help with cooking their own meals and go shopping with staff for food. This helps them to be more independent. When decisions have to be made for the people living there, health care professionals help to do this. This makes sure the decision is in the person’s best interests. People have the medication they need to help meet their health needs. The people living there have information about how to make a complaint. This has pictures so it is easier for people to understand. Each person has their own bedroom that is decorated in the way they want. People said they liked their bedroom and had their things in it. People living there said that they like the staff and they are nice. Staff had training in how to work safely so they can help people to be safe. Equipment in the home is checked often so that the people living there and the staff are safe. What has got better from the last inspection Since we last visited there has been changes in the management of the home. There was a few months where there was little management support. This has meant that staff have not been well supported to make sure that peoples needs are met. Staff know more about how to help people with their diet so they have the diet they need. There are more staff working there so that people are supported by staff that know them well. What the care home could do better Information about the home should be updated. This will help people to make a choice as to whether or not they want to live there. Peoples goals should be reviewed when needed so that staff know how to help them. People should be able to go out more so they can enjoy their life. People should be supported in the way they want and that respects their dignity. People should have regular health check ups to make sure they are well. Staff must know how to report things quickly to the right people so that people are kept safe from harm. Records of peoples belongings should be updated when they buy new things so it is clear what belongs to each person. Staff should follow peoples behaviour care plans so they support them in a way that helps them. The home should be redecorated and new furniture bought so it is homely and comfortable to live in. Staff should have the equipment they need to make sure food is cooked safely and people do not get food poisoning. The manager should have enough time to do management tasks so they can run the home well to benefit the people living there. 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 Sarah Bennett Citygate Gallowgate Newcastle NE1 4PA 03000 616161 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 http:/www.cqc.org.uk/. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. 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 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People do not have all the updated information they need to help them make a choice as to whether or not they want to live there. Evidence: The service users guide included pictures and was in a format that may make it easier for the people who live there to understand. It included the information that people would need about the home so they can make a choice as to whether or not they want to live there. It needed updating with the changes to the manager and operations manager, changes to the night staffing arrangements and our contact details so that people can contact us if they want to. It stated what the person pays towards the vehicle but this is no longer provided so this information needs changing. The AQAA stated that they were considering producing the statement of purpose in alternative formats to make them easier for people to understand. There were three people living there so there were three vacancies. The manager said that recently there had been a referral for someone to move in but they had not heard from the persons social worker that this was happening. The people living there have lived there for several years therefore the standard relating to assessment of peoples needs before they move in was not assessed. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have the information they need so they know how to support people to meet their needs and make choices about their lives. Evidence: Records sampled included an individual care plan. These were detailed, centred on the individual and included pictures making them easier for the person to understand. They detailed how staff are to support the person to meet their needs and achieve their goals. One persons short and medium term goals had been reviewed to ensure that staff were supporting them to meet these. However, their long term goals should have been reviewed in December 2009 but this had not yet been done. This needs doing to ensure that staff are supporting the person appropriately. Records showed that people had been involved in their reviews so they had an opportunity to say what they wanted to do in their lives. Care plans had been signed by the previous manager or the persons key worker. There was a space for the person or their representative to sign but this had not been done. This should be done to show that they were involved in and agree to it. Records showed that the previous manager had tried to access advocacy services for individuals. Each person had received a letter from the advocacy service to say that as this resource is limited they were not available. Records showed that where a decision needed to be made in a persons best interests that an assessment of the persons mental capacity had been done to assess whether or not they were able to make this decision. As it was assessed they could not make this decision health professionals had liaised with staff at the home and the persons relatives to ensure the decision made was Evidence: in the persons best interest. Records showed that meetings with the people living there had not happened regularly while there was not a permanent manager at the home. The manager said and records showed that a meeting was planned for the following Sunday. Staff said these would now happen regularly. Staff were observed offering people choices during the day about what they wanted to wear and what they wanted to eat and drink. Records included risk assessments that detailed how staff are to support the individual to be independent and take risks whilst minimising the risks to their safety and well being. As at the last inspection a copy of the risk assessment that related to each individual care plan was repeated, so for example one risk assessment may be repeated in the file five or six times. This made the files very bulky and there was a risk of staff missing a new risk assessment that was amongst all the repeats. Risk assessments had recently been reviewed and the manager said these were to be updated when the new computer arrives, which was due in February. The manager had written which risk assessments needed updating so that staff were aware of this. Staff had signed to say they had read individuals care plans and risk assessments so they know how to support people. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are not always supported to experience a meaningful lifestyle, which could impact on their well being. Evidence: One person went out with staff to the supermarket to buy food for the home, while they were there they had their brunch. The other two people did not go out during the day. One person asked the manager if they could go to the local shop which they said they would ensure staff supported them to do. However, this did not happen as there were not sufficient staff who could support them to do this. This was raised with the Operations Manager after our visit who said they would ensure that sufficient staff were on duty who could support people to go out. Recent visits by the operations manager had highlighted that more activities were needed to ensure people had a meaningful lifestyle. The manager also said that they were offering more activities but this could be difficult as people often refused to go out. Surveys were sent last year by the home to relatives of the people living there. One said that more activities were needed out of the home particularly in the evenings. This is important so that the people living there can have an opportunity to lead a lifestyle reflective of other people of their age who do not live in a care home. There is no longer a vehicle that people can use to access the community but the manager said this would allow people opportunities to use public transport. Each person had an activity plan that included pictures making it easier for the person to understand. One persons for that day stated that they would be going out for lunch but Evidence: this did not happen. It also said in the afternoon that they would do some rug making but this was not observed. Activities observed of all people in the home included looking at magazines, watching TV and listening to music. Records sampled showed that people did little activity outside of the home. Staff said that people have had opportunities to go on holiday but not all the people living there like to go away. They said that people prefer going on day trips and were discussing with individuals where they would like to go. Care plans stated whether the person preferred to go away or out for days. Records sampled included a care plan that stated how staff are to support people in their relationships with their family and friends. Records showed that people have visits from their family and go to visit them. Care plans included how people are to be supported to meet their cultural and spiritual needs. One persons showed they were from a different cultural background to the other two people living there but did not practice their religion. It stated they liked food and going to restaurants that reflected their cultural background. Other parts of the plan stated that they celebrated the same festivals as the other people living there but did not show much interest in these. It had not been explored how they would respond to experiencing other parts of their culture such as music, films, festivals and art. Records sampled showed that people were supported to develop their daily living skills by doing tasks such as putting their laundry away, laying the table and helping to make their meals and drinks. Care plans stated how people are to be supported to do these to increase their independence. Records sampled showed that people have a varied diet that includes fruit and vegetables. Care plans stated peoples likes and dislikes of food and drink. Staff said that they know these and adapt the menus if needed so that people do not eat food they do not like. One person has their own menu that they choose and staff support them to cook their own meals. People go shopping with staff for food. At lunch time people were given a choice of sandwiches. Staff sat with people to eat so making it a social occasion. 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 do not always receive the support they prefer with their personal care and to meet their health needs, which could impact on their well being. Evidence: People were dressed in individual styles that reflected their age, gender, the weather and what they were doing. Care plans included detailed information as to how the person wanted to be supported with their personal care. Peoples records included details of which gender of staff they preferred to support them with their personal care. Records for one person showed that although they preferred female staff to support them, they had been supported by a male member of staff four times in January 2010. There is only one male member of staff who works at the home. The manager said this was because a member of staff who was pregnant was unable to do personal care, so this was done by the male member of staff. Where possible rotas should be adjusted to ensure that people have support with their personal care in a way that respects their preferences and dignity. Records included an individual health action plan. This is a personal plan about what a person needs to stay healthy and what healthcare services they use. These included pictures making it easier for the person to understand and to be involved in. Records showed that other health professionals were involved with people where appropriate. Staff had followed their advice so ensuring peoples health needs are met. Where appropriate decisions had been made about peoples health needs by a team of professionals ensuring that intervention was in the persons best interests. One persons health action plan stated that they needed to visit their dentist regularly but there was no record that they had in 2009. Another persons stated that they needed Evidence: regular chiropody but their records showed that they last had this in March 2009. This does not help to show that peoples health needs are being met. Both peoples care plans said that they were at risk of constipation, which could impact on their other health needs. Records of peoples bowel movements were not always completed. The manager said and it was observed that people go to the toilet on their own. This makes it difficult for staff to monitor without impacting on peoples privacy and dignity. One persons care plan stated that they needed to have prunes with their breakfast to reduce the risk of them being constipated. Their food records that were sampled did not show they had these. Staff should take all action they can to help reduce the risk of people being constipated so to ensure peoples health and well being. Weight records showed that people were weighed regularly and their weight was stable. However, their records did not indicate what their ideal weight should be. This makes it difficult for staff to know whether the person is at a healthy weight or not, which could affect the individuals health and well being. Records sampled included a care plan and risk assessment for people who have epilepsy. Records detailed when people had a seizure and what type of seizure this was to ensure that good monitoring of peoples epilepsy is made. This can help the doctor when they are reviewing peoples medication to ensure their epilepsy is well controlled. Medication is stored in a locked cabinet so that people are not at risk of taking medication they are not prescribed. Medication records sampled showed that people had been given their medication as prescribed. Staff said and their training records showed that they are trained in giving medication. Where people are prescribed as required (PRN) medication a protocol was in place stating when, why and how much of the medication should be given. This ensures that people have the medication they need when they need it. Records showed that people regularly had their medication reviewed and this was changed where appropriate. This ensures that people are taking medication that helps to meet their health needs. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements ensure that people know their views will be listened to but it is not always clear that they are protected from harm, which could impact on their well being. Evidence: The complaints procedure included pictures, making it easier for people to understand how to complain if they wanted to. Peoples records included a copy of the procedure and it was displayed in the home. The home and us have not received any complaints since we last visited. There is a comments book at the entrance of the home but none had been received. Since we last visited one person had some of their jewellery stolen from the safe. This was reported to us and the police. However, records showed that there was a delay of two days before this was done and it was not reported to social services until five days after it was known to be missing. This could have resulted in important evidence being lost. An investigation was carried out by the organisation after the police stated they did not have enough evidence to investigate. It was not found out who stole this but the person has been reimbursed and has been supported to buy jewellery of their choice. Measures have been put in place to safeguard peoples belongings. However, it was disappointing to see in records that a gift that one person had bought had been opened and used. The manager said that this was done by staff but was unable to find out who. Again the person was reimbursed for the cost of this. The operations manager responded promptly and appropriately to our concerns about this. Further measures have been put in place to safeguard peoples belongings including inviting the police to visit the home for advice, providing further training to staff in safeguarding including how to report this, ensuring service users records of belongings are up to date and regularly monitored and staff checking peoples valuable items at the handover of each shift. Records of peoples belongings showed that one persons had been updated regularly but the other persons had not been updated since December 2008. It is hoped that with these additional measures in place to safeguard people that these will now be updated regularly. Evidence: Peoples personal monies are held safely in the home. Records sampled matched the amount held for them and receipts were available of all expenditure. These showed that money had been spent on personal items not on things that should be provided by the home as part of the fees they pay. Some people who live there may at times display behaviour that can be challenging to others. Plans were in place that showed staff how to support individuals when they displayed these behaviours. These stated that staff were to act in a non confrontational way so to help the person calm down. Records sampled for one person showed that on two occasions in September and November 2009 that staff had not responded in this way. On one occasion they had removed some of the persons belongings from their bedroom until the person apologised. On the other occasion they denied the person their dessert at mealtime and sent them to their bedroom. This does not show that staff always follow the persons plan, which could impact on their well being. Staff training records showed that all staff had received training in safeguarding the people living there from harm. The operations manager said that all staff would be given updated training in this. Staff have received training in the Mental Capacity Act and how this legislation may affect the people living there. Records showed that this act was put into practice when supporting people to make decisions so these decisions were made in the persons best interests. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and safe but not homely and comfortable for people to live in. Evidence: The decoration and furnishings in several areas of the home looked worn and was in need of replacing to make it homely and comfortable to live in. The manager said this had been identified and quotes were being obtained for this work to be done. At the last inspection we were told that there were plans for the kitchen to be refurbished and this had been done. Carpets were stained in the dining room, lounge and one persons bedroom and needed replacing. The dining room table was worn and the dining room chairs were worn and of different styles so did not match. The manager said that when things need repairing this is done quickly to keep the home well maintained. Peoples bedrooms were personalised according to individual tastes and interests. One person has a double bed as they said this is what they prefer. People said they liked their bedrooms and had all they needed in them. The vacant bedrooms had been redecorated in a neutral style so that people who move in would be able to choose to personalise this to their tastes. The home was clean and free from offensive odours making it pleasant for people to live in. The people living there help with cleaning the home so developing their independence. The AQAA stated that high standards of hygiene are maintained and eight out of ten staff had received training in infection control. 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. The arrangements for staffing, their support and development are variable, which could impact on the people living there. Evidence: The AQAA stated that 50 per cent of staff have achieved National Vocational Qualification (NVQ) level 2 or above in Care and three staff are working towards this. This meets the standard and should ensure that staff have the skills and knowledge to meet the needs of the people living there. The manager said there were no staff vacancies. This helps to provide continuity of support for the people living there. The manager works some shifts as part of the rota and was working as part of the shift on the day we visited. This can make it difficult for the manager to concentrate on management tasks. As there are only three people living there, there are two staff on each shift during the day and one waking night staff. As stated earlier in this report this does not always ensure that the people living there can do the things they want to do. Staff meetings have not been held regularly due to the change in management. There were a few months where the previous manager was managing this home and another followed by a time where there was not a manager at this home. Staff said and records showed that a staff meeting was planned for the next day. The manager said that these were now to be held regularly so that staff have information about peoples needs, are kept updated with changes within the organisation and with best practice. The records of three of the staff that work there were looked at. An agreement has been made with us and the oragnsaition that some of the staff recruitment records are kept at their Head Office. Records showed that the required recruitment checks were completed before staff started working there to safeguard the people living there. Evidence: The majority of training for staff is done on the El Box. This is an on line training programme and the laptop used for this is shared with another home so that staff at the home have this for two weeks at a time. Staff said that they have most of the training they need on this but do go on other courses also. Staff training records showed that staff have the training they need to meet the needs of the people living there. However, as identified earlier in this report more training is needed in safeguarding so that staff have a good awareness of this. Due to changes in management staff have not had regular, formal supervisions sessions. However, records showed that since the manager had been in post the frequency of these had improved and further sessions were booked. These included night staff so they were included in these and had the support they needed. 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. Management arrangements do not always ensure that the people living there live in a home that is safe and well run. Evidence: The manager has worked at the home for four weeks. She was the registered manager at another home owned by the organisation but has swapped with the previous manager of this home. The manager has been on maternity leave for a year. As stated earlier in this report the manager works some shifts as part of the rota. This can make it difficult for the manager to concentrate on management tasks. Prior to the manager working at the home the previous manager had been managing both homes for a year. In recent months they had been unable to have the time to have much input into this home. Findings of this inspection show that this has resulted in some standards not being met and in some instances the well being of the people living there being affected. Staff said that since the manager had been in post improvements were being made. The manager said she is well supported in her role and has the opportunity to meet with other managers within the organisation to share ideas and best practice. Records showed that the operations manager visits regularly, unannounced, to do an audit of the home and how it is meeting the standards and benefiting the people living there. They meet with the people living there and staff during these visits and seek their views. Some of our findings had already been raised in reports of their visits and action is being taken to make the necessary improvements. An annual review of the home is completed. This includes giving surveys to the people living there and their relatives to ask their views. These were generally positive with some comments made about lack of staff support for people with activities. Evidence: Staff check the water temperatures regularly to make sure they are not too hot, which could put people at risk of being scalded. Records showed that these were generally within the recommended temperatures so that people are not at risk. Fire records showed that staff regularly test the fire equipment to make sure it is working. It is regularly serviced by an engineer to ensure it is well maintained. Regular fire drills are held so that staff and the people living there would know what to do if there was a fire. Staff said they regularly check the fridge and freezer temperatures to make sure that food is stored at the right temperature and records of this were seen. Staff said that they were unable to test the temperature of cooked food, as the food probe had broken. This ensures that food is cooked at the right temperature so that people are not at risk of food poisoning. Records in the staff communication book showed that this had not been working since December and that staff had requested another one be bought. 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 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 1 23 12 Safeguarding issues must be 28/02/2010 reported to the appropriate authorities without delay. To safeguard the people living there from harm. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 The service users guide should be updated to include the current information about the home so people can make a choice as to whether or not they want to live there. The person or their representative should sign their care plan to show they have been involved in it and agree to the way staff are supporting them. Peoples goals should be reviewed when needed to ensure they are being supported to meet them and they are still appropriate for the person. Risk assessments should not be repeated in peoples files so the risk of staff missing a new risk assessment is 2 6 3 6 4 9 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 reduced and staff know how to support individuals. 5 12 People should be offered opportunities to experience a range of activities inside and outside the home to help them develop as an individual. Sufficient staff who can support people to go out and do the activities of their choice should be available so that people can experience a meaningful lifestyle. Individuals should be given the opportunity to explore their cultural background so they can experience a meaningful lifestyle. People should be supported with their personal care in a way that respects their preferences and dignity. Staff should be aware of what each persons ideal weight should be so they can monitor their weight records to ensure the persons health needs are being met. Staff should take all action they can to help reduce the risk of people being constipated so to ensure peoples health and well being. People should have regular contact with appropriate health professionals to ensure their health needs are met. All staff should be aware of how to respond to and report any suspicions or allegations of abuse so they know how to safeguard the people living there. All staff should follow peoples care plans so they respond to their behaviour appropriately and ensure their well being. Records of peoples belongings should be regularly updated. This will ensure that it is clear what belongs to each person if anything should go missing. The home should be redecorated and furnished making it homely and comfortable for people to live in. There should be at least six staff meetings a year. This will ensure that staff have information about peoples needs, are kept updated with changes within the organisation and with best practice. 6 13 7 15 8 18 9 19 10 19 11 12 19 23 13 23 14 23 15 16 24 33 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 17 18 33 36 Staffing levels should be reviewed to ensure that there are sufficient staff to meet the needs of the people living there. All staff should have regular, formal supervision sessions with their manager to ensure they are supported in their role and know how to support the people living there. The manager should be given sufficient time to manage the home so it is well run and benefits the people living there. The food probe should be working so that staff can ensure that cooked food is at the right temperature so that the risk of food poisoning is reduced. 19 20 37 42 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. Copyright © (2010) 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. - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!