Care Home: 264a Vicarage Road

Similar services:

• Polesworth Group Friary Road
• Polesworth Group Pooley Heights
• Polesworth Group 32 Station Road
• Polesworth Group 70 Long Street
• Polesworth Group 64 Long Street
• Polesworth Group 68 Long Street
• 1a White Ladies Close
• Leabrook House Nursing Home

What the care home does well The house is well designed and allows privacy with single bedrooms and a number of communal areas. It is also well positioned for access to transport links and local shops and facilities. The home has a stable and experienced management team that know people living at the home well.The staff promote the independence of people living at the home through day to day domestic, occupational and social opportunities.The manager seeks the views of the people living at the home through regular group meetings.Staff have developed good working relationships with the people they support, their relatives and other agencies. They identify and respond to changes in people`s health care needs well and seek help from others where necessary (such as community nurses, doctors and such like). People`s medication is safely managed by the staff.The dietary needs of people living at the home are identified and catered for by staff, so people can eat what they want in a way that does not put them at risk. What has improved since the last inspection? stThis is the first main inspection of the home since a change of ownership late last year.We did see that there are improvements taking place in respect of people`s records, so as to improve their clarity.There is also on going redecoration of the house to improve the environment, this with the involvement of people living at the home in choosing the decor. What the care home could do better: The management need to ensure that suitable steps are taken to ensure any potential safeguarding alerts are reported to the appropriate external agencies without delay, this so they can take any actions necessary to protect people living at the home. There could be more clarity inrespect of where their maybe limitations for people living at the home, such as people not holding bedroom and front door keys due to risk.People`s involvement in their inhouse reviews of individual support plans with key workers could be better recorded. Development of an audit tool to measure how well staff manage infection control would help identify how the staff can protect themselves and people living at the home from infection.There are areas of training that staff need to promote people`s safety, these however identified and planned by the manager. Key inspection report Care homes for adults (18-65 years) Name: Address: 264a Vicarage Road 264A Vicarage Road Kings Heath Birmingham W Midlands B14 7NH 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: Jonathan Potts Date: 1 8 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 34 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 34 Information about the care home Name of care home: Address: 264a Vicarage Road 264A Vicarage Road Kings Heath Birmingham W Midlands B14 7NH 0121 443 4347 0121 443 4347 Viviene.brooks@reachthecharity.org.uk www.reachthecharity.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Trident Sphere Name of registered manager (if applicable) Miss Vivienne Brooks 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: 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 6. 2. The maximum number of service users to be accommodated is 6. Date of last inspection A bit about the care home Care Homes for Adults (18-65 years) Page 4 of 34 246a Vicarage Road is registered with the Care Quality Commission to provide accommodation and personal care for a maximum of six adults with a learning disability. The home has recently changed ownership. The new registered provider is a not for profit charity called Trident Sphere that provides a range of social services in a number of locations. The homes manager Miss V Brooks has worked at Vicarage Road for a number of years. The staff team also worked at the home before the change of ownership. There are a number of senior and support staff that are available to support people living at the home 24 hours a day. The house was designed and built as a care home. It is a bungalow that is set in private grounds. The house offers six single bedrooms, large bath/shower rooms, a dining area, conservatory Care Homes for Adults (18-65 years) Page 5 of 34 CHANGE STAFF ALL DAY & ALL NIGHT. and lounge. There is also a separate laundry. The house offers facilities that would accommodate people with physical disabilities. The house is sited near shops and a main bus route with parking available close to the front entrance of the house. The information book about the home is currently nearing completion, this however meaning fees for residency were not available at the time we visited. The home should be contacted for more information. Care Homes for Adults (18-65 years) Page 6 of 34 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 Care Homes for Adults (18-65 years) Page 7 of 34 How we did our inspection: CQC This is what the inspector did when they were at the care home Our surprise visit to 246a Vicarage Road House was carried out on the 18th May. We arrived at 10.35am and left at 5.35pm. Our visit followed consideration of all the information we have received about the service since its recent change of ownership. This included information sent to us by the care provider and information from different organizations. We have assessed the homes performance against key standards and looked at outcomes for people living at the home. This was carried out by us talking to 2 people using the service, and asking staff about these peoples needs. We also looked at care plans, medical records and daily notes for these 2 people. This is called case tracking. We also looked around the building, looked at a number of management records and talked to management and staff. CQC Care Homes for Adults (18-65 years) Page 8 of 34 What the care home does well The house is well designed and allows privacy with single bedrooms and a number of communal areas. It is also well positioned for access to transport links and local shops and facilities. The home has a stable and experienced management team that know people living at the home well. The staff promote the independence of people living at the home through day to day domestic, occupational and social opportunities. The manager seeks the views of the people living at the home through regular group meetings. Care Homes for Adults (18-65 years) Page 9 of 34 Staff have developed good working relationships with the people they support, their relatives and other agencies. They identify and respond to changes in peoples health care needs well and seek help from others where necessary (such as community nurses, doctors and such like). Peoples medication is safely managed by the staff. The dietary needs of people living at the home are identified and catered for by staff, so people can eat what they want in a way that does not put them at risk. What has got better from the last inspection Care Homes for Adults (18-65 years) Page 10 of 34 1st This is the first main inspection of the home since a change of ownership late last year. We did see that there are improvements taking place in respect of peoples records, so as to improve their clarity. There is also on going redecoration of the house to improve the environment, this with the involvement of people living at the home in choosing the decor. What the care home could do better The management need to ensure that suitable steps are taken to ensure any potential safeguarding alerts are reported to the appropriate external agencies without delay, this so they can take any actions necessary to protect people living at the home. There could be more clarity in Care Homes for Adults (18-65 years) Page 11 of 34 respect of where their maybe limitations for people living at the home, such as people not holding bedroom and front door keys due to risk. Peoples involvement in their inhouse reviews of individual support plans with key workers could be better recorded. Development of an audit tool to measure how well staff manage infection control would help identify how the staff can protect themselves and people living at the home from infection. There are areas of training that staff need to promote peoples safety, these however identified and planned by the manager. If you want to read the full report of our inspection please ask the person in charge of the care home, Vivienne Brooks. Care Homes for Adults (18-65 years) Page 12 of 34 If you want to speak to the inspector please contact Jonathan Potts 77 Paradise Circus Queensway Birmingham W Midlands B1 2DT Jon - CQC 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 13 of 34 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 14 of 34 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 use the service, and their representatives will soon have access to updated and current information. The home checks that it is aware of the current needs of people living there. Evidence: Due to on -going review following the recent change of the homes ownership, the book about the home (statement of purpose/service users guide) is not currently available as it is being updated. The manager told us that this is very near completion and will be available to people in the near future. The manager told us that these will include the current fees for living at the home. The people living at the home have resided there for a number of years, this meaning that there have been no recent admissions to the home. We did discuss the admission process with the manager of the home and she confirmed that an admission would be planned and gradual. The home we saw to have a procedure in place underlining the need for a robust checking process for any one looking to move into the home. There is no procedure to show the phased nature of any admission process that the manager told Care Homes for Adults (18-65 years) Page 15 of 34 Evidence: us would be carried out, procedures only detailing what staff need to do on the day of the admission and the expectations in respect of checks (assessments) that are to be carried out. We looked at the case files for two people living at the home and saw that they have had involvement in a review with social services and significant others in the last 12 months. These have clearly updated the progress of the individuals to whom they relate and provided the home with a summary of what is important for the individual; this is respect of their current needs and aspirations. We saw that the staff are currently updating records in case files, this including the completion of review forms of individual needs. We saw completed copies of these that clearly highlight where there are changes in peoples needs and wishes, and what could and should be changed to encompass these. The level of involvement of the individuals in these reviews is not at present recorded, although from discussion with one person living at the home the accuracy of the information within their review was confirmed. Care Homes for Adults (18-65 years) Page 16 of 34 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. Individuals have involvement in planning the care and support they wish to receive. Limitations that maybe present due to risk factors could be more transparent. Evidence: We look at the care plans for two people living at the home. We found these to be reasonably well detailed reflecting peoples needs, wishes and aspirations. We saw that they have been written in the first person, this conveying ownership of the information to the individual whose support they relate to. We spoke to the people about their individual plans and discussed parts of them. What they told us are accurate confirmed the accuracy of the plan, reflecting what they see is important. We looked at the last multi agency review records, where the support these people needed was discussed with them and significant others. The information within these supported what we saw written in the plans as did records we saw that staff record daily. Communication plans that we saw reflected the way we saw individuals communicated with us during the course of our visit. Care Homes for Adults (18-65 years) Page 17 of 34 Evidence: The plans we saw are supplemented with pictorial information including photographs of the individual. One individual we spoke to recognized themselves in photographs and told us what they related to. We saw that the home is introducing new review formats, these clearly highlighting any changes or issues for peoples individual support. Whilst evident that support plans do reflect peoples preferences, how they may be involved in the in house reviews was not recorded. It would also be beneficial for the staff to support individuals to identify clear and achievable goals that they would like to be supported to achieve, these then summarized with the plan. Measurement of these could then be undertaken through the homes in house reviews, this showing how individual choices have been made. We saw that there was information available in files that summarized any potential risks that maybe presented to the individuals based on their lifestyle. There could however be more clarity in respect of where their maybe limitations, such as people not holding bedroom and front door keys due to risk. The manager and staff informed us that only one individual has expressed an interest in holding a bedroom door key. Care Homes for Adults (18-65 years) Page 18 of 34 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 living at the home are involved in making choices about their life style and are supported to their develop life skills. The range of activities people are involved with match their individual preferences. Evidence: We looked at peoples individual activity plans and these show that they are encouraged to have involvement in college courses that provide opportunities for them to develop life skills. One person we spoke to said they enjoyed college and showed us some of the certificates they had achieved. Activity plans show that people living at the home are involved in the homes domestic routines, with set days to tidy their rooms and wash their laundry (with the support they need detailed in their plans). These activity plans also show the range of leisure activities individuals are involved with, these reflecting their preferences as detailed in their individual plans. The home is positioned so as to allow easy access to a range of shops, these within walking distance. We heard that people living at the home are able to visit these shops Care Homes for Adults (18-65 years) Page 19 of 34 Evidence: independently where able, or with staff to support where needed. There is also easy access to bus stops. The home did previously have a minibus that staff used to facilitate peoples access to the community, this no longer available due to the cost and the fact only some of the people living at the home are not receiving mobility allowance. The manager is currently exploring different ways to facilitate peoples transport arrangements, with the aim to be able to offer cheaper transport arrangements to people, whether through use of public transport or people agreeing to fund the lease on a vehicle. We saw that peoples links to family and friends are detailed within their individual plans, as is the ways they choose to maintain contact with them. We saw clear information as to how staff support people, this highlighting in one instance the need to observe the persons need for privacy. The home facilitates people going on home leave with their family. We saw that there is space within the house to allow visitors to see people in private if needed. People are also supported to attend church and follow their chosen religion. We saw that the home has a menu that is on display in the kitchen. We were told this can be subject to change dependent on peoples choices on the day, as can be the times of the meals dependent on the activities people maybe involved with. We saw that there are monthly meetings with people living at the home where menu planning is discussed. We saw from case files that we looked at that staff have explored what individuals food preferences are and we saw that daily records of the meals people have reflected the choices that they have expressed. We saw that there is clear guidance to inform staff where people have special dietary needs. We spoke to a member of staff who clearly understood this guidance and the implications it had for the support of the individual, so as to promote their nutrition and well being. Care Homes for Adults (18-65 years) Page 20 of 34 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. Individuals health care needs are promoted and there is prompt follow up on any areas which compromise a persons well being. Personal support is provided in a way that promotes independence. Evidence: We saw that the way people wish to receive their personal care and support was clearly detailed in the two individual care plans that we looked at. We saw staff conversing with people living at the home during the time of our visit, who seemed relaxed in their presence. We saw that staff spoke to people respectfully and involved them in on going discussions. One person living at the home that we spoke to told us that they are happy at the home, and when shown photos of staff recognized their key worker. They also confirmed how their independence is promoted with staff supporting them to complete daily tasks rather than doing it for them, this as outlined in their individual plan. A member of staff we spoke to explained how the key worker system works, telling us how this identified an allocated worker to have responsibility for monitoring individuals care and support. We have been told that the key worker is supported by a co-worker who assists with reviews and can fill in when the key worker is absent, this to promote a more responsive service. Care Homes for Adults (18-65 years) Page 21 of 34 Evidence: We saw that the individual plans are supplemented by easy to understand, yet detailed health action plans. These outline the health care needs for the people they relate to with access to health professionals is promoted based on these needs. We saw that issues that are flagged up with these action plans are followed up with access to such opticians, dentists, psychology and dieticians. The plans also summarizes outcomes from health professionals visits so that individual plans reflect the support people need to promote their well being. There was no evidence of annual health checks by the individual G.Ps however, this an issue that the manager said she was fully aware of and pursuing. We saw from sight of staff training certificates and the homes training plan that some staff have received training that reflects the health care needs of people living at the home, examples of this including dysphasia and mental health awareness. The home has a suitable medication policy and procedure that the manager stated is updated as needed. We looked at medication records and found these to be well recorded with no gaps found in records of administration. The manager showed us the systems that she has in place for checking and auditing the medication, these including stock audits and drug cupboard temperature checks. We also saw records of checks the manager carries out on staff competency when handling medication. The home promotes the self administration of medication where individuals are able to do so safely. We saw from the homes training records, with further confirmation through sight of training certificates, that the staff that handle medications are appropriately trained, with some staff booked in for further medication training updates. Whilst we judged the homes medication to be well managed there was no evidence of recent audits by external pharmacists, this to be sourced from the contracted pharmacist or the local Primary Care Trust. We advised the manager to access an external check as an additional evidence of appropriate medication management. Care Homes for Adults (18-65 years) Page 22 of 34 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. People are encouraged to voice their concerns through an accessible complaints procedure. People’s safety is not always promoted by the organisations safeguarding procedures and practices. Evidence: We saw that the home has a clear complaints procedure. There is a pictorial version of this available in the foyer of the home, this accessible to people living there or visitors. These are supplemented by complaints forms which people can help themselves too. We saw that asking people who live at the home as to their satisfaction with the service they receive is a standard agenda item at residents monthly meetings. We saw that records of complaints and concerns are fully documented in the homes complaints record. It was stated that there are plans to fit a comments/complaints and compliments box in the home so that people can make comments anonymously. We saw that their photographs of all the staff are available in the reception area of the home, this with their names. This is a useful tool that does allow people to identify staff should they not know their names, in the event they wish to offer compliment or complaint. We saw that the home has a copy of the local multi - agency safeguarding procedures available to staff, this to support the homes own procedures. The homes procedures state that where there is a safeguarding issue this is to be reported to designated safeguarding Care Homes for Adults (18-65 years) Page 23 of 34 Evidence: officers within Trident (the provider). Birminghams safeguarding policy makes reference to any allegations or complaints about abuse being brought promptly to their attention, this clarified as at least on the same day. We have seen that the homes response times in reporting a recent safeguarding alert has resulted in over a weeks delay, this as the home manager is not expected to take responsibility for reporting the allegation, but needs to refer to a senior manager (who has delegated safeguarding responsibility). The approach of the organization to fact finding to the extent that there are delays in referral of allegation is not acceptable, especially where investigation of allegation is the responsibility of the local authorities safeguarding team. The decision making as to whether to refer allegations must be made on the same day that they arise, so that any investigation can be passed promptly to social services. Consideration also needs to be given to how to protect people following an allegation, this in respect of people living at the home and staff. Discussion with the manager showed us that she does have a very good understanding of what should be done if allegations are raised, but does not feel she is able to do so directly due to company policy. This is indicative of a need to review the homes procedure so that allegations are reported promptly. Staff we spoke to confirmed they had received safeguarding training and are aware of the homes whistle blowing policy. We saw looked at records relating to the safekeeping of peoples monies and found these to be accurate and well maintained. We observed staff booking money out in accordance with good practice. All monies are checked on changeover of staff, these checks documented. There are also weekly checks by the manager and checks by senior managers when they carry out their statutory visits. Inventories of personal possessions were last reviewed in December 2009. The manager told us that she is looking to introduce a monthly check on these. The manager told us that there is to be a review of recording keeping in respect of financial records that will lead to more robust financial risk assessments for individuals. Care Homes for Adults (18-65 years) Page 24 of 34 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 overall physical design and layout of the home is suitable in meeting the needs of the individuals that live there and meets with their expectations. Evidence: 246a Vicarage Road is sited on a side road off a main A road. As such this affords good access to local amenities yet allows a degree of privacy. The building was designed as a care home, with easy access, various adapted facilities and all single bedrooms. The size of the home also lends itself to the creation of a homely environment that is spacious and well maintained. From sight of the premises we saw that it is well maintained with little exception, and people living there told us they have a choice in how their rooms are decorated. There are three communal sitting areas which allows space for privacy. There is also a pleasant private garden area. We saw that people living at the home are able to move around freely without any restriction. We sampled the records relating to ensuring equipment and fixtures are checked for safety and found that all these are up to date (this including such as checks on hoists, gas appliances and electrical equipment). Whilst people living at the home are all mobile, there are a number of adaptations available including hoists, grab rails, wider corridors and such like that would benefit people if they are more physically dependent. Care Homes for Adults (18-65 years) Page 25 of 34 Evidence: The home has not had any recent visits from the Fire Prevention Officer, but the manager has reviewed fire safety arrangements through a fire check. There are also clear plans for peoples evacuation in the event of a fire. The home last received a visit from Environmental Health late last year, this not giving rise to any issue that changed the homes five star food hygiene rating. We saw that the home has a plan for redecoration and refurbishment in place and there has been some redecoration in the home that the people living there have had involvement in. Redecoration of the dining area was in progress at the time we visited. We saw that changes to communal areas, such as the new flooring recently installed, were discussed with all the residents with their choices documented in meeting minutes. We saw that overall the home was clean and there were no unpleasant smells. Most staff have received training in infection control. We saw that the home has liquid soap and paper towels available and there are notices on display in respect of hand washing. We asked the manager as to any audit of the homes infection control procedures and we were told one is not currently in place. Completion of such an audit would help highlight what staff do to maintain good infection control. The only area that we noted would benefit from attention is some of the grab rails in bathrooms, that have patches of rust. Care Homes for Adults (18-65 years) Page 26 of 34 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 at present well trained, skilled and available in sufficient numbers to support individuals with their chosen lifestyles. Evidence: We looked at the homes staffing rota and found that this was consistent with the staff on duty. There is usually three staff members available to support the six individuals living at the home, with some doubling up at the point of staff handover. Based on the levels of dependency of individuals living at the home we judged this to be sufficient to allow staff to meet their needs within the home. The home does have access to use of agency staff , although the manager told us that this has been no need for this recently, with staff working additional hours to cover any gaps in the rota. Further to this there are plans to build up a pool of bank staff employed by the provider. We saw that the manager adapts working hours to fit in with the needs of people living at the home, an example of this the review of the time staff finish on some evenings to allow for some individuals to stop longer at a disco they go to. We looked at the homes training plan and saw that this was clearly documented, and whilst there are some areas where there is more staff training needed, (most importantly first aid and food hygiene) these are clearly identified and the manager showed us documentation that showed she has booked, or is planning to book this training. The Care Homes for Adults (18-65 years) Page 27 of 34 Evidence: training that staff currently hold we saw to be evidenced by certificates within from staff files we looked at. The home utilizes training through Birmingham City Council, but the manager told us that each staff member has an amount of the training budget allocated to them for identified individual training needs, subject to its relevance. We did suggest that the identification of training for staff should also include a range of core skills beyond what would be considered as mandatory (such as those related to safe working practices). These would include areas of training that are specific to the needs of the people living at the home such as communication skills, managing challenging behaviour and dysphasia. We did however note that whilst not identified on the training plan as core skills training, a number of staff have received input in these areas which is positive. We saw that the majority of staff hold a vocational qualification in care to level 2 or above, this meaning that they have a good knowledge of how to support people in a way that caters for their diversity. The home has had a very limited turn over of staff, with no new staff employed since transfer of ownership. We looked at the records related to a number of staff and found these to be in good order, containing all the information we expected to find. Discussion with the manager confirmed that she was well aware of the checks needed for new staff so as to protect people living at the home. Management of the recruitment process is initially undertaken on a centrally managed basis, and there are strategies in place to involve people living at the providers homes in the recruitment of staff. The manager showed us that staff support meetings (supervisions) occur on a frequent basis, this well documented from the records we saw in staff files. We also saw evidence of regular staff meetings, these again well documented. Care Homes for Adults (18-65 years) Page 28 of 34 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 home manager, who is qualified and competent, listens to the views of people living at the home and works to develop the service accordingly. Evidence: We looked the homes certificate of registration which was on clear display in the front hallway of the house. This is the current certificate and reflects the service that the provider delivers. The manager Vivienne Brooks, has run the home for eleven years and in discussion, and from the information we received prior to the inspection we saw that she is aware of how to run the home to meet the needs of the people living there. She is well qualified and has demonstrated that she knows where the home performs well and where and how it can be better so as to improve outcomes for people living there. Staff we spoke to have also said that the manager is approachable and supportive. We saw during the time of our visit that people living at the home appeared comfortable approaching the manager, or coming to the office. We are aware that the home has recently transferred ownership and as such there is still Care Homes for Adults (18-65 years) Page 29 of 34 Evidence: a degree of change in respect of the homes policies, procedures and management systems. We saw that new systems are being introduced on a phased basis, evidence of such seen within the case files and management records that we looked at. The manager has told us of a number of systems that are to be introduced that will assist with the smooth running of the home. The manager is aware of the need to promote safeguarding, although the homes procedures do impact on her ability to make decisions on such as safe guarding referrals, although the home has promptly informed us of any incidents at the home. As previously stated the manager is currently reviewing the information about the home to reflect the transfer of ownership. We asked about the homes development plan and this again is still in development, although we saw the Annual quality assurance assessment (information that the home sends us every year about how the home is performing) to be well completed. The manager told us that she will draw up the homes development plan, with use of the findings from meetings and questionnaires influencing the homes future plans. We heard, and saw evidence of how the manager has gained the views of individuals living at the home, this through group meetings and questionnaires as well as speaking to people on a day to day basis. This has enabled the manager to send us information that, based on other evidence we have gathered, is mostly accurate as to the homes performance. The only procedural concern we raised is in respect of the homes safeguarding procedures (see earlier in the report). We saw that the home has procedures relating to safe working practices that are acceptable; these supported by records of health and safety checks and senior managers visit records. Staff training records also show that most training within the scope of safe working practices is provided to the staff team although, as the manager has identified, there is need for some training for staff in this area. The home we saw to have systems in place for logging and reporting any issues related to potential hazards. Risk assessments in respect of most areas of safe working practice are in place. We looked at the homes accident book and this did not indicate an causes for concern, with the occasional minor accident well documented. Care Homes for Adults (18-65 years) Page 30 of 34 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 31 of 34 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 13 The registered provider must 30/06/2010 ensure that suitable steps are taken to ensure any potential safeguarding alerts are reported to the appropriate social services department without delay. This is so the local authority is able to take any actions necessary to protect people living at the home without delay. 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 To complete the review of the homes statement of purpose and service users guide and make this information book available within the home To develop the homes admission procedures to reflect how Page 32 of 34 2 2 Care Homes for Adults (18-65 years) 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 any person looking to move to the home would be introduced on a gradual basis. 3 7 To record any involvement of people that live at the home within the in house reviews of their support plans. To ensure all possible limitations are identified through risk checks. To continue to explore the day to day transport options for people living at the home so these and their cost can be presented to people, and their representatives. To source an external audit from a pharmacist of the homes systems for management of medication. The home manager should develop an audit tool to measure the effectiveness of the homes methods for infection control. This tool should reflect guidance form the department of health document The code of practice for health and adult social care on the prevention and control of infections and related guidance. Any areas of rust on adaptations in bathrooms should be removed so that a smooth and easily cleanable surface is present that will not compromise cross infection. To progress the delivery of training as identified in the homes training plan, with priority given to those areas where there are a number of staff that need update (such as first aid, food hygiene and moving/handling). 4 5 7 13 6 7 20 30 8 30 9 32 Care Homes for Adults (18-65 years) Page 33 of 34 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. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 34 of 34 - 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!