Care Home: 339 Pershore Road

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What the care home does well People living in the home looked well cared for. They had their personal hygiene needs met and their clothes were well laundered. People appeared to be happy on the day of the inspection. How people`s care was given was planned and the care plans took account of what staff knew about the person. Staff spoken to were clear about people`s health difficulties and their likes and dislikes and this helps them give the care in the way people want. Any risks to the people were identified and plans were put in place to make people safe. As a result there was only one accident to a person living in the home in the last year. There was a good stock of food available which included fresh fruit and vegetables. There were varied menus and people`s special food needs were met. This helps to keep people healthy. People had access to health professionals, such as GPs, chiropodist, dentists regularly and if needed and this helps to keep people well. Medication was given appropriately and this keeps people as well as possible. Staff were recruited well and tended to stay at the home. This means that people are cared for by staff that know them and are safe to work with vulnerable people. The manager has worked at the home for a number of years and knows all the people well. All the appropriate Health and safety checks of the building are completed and this means that people can be assured that the environment is generally safe. What has improved since the last inspection? A number of the staff have undertaken training in dementia care. This is important as most of the people in the home are now over 65 years old. The ground floor of the home has been decorated including the two ground floor bedrooms. This makes it more comfortable for the people living in the home. There are plans to redecorate and refurbish the first floor rooms. A new carpet has been put on the landing on the stairs. The number of activities available to people in the home has improved since the last inspection and this helps to give people engaged and calm. What the care home could do better: Some changes were needed to procedures so a new law called the Mental Capacity Act is thought about before people live in the home. People`s plans and activities need to show that their individual interests are taken account of. More activities within the wider community should be planned. When people`s weight changes this should be looked at to ensure that people are not becoming ill, or unhealthy. The outside of the home needs some work on the drive way, the patio doors, security lights and signs within the building to ensure that it is safe and meets people`s needs. More could be done to make sure that surveys completed for people living in the home help to improve the service. Key inspection report Care homes for adults (18-65 years) Name: Address: 339 Pershore Road Pershore Road (339) Edgbaston Birmingham West Midlands B5 7RY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jill Brown     Date: 2 8 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: 339 Pershore Road Pershore Road (339) Edgbaston Birmingham West Midlands B5 7RY 01214720224 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: PershoreRdOcs@aol.com Optimum Care Services care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 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 Brief description of the care home The home is registered to provide personal care and accommodation for up to six people who have a learning disability. All of the people currently living in the home are male. It is a detached house situated on a main road with other large properties, on a bus route and fairly close to the centre of Birmingham. Accommodation is provided in two single bedrooms on the ground floor and four single bedrooms on the first floor. All have wash hand basins. The home has a large fitted kitchen, a dining room, lounge, small laundry and a bathroom and shower room. The front of the house has a driveway that provides parking for several cars. The rear garden is large and has two patio areas. There are shops within walking distance of the home and Cannon Hill Park Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 6 Brief description of the care home containing the Midlands Arts Centre is nearby. Fee levels were requested but were not available. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We visited the home without notice on a day in January 2010. We completed a key inspection which means we inspected the homes performance against most of the National Minimum Standards. The last key inspection took place in August 2007. The home has had annual service reviews since. The home gave us information in an Annual Quality Assurance Assessment before the inspection. The AQAA shows how the home rates their performance in the areas set out in this report and what improvements to the service they intend to make. During the inspection we case tracked one persons care. This means we looked at all the homes records about the person, their medication, any money held on their behalf and their bedroom. We also looked at parts of the care provided for other people. We looked around parts of the building and looked at records about the safety of the Care Homes for Adults (18-65 years) Page 6 of 30 building, complaints accidents and so on. We observed how people were cared for and spoke to staff about the care they give. People living in the home are non verbal some could use a limited number of signs for their immediate needs. There have been no new people admitted to the home since the last key inspection. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: Some changes were needed to procedures so a new law called the Mental Capacity Act is thought about before people live in the home. Peoples plans and activities need to show that their individual interests are taken account of. More activities within the wider community should be planned. Care Homes for Adults (18-65 years) Page 8 of 30 When peoples weight changes this should be looked at to ensure that people are not becoming ill, or unhealthy. The outside of the home needs some work on the drive way, the patio doors, security lights and signs within the building to ensure that it is safe and meets peoples needs. More could be done to make sure that surveys completed for people living in the home help to improve the service. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 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 10 of 30 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. Information is available to people and their representatives to help them decide whether this home will suit them. People have their needs assessed before admission and this is reviewed regularly so the home can be sure they are continuing to meet the persons needs. Evidence: We looked at the service user guide and found that these were in a style that was easy for people to read. They contained photographs of staff and some information about what people can expect if they wish to live in the home. Some updating of this information is needed to ensure all the information is correct. People living in the home have a contract which protects their rights. This contracts includes information about the charges for their stay but this too needs to be updated. There had been no new admissions to the home since the last key inspection in August 2007. However information held about peoples needs (the assessment) are reviewed every year to see if the information is still correct. The assessment looks at peoples abilities and difficulties with for example their health, daily living, social, Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: behaviour and communication. This helps staff look at ways the person can be supported in these areas. We were told that the assessment and admission procedure had not been changed since the last inspection and this would mean that people have opportunities to visit and experience the home before any admission. Consideration of the Mental Capacity Act should be part of the admission procedure to ensure that no person is admitted against their will. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in this home have care and risk management plans that ensure that their needs are met safely. Further efforts are needed to ensure that clear peoples goals and interests are taken account of. Evidence: Each person living in the home has detailed care plans that show how the needs identified in their assessment are going to be met. So for example there is information about each persons morning and evening routines that indicate the times a person has to get up to go to a day service and the time they get up if they are not. There is information about the personal care tasks the person can do themselves and those they need assistance with. These details help to ensure that peoples independence is maintained. Information is recorded about how the person communicates. These detail the signs the person uses such as Makaton signs for a drink, or picture symbols or whether the Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: person has their own signs such as bringing a coat to say they want to go out. During the inspection we saw staff and a person using Makaton signs for a cup of tea. Later on we saw a member of staff asking a person to find the appropriate picture cards. This can help people devlop and maintain communication skills. People living in the home are non verbal but efforts are made to ensure that care plans reflect peoples preferred patterns of care. Some further work should be undertaken to ensure that peoples interests are more represented in care plans by goal setting and person centred planning. Risks to people living in the home and risks from people with challenging behaviour are identified. The risks for one person for example are identified as walking with sticks, getting in and out of the bath on a bath lift, hitting staff, having a locked front door and for choking when eating. Risk management plans are in place to ensure that risks to the person and to other people are minimised. However we found plans in place that are no longer needed and this can cause confusion. For example one indicates that the person should not have a bath because it is not safe when this has been resolved through the provision of an in bath lift. We spoke to staff about the risks to and from a person living in the home and found staff knew what the risks are and how these are overcome. Although we found that there were moving and handling instructions for a person being moved there needed to be more instructions for staff to protect themselves when moving equipment. Care Homes for Adults (18-65 years) Page 14 of 30 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 living in this home are supported to have activities however more could be done to make these relevant to their interests. People have good wholesome meals and are supported to make healthy food choices and this helps to keep them well. Evidence: People living in the home have the opportunity to be involved in activities. For example 3 out of the 4 people attend day placements on a number of days of the week. For one person this placement includes courses in self advocacy, home skills, leisure, travel training and sexual awareness. The persons records show that currently they are enjoying the cooking in the home skills session. On the day of the inspection all of the people were in the home. Throughout the day people were observed to be involved one to one time with staff undertaking activities in the home. People are Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: encouraged to take part in daily living tasks within the home as much as they able and this time is recorded on the persons timetable. One staff told us that a person liked to do dusting and a number of the people enjoy gardening. We looked at the records of activities for one person and found that board games, wii programmes, arts and crafts, progressive mobility and other indoor activities were provided. The home is opposite the park and this is seen as a good resource. People had taken trips to the safari park, to a pantomime and to a pub lunch in the last six months. Peoples timetable of activities did not show that going out of the home to other community and leisure activities were part of their weekly routine part. The homes Annual Quality Assurance Assessment stated that people living in the home went for a weekend away in Wales in June 2009. It also stated that the external activities could be improved by more staff being able to drive. We discussed with the manager using person centred planning and goal setting as part of the process for ensuring external activities for people matched their interests and their goals. The majority of people living in the home are now over 65 years old and contact with relatives is limited. People are assisted where possible to remain in touch with their relatives. People are given help to choose meals. There are picture representations of food to tell people what is available each day. Looking at the food supply we found that there is a good supply of food with plenty of fresh fruit and vegetables. Staff are given information about natural occurring vitamins in food and healthy foods such as fish and liver are planned as part of peoples weekly diet. We looked at a weeks menu and found a range of dishes available. For example spaghetti Bolognese, roast chicken, cod fillets, savoury couscous, roast lamb, faggots and fish cakes all with appropriate vegetables or salad. Where people have special requirements for food to be liquidised and drinks to be thickened appropriate equipment is place. The manager told us that they ensure that liquidised food is prepared individual tastes. Staff spoken to were aware of any risks that people may have eating such as choking. Care Homes for Adults (18-65 years) Page 16 of 30 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. People receive health and personal care and are supported to receive appropriate health care and this keeps them as well as possible. The arrangements for administering medication are safe and this helps to keep people well. Evidence: People appeared to be dressed appropriately for their age and being indoors. One person whose care plan indicated that they liked to be dressed smartly had matching clothing on, on the day of the inspection. There were good interactions between staff and people in the home observed throughout the inspection. The home was calm during the day and people walked around with out undue restriction. We saw choices such as activities being offered to people throughout the inspection. Each person has a Health Action Plan which shows the contacts the person has had with health professionals. This ensures that routine appointments with GPs about their medication, dental and chiropody appointments and so on, are made as well as appointments for new health problems. People have their weights recorded monthly however big changes in weight are not brought to the attention of the manager. For Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: one person the changes were marked. This may be because the person may have been weighed with their built up boots on as they appear to have lost half of their weight gain on the next weigh in. Large changes in weight need to be investigated as it may indicate that a persons health is deteriorating. There is a medication policy to show how medication should be stored and recorded and administered. The manager checks the medication on a weekly basis to see what medication has been given and whether the amount of medication is left is correct. The home uses a monitored dosage system for the management of medication where possible. The medication was stored securely. Copies of the current prescription are kept and this helps to ensure that the medication dispensed from the chemist is as prescribed. In front of the medication administration records (MAR) there is a photograph of the person. This is an extra check to ensure the right medication is administered. We looked at the records of some administered medications and compared them to the drugs held and found these were correctly accounted for. We spoke to a staff member about medication they knew what medication had been prescribed for a person and what the medication was for. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in this home are safeguarded by by good policies and procedures and by staff that are well recruited and understand how people need to be protected. Evidence: The home has recorded no complaints in the last 12 months. There is a copy of the complaints procedure in the service user guide and on display. People in the service are unlikely to make complaints or comments about the service they receive verbally. Consideration should be given to look at ways that people can be enabled to do this. There are few visitors to the home and this can make it difficult for the home to reassess the service they are providing. There are monthly surveys of the service for each person which look at identifying what the person has done and what may be outstanding. These could be improved if linked with any goals that people have. Any improvements that have been identified should have a timescale for them to be implemented. We found for example that activities that people were involved in were not always well evaluated on the survey and that where a TV had been identified as being needed for a person this was not purchased for several months. The home has appropriate policies in place for safeguarding people. We spoke to staff about the reporting of incidents of a safeguarding nature and they were aware of their responsibilities and this helps to protect people. Staff were recruited appropriately and had received training on safeguarding and this helps to keep people safe. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: We looked at the homes systems for managing two of the four peoples money. We found that people spent money on progressive mobility, hair care, tea at college, taxis, repair and petrol for the homes vehicle, toiletries and personal leisure items. There were clear records and receipts for each amount spent. People in this service have access to all of their mobility allowance. The balance of day to day money held matched the record. A small amount of day to day money is held for each person in one safe. In the other safe bank books and other valuables are held such as passports and access to this safe is more restricted. There is not sufficient records of the balance of money in the bank accounts of each person to ensure that should the bank book be lost the home can verify the balance at their last transaction. People have a good record of their personal belongings such as DVDs kept and this helps to ensure the safety of their property. Care Homes for Adults (18-65 years) Page 20 of 30 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. People live in a safe, and comfortable home that is homely which at this point meets their needs. Evidence: We toured the premises of the home and found no health and safety concerns inside the home. The front drive of the home has become pitted this could present health and safety risks to people in the home. The front porch sliding door is resting on the hedge in front portion of the garden and this is giving the outside of the home an unkempt look. We could see no security lights on the outside front of the building and given the position of the home, opposite the park, this would be advisable. On the ground floor there is a spacious lounge with two seating areas making it look comfortable and intimate. There is a dining area large enough to accommodate all of the people living in the home and the staff that may be assisting them. We looked in each persons bedroom; bedrooms are accommodated on the ground and first floor. All of the people living in the home are currently able to use stairs safely. However the majority of the people living in the home are elderly and this must be kept under review. Two people that have more mobility difficulties have their bedrooms on the ground floor. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: There is little signage in the home to assist people to orientate themselves. There are no signs or photographs on the bedroom doors or communal areas. Although this may appear to make the home less homely it is likely to become more necessary to maintain peoples independence as they age further or for any new admissions to the home. Bedrooms are decorated to the individuals taste. We found one bedroom demonstrated a persons interest in fish and anothers in watches and clocks. The home has been redecorated on the ground floor. Upstairs redecoration and refurbishment is planned. We looked at the bathroom upstairs, the laundry and kitchen of the home and found these are appropriate to the needs of people living there. The laundry at the moment does not have a sluice washing machine and this should be considered at the point of the current washer needing replacing or if the continence needs of the people accommodated change. All areas of the home were clean and odour free. There is a good garden space to the rear of the home that is enclosed. There is a paved area and a lawn. We were told that the intention is to redevelop the garden with the people that live there so that people can do some gardening safely. There is a shed without a roof and some items that need to be removed from the garden. Care Homes for Adults (18-65 years) Page 22 of 30 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. People can be assured that there are enough trained staff who know them to meet their needs. Staff are recruited well and this safeguards people. Evidence: The staffing level in the home is set at 2 staff on duty in the mornings and afternoons and 1 member of staff awake during the night and one member of staff on sleep in duty. Management hours are in addition to this. All staff undertake cooking and cleaning roles in addition to care. Rotas showed that this level of staffing was maintained. The home has both male and female staff all the people living in the home currently are male. This gives people the opportunity to be with people they can identify with. We found that the majority of staff have completed a National Vocational Qualification Level 2 in care (NVQ2) which is the recognised qualification for undertaking care work. We were told that a number of staff have also completed a NVQ3. We looked at the staff records for the newest person and appropriate checks had been undertaken to ensure that they were suitable to support people living in the home. Prospective staff complete an application form, references and checks with the criminal records bureau (CRB) are undertaken. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: We looked another staff file to check their training and found on discussion with that member of staff that they had undertaken more training than their staff file indicated. We were unable to see the full training matrix. Since the last key inspection some staff in the home have undertaken dementia training and this is useful when considering the homes ageing population. Staff showed on interview that they knew the people they care for well, their likes and dislikes and their health conditions. We looked at a matrix of supervision and sampled staff files and found that staff have supervision 6 times a year as recommended. Supervision of staff allows staff performance to be measured and allows staff a time to raise any concerns they may have and this helps to keep people safe. Care Homes for Adults (18-65 years) Page 24 of 30 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 staff and management of this home ensure that it is run in the best interests of the people that that live there and has a regard to peoples health and safety. Evidence: The home has a registered manager as required. She stated that in the homes Annual Quality Assurance Assessment (AQAA) that she has completed the Registered Managers Award (RMA) and an NVQ4 in care which we recognise as the most appropriate training for managers of care homes. She has been the manager at the home for 7 years. As stated surveys are completed on behalf of people on a monthly basis. These surveys include the evidence that the key worker has used to say that people remain happy with areas of their care, such as equipment, environment, activities and food. These could be improved by including peoples goals and aspirations and including a timescales where issues are identified. We discussed with the manager that a record could be kept when people have shown that they disliked or liked something very much to improve their planning. The representative of the service provider visits the Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: home on regular basis to check the quality of the service and reports are written of these visits. There are a number of systems in place for monitoring the quality of the home including peoples finances, medication and health and safety. We found the records of this home to be well ordered and available on request. There had been no best interest assessments under the Mental Capacity Act in this home and we did not see at any point where people were being deprived of their liberty. We have advised that the homes admission procedure needs to consider the implications of this legislation as there is a vacancy in this home at the present. We looked at health and safety certificates for the building including gas, electrical and fire safety and found these were in place. The home has appropriate accident and incident records there has been only one accident to a person living at the home in 2009. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 Information in the service user guide and the contract needs to updated to ensure that the information is correct especially before a new person is admitted The admission procedure needs to include a consideration of whether a deprivation of liberty may be taking place by admitting the person to the home. If so what steps the home must ensure are to be undertaken before admission. Care plans should include peoples goals and aspirations. Risk management plans should be removed when the risk has been removed as this is potentially confusing. Mobility risk assessments should be expanded to include any instructions to staff to ensure the safe lifting of equipment. Consideration needs to be given to expand community activities to ensure a fuller leisure programme that meets the interests and goals of people. Systems should be put in place to ensure that changes in weight are investigated and appropriate action taken. 2 2 3 4 5 6 9 9 6 13 7 19 Care Homes for Adults (18-65 years) Page 28 of 30 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 8 9 22 23 The service should investigate ways that people can be assisted to make comments on the service they receive. A record should be kept of the valuables, bank balance and transactions from the bank to ensure a full record can be kept. The porch door should be repaired to ensure that the front of the building is kept in a reasonable state. Consideration should be given to security lights external to the building to ensure the safety of people living in the home and staff. The drive way should be repaired to ensure that it does not become a trip hazard to people living in the home. As the home is redecorated consideration should be given to increased signage in the building to assist people finding their way around the building. Consideration should be given to providing a sluice washing machine to meet emerging needs of the people living in the home. Surveys should be improved by my rigorous review and by including peoples goals and aspirations to measure their success. 10 11 24 24 12 13 24 29 14 30 15 38 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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