Care Home: 34 Sheepwood Road

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What the care home does well Staff understand peoples` needs. They help people to make choices about their care.People make choices about where they want to go.People make choices about what they want to eat.People are listened to and helped to say how they feel. What has improved since the last inspection? The home is keeping a record of what people pay for their transport. What the care home could do better: Some staff need to have more training in helping to keep people safe.Risk assessments are needed to show how staff should support people with their money. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 34 Sheepwood Road 34 Sheepwood Road Henbury Bristol BS10 7BS two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sarah Webb Date: 2 0 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: 34 Sheepwood Road 34 Sheepwood Road Henbury Bristol BS10 7BS 01179509968 01179699000 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Brandon Trust care home 3 Number of places (if applicable): Under 65 Over 65 3 0 learning disability Additional conditions: The registered person may provide the following category 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 category: Learning disability (Code LD) The maximum numbrr of service users who can be accommodated is 3 Date of last inspection 2 1 0 2 2 0 0 7 A bit about the care home 34 Sheepwood Road is a bungalow in a residential area close to local shops. It provides accommodation and personal care to three people who have a learning disability. The home comes under the Brandon Trust. The home provides ground floor accommodation and has one single and one double bedroom. The fees payable currently range from £1092.99 to £1010.43 per week. 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 How we did our inspection: This is what the inspector did when they were at the care home The inspector visited the home without telling them she was coming. The report has been written using the information we got before and during the inspection. We spoke with the manager and a member of staff. They gave us the information we wanted. We saw the 3 people living at home being supported by staff. We looked at the 3 peoples care files. We looked at records kept in the home. What the care home does well Staff understand peoples needs. They help people to make choices about their care. People make choices about where they want to go. People make choices about what they want to eat. People are listened to and helped to say how they feel. What has got better from the last inspection What the care home could do better Some staff need to have more training in helping to keep people safe. Risk assessments are needed to show how staff should support people with their money. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Sarah Webb Colston 33 33 Colston Ave Bristol BS1 4UA 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People have up to date information made available for them to help them understand about their home. Peoples needs are assessed and reviewed regularly so that the home know any changes to their care can be met. Evidence: The home has a statement of purpose and pictorial service user guide. These have been updated with relevant information. A requirement has been met for the home to keep a record of any extra amounts payable for additional services, such as transport contribution. These are signed on behalf of their relative to agree to these charges. This was seen in care files. The home has been providing a service to the same 3 ladies with a learning disability for many years. There have been no new admissions since the last inspection. We saw assessments and reviews of peoples care that showed the home is meeting their physical, social and psychological needs. The home has supported people when their needs have changed and has been advised by specialist healthcare professionals when needed. People were at the home during the day as it was a holiday period and the usual day services they attended were closed. We saw the manager and another member of staff supporting them in a respectful and understanding way. Evidence: 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People are supported and involved through person centred care planning by staff who understand their needs. People are supported well in making decisions and choices about their lifestyles and in taking risks safely. Evidence: We saw all three Planning for Life care files. These showed all areas of peoples care and how staff should be supporting them including communication, personal care, eating and drinking, relationships and activities. Care files also showed peoples preferences, routines,and relevant history. Individual Person Centred Care Plans also support people in helping to understand their care. Photographs showed peoples individual activities and lifestyle. Peoples care is reviewed every month through written summaries taken from daily written records. A record was seen of peoples progress and the goals they set. Care files showed social services had also reviewed peoples care. It is evident the staff are enabling people with their communication needs. A separate commnication profile shows how people communicate and where staff may need support to understand or interpret a specific and individual communication. Various assisted technology equipment provides people with support in making decisions about their lifestyle. Talk One boards provide a pictorial and vocal daily diary telling people about their day. Other Talk Boards help people in making decisions and choices about different areas of their lifestyle. For example, choices are made Evidence: about what they want to drink, and the activities they want to do. This shows people are being helped to be in control of their lives and is good practice. Some staff have been trained in electronic assisted technology and the home has plans to extend this innovative practice into other areas of peoples lives to further enable their independence and choice. Talking photograph albums show pictures of people with a vocal summary of the pictures. Digital photograph frames offer a reminder for people of holidays, trips and activites. Risk assessments showed how people are supported with different areas of their lifestyle ensuring they are supported safely in taking risks. They had been reviewed on a regular basis. 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 benefit from being supported and encouraged to lead a fulfilling life. People benefit from contact with their families and friends. Peoples rights are respected through independence being encouraged. People are provided with a varied well balanced diet. Evidence: People have individual daily programmes and go to a day service on different days during the week. Staff are actively involved in supporting people with their interests and some staff have attended training in community involvement. People are supported on visits to the theatre, swimming, church activities, trips to the Zoo and garden centres, discos, and shopping. Activities are well recorded through a community involvement file showing people are involved locally. Photographic information displayed and albums also showed recreational and leisure pursuits. People have an annual holiday together, usually at Torquay. It has been identified that people would also benefit from a long weekend away supported individually by staff. Photographs and albums showed people staying at hotels, 60s weekends, war memorabilia weekend. The home uses a mobility vehicle that is in the name of an individual person living at Evidence: the home. The cost of the running of this vehicle is shared between the others with records kept of petrol costs and repairs. It is evident that the home shares this resource fairly between the three people. The home has good relationships with families and supports people to maintain contact with them. Families are welcomed to the home and we were told a family was visiting to share a sunday lunch with their relative to celebrate their birthday. We were also told staff had recently supported an individual to go on holiday with their family which was very successful. Staff follow a written cleaning schedule carrying out daily household tasks. People are not involved in cleaning routines but are expected to take some responsibility such as taking their cups back to the kitchen. The home follows four weekly menus. These were seen to offer a good choice of nutritious and varied meals, which respect peoples individual preferences and meet their dietary needs. People have lived together for many years and staff know their preferences about food. However staff explained how they support people in making food choices through pictorial food files. People are informed about the meal of the day through pictures displayed in the dining area. 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 are supported to lead healthy lifestyles with their healthcare and personal needs being monitored well. The home operates a robust medication system ensuring peoples safety. Evidence: Care plans showed how people are supported individually and respectfully with their personal needs. Care plans included how staff help people with their bathing through use of a hoist. The manager explained this practice showing people are being supported safely. Since the last inspection the home has a new format for recording health action plans. Staff are being trained in this new approach with cocordinators being responsible for ensuring these are completed correctly. Health action plans are pictorial showing how people are supported. For example, photographs of their doctor help people understand the planning of their care. Health profiles include information about peoples physical and emotional health, moblity, dental care and screening. Daily routines include diet, nutrition, and records of appointments to health care professionals such as dentist, speech therapist, nurse and psychologist. These records were all seen to show the home is monitoring peoples health care needs. The manager and a staff member showed how medication is administered to people. Individual profiles included medication to be taken, side effects of medication and written protocols for administering medication. Records showed the medication stock is checked weekly. The balances of two peoples medication were checked and these were consistent with the stock records. The medication administration records showed there were no gaps in medication being Evidence: given. The homes practice showed that people are being supported safely with medication and with staff having competed a national vocational qualification unit in medication. 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 benefit from robust systems for complaints and protection. Although they can be confident that they will be listened to and that they will be protected from abuse, they would benefit further from staff updating their knowledge and practice. Evidence: The home follows the organisational complaints policy and procedure. Accessible complaints brochures were seen in peoples care files and displayed in the home. There have been no complaints since the last inspection. Due to peoples individual communication, both the staff and families help to advocate for people. The home has good relationships and ongoing communication with families. This helps ensure that staff would be told of any concerns that families may have regarding their relatives care. Care files held well documented information about how people communicate and express their emotions. Staff showed they have knowledge of when people are unhappy. Examples were given of this including understanding individuals body language. There are organisational policies and procedures in place relating to the protection of vulnerable adults from abuse. Staff training records showed that staff have been trained in safeguarding. However, there were some staff who need to be updated in current practice as they received training five years ago. Peoples finances are audited by the organisation and the home has procedures and controls in place to help ensure the protection of peoples financial transactions. All three people living at the home are supported by staff in accessing their finances and handling their money. To help ensure greater controls it was recommended that the manager risk assess peoples ability to understand their finances and record how staff should be handling their money safely. We looked at two peoples personal allowances. These were correct and consistent with balances kept. Evidence: Care files showed how people are being supported with their behaviours. Guidelines and approaches in place for staff include recognising peoples stress and strategies for support. A Comprehensive Risk assessment and Management Plan (CRAMP) was seen for an individual showing the home had involved specialist agencies in supporting them. 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 . 34 Sheepwood Road is clean and homely and meets the care needs of the people living there. Evidence: 34 Sheepwood Road is a bungalow set in mature gardens to the front and back of the property. The home is accessible to the people living at the home. The home is leased to Brandon Trust from Western Challenge, and there has been a recent change in the maintenance contract. The premises are homely, clean and free from odour. The home is decorated to a good standard with comfortable furnishings. The property has a lounge, kitchen, dining room, two bedrooms (one being a double), an office that is also a sleep in room and a bathroom and separate toilet. Bathrooms have been fitted with aids and adaptations to enable people to be bathed safely. The bathroom and the toilet have been painted by staff with a mural depicting sea life. Staff have been on training in how to improve peoples environment and it was evident that the staff team help to provide people with a homely environment. 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 living at the home benefit from clarity of staff roles and responsibilities. People benefit from an effective and competent staff team with their training needs well met and appropriate training offered in order to meet individuals needs. Evidence: Staff told us about their roles and responsibilites, and the aims of the home. It was evident they had a good understanding of peoples needs and how these should be met. We were told the staff are a good team who communicated well and worked well together. There are two staff on duty during the day and one sleep in member of staff at night. The manager and a member of the care staff were on duty during the inspection with the manager sleeping in that night. Staffing is flexible to help provide extra cover if people need to be supported with external activities such as going to the theatre or parties. The home currently does not use bank staff. The home has been proactive in ensuring staff are qualified through a national vocational qualification (NVQ). All staff apart from one has a NVQ level 2 with one staff in the process of completing this. The home follows organisational recruitment policy and procedures. Although we did not see recruitment records the manager told us, new applicants are interviewed and appropriate checks are made to help ensure people are kept safe. The home keeps an employees record checklist that shows a Criminal Records Bureau(CRB) check has been received. This was seen in staff files. Staffing records are held at the Trusts Headquarters and are inspected periodically by us. They were not seen during this inspection. A requirement has been met for staff training records to be updated. Staff Evidence: training records showed staff have attended training in manual handling, first aid, fire and food hygeine. Other training staff have attended include training in dementia, health and safety, building community networks, eating and drinking, mental health and learning disabilities. It is evident the team are competent and trained in the areas relating to the needs of the people living at the home. 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 . People benefit from a well run home that is managed with a clear sense of direction. People benefit from formal quality monitoring systems in place to measure the aims and objectives of the home. Peoples rights and interests are safeguarded through robust record keeping. Procedures and protocols help to ensure the health, safety and welfare of both people and staff. Evidence: Ms Martin is the registered manager. She has been in post for the past eight years. She has successfully completed her NVQ 4 in care and management and is an NVQ assessor. She continues to manage the home competently through a person centred approach in supporting people. She has attended further training such as Moving forward and accepting change, Leading Change and make it successful, and Achieving equality and diversity for managers. She has also attended training in the Mental Capacity Act. Brandon Quality Standards review the aims of the home. These were seen to show the home has fully met several of the areas and that there are good outcomes for people living at the home. These results inform both the homes and organisational business plan. Generally records were up to date and well maintained. Individual records seen have been recorded in the appropriate standard. Evidence: There are health and safety procedures in place for staff to follow. This was seen through records that showed monthly audits monitor all aspects of the health and safety of the home. A current fire assessment was seen. Individual risk assessments have been completed for individuals in the event of a fire with appropriate action to take. An annual health and safety appraisal of the home is also implemented. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 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 2 23 23 Update staff in safeguarding practice and procedures to ensure people living at the home are kept safe. Risk assess peoples understanding of their finances and how staff should be supporting them if handling their money. 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