Care Home: 38 Attwood Street

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What the care home does well People`s needs are thoroughly assessed so that their care and support can be planned properly. Good use is made of "person-centred" approaches in people`s care planning. This helps to ensure that they get their support in ways that suit them best. Plans are reviewed regularly, so that important information is kept up to date. Careful risk assessing helps to ensure they get the support they need to stay safe. Particular efforts are being made to meet people`s communication support needs, so theycan actively make choices and decisions about their lives. People get the support they need to do things they value, go to places they like and keep in touch with the people who are important to them. They enjoy their meals because they get to choose things they like to eat and drink. People`s personal and healthcare needs are generally well met. They get the support they need from staff and a range of other professionals to help them stay healthy and well. Staff work hard to ensure that people enjoy the benefits of living in an environment that is comfortable, homely, safe and clean. The service provides sufficient staff to ensure that people get the support they need. Recruitment and selection procedures are robust, to ensure that people are fit for their jobs. Staff are generally well trained and supervised to ensure that they have the knowledge and skills and get the support they need to do their jobs well. The home is generally well run for the benefit of people using the service. Regular maintenance and checking of important equipment helps to ensure that people living and working at the home stay safe. People using this service continue to experience excellent outcomes. What the care home could do better: No requirements were made following this inspection. A small number of good practice recommendations can be found at the end of this report Random inspection report Care homes for adults (18-65 years) Name: Address: 38 Attwood Street 38 Attwood Street Halesowen Dudley West Midlands B63 3UE three star excellent service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Gerard Hammond Date: 1 8 0 6 2 0 1 0 Information about the care home Name of care home: Address: 38 Attwood Street 38 Attwood Street Halesowen Dudley West Midlands B63 3UE 01215850491 Telephone number: Fax number: Email address: Provider web address: attwoodstreet@mailauth.co.uk Name of registered provider(s): Name of registered manager (if applicable) Langstone Society Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 5 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 5 The maximum number of service users who can be accommodated is: 5 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) 5 Date of last inspection Brief description of the care home Attwood Street is a purpose built home providing care and accommodation to five adults with a learning disability, one of who may also have a physical disability and two who may also have a sensory disability. The Home is owned by the Langstone Society Care Homes for Adults (18-65 years) Page 2 of 10 Brief description of the care home who rent the premises from the Churches Housing Association of Dudley District (CHADD) The house is a bungalow in a quiet residential area. It is close to local facilities and bus routes, allowing easy access to shops and surrounding areas. There is level access to the front and rear of the premises with a secluded garden also at the rear. There is a small car parking area at the front of the building. There are five single bedrooms, a lounge and dining room together with adequate numbers of WCs, bath and shower facilities. The home aims to enable people to live valued lives, to exercise choice and to learn new skills and to support staff to achieve these aims. The service should be contacted directly for current information about fees and charges. Care Homes for Adults (18-65 years) Page 3 of 10 What we found: This services last key inspection was on 18 August 2007, when its quality rating was 3 stars. This means that people using the service experienced excellent outcomes. The purpose of this inspection was to monitor compliance with essential standards of quality and safety against current National Minimum Standards. The Manager sent us an Annual Quality Assurance Assessment. We made a visit to the home and met people who use the service, the Manager and members of staff. Peoples communication support needs and levels of learning disability meant that it was not possible to seek their views directly. We also received written responses to questionnaires we sent to staff at the home. We looked at records including personal files, care plans, staff records, previous inspection reports, safety records, and other documents. There have been no recent admissions to the home. We looked at peoples personal records to check that their needs and strengths had been assessed. All of the files we saw had a detailed assessment which had been kept under regular review. This forms a sound basis for planning their care and support. The records we looked at all contained a detailed care plan, which we saw had been reviewed regularly. This ensures that important information can be kept up to date. We saw that care plan reviews also included other professionals involved in individuals care and support. This shows that the service seeks support and advice appropriately, to make sure people get the support they need. Individuals key workers meet with them each month to review goals and activities, keeping the plan under constant review. We also noted that care plans include risk assessments, to ensure that people get the support they need to stay safe. Clear efforts have been made to make plans personcentred so that the individual concerned is always at its focus. It is recommended that good work already done be continued and developed, to ensure that people get the support they need in the ways that suit them best. We suggested that care plans and risk assessments are indexed and cross-referenced, so that important information can be found quickly and easily. We also talked to the Manager about developing the ways in which some goals are set. It is suggested that goals work best if they are clearly measurable and time limited. Making some of the goals tighter might help to achieve this, so that people get all the support they need to achieve the things most important to them. This is merely a good practice recommendation, building on the good work already being done in this area. Peoples records show that they attend day centres on a sessional basis. Currently there are concerns among the care team about continuing to meet their needs appropriately if these services are reduced or disappear altogether. We saw that the staff actively support people to access a range of other facilities so they can be part of the life of their local community. These have included going to the cinema, eating out in local pubs and restaurants, going to the hairdresser, on day trips to places of interest, using local parks and leisure facilities, going shopping, attending drama group, going to see concerts and shows at the theatre, and so on. Records we looked at also contained training programmes for individuals. These are designed to help people develop their skills, improve their mobility and so on, so as to promote individual independence. We saw that Care Homes for Adults (18-65 years) Page 4 of 10 people also get the support they need to keep in touch with families and friends, where this is possible. We saw that routines in the home are flexible, according to individuals needs and preferences. We looked at food stocks in the house and saw that these were plentiful and included fresh fruit and vegetables. Records of meals showed that people enjoy a varied, balanced and nutritious diet. The small size of the home means that alternatives to the menu can always be provided easily. We were able to directly observe interactions between staff and residents. We saw that support was given with respect, warmth and friendliness, and that both are clearly at ease in each others company. Detailed care plans mean that staff have clear guidance about how to support people in ways they like. Low turnover of staff means that they are familiar faces to the residents, and they know each other well. Peoples records show that other professionals have been actively involved in their health care and that referrals are made and support gained as required. We saw records of weight monitoring and epilepsy management plans and appointments with GPs, consultants, community nurses, hospital outpatients, chiropodists, and dentists. Health action plans are in place, but we noted that some of the information on these had been recorded some time ago. The Manager advised that these are currently under review with the local health facilitation team. Also that people at the home enjoy good support from the local community nurse for people with learning disabilities. We looked at the Medication Administration Record (MAR). The home now uses the Boots Monitored Dosage System (MDS). We saw that 2 members of staff are involved each time that medication is given: one signs to show it has been administered and another signs as a witness. This good practice helps to minimise the risks of administration errors. We saw that the record had been completed appropriately. We also noted that the record includes sample signatures of staff responsible for administering medication, photographs of each person using the service, written protocols for PRN (as required), and checks of the temperatures in the medication store. We saw that other medication had been labelled with the date of opening. Stock checks of all medication are carried out each week. The Annual Quality Assurance Assessment shows that all staff administering medication have received appropriate training. Appropriate policies and procedures are in place covering complaints and safeguarding in the home. It has to be acknowledged that the levels of learning disability and communication support needs of the people using this service mean that formal procedures have little relevance for them individually. They are reliant on the vigilance and knowledge of their carers to notice changes in behaviour, demeanour or body language as indicators that people are unwell or unhappy. We noted that records we looked at contained information about how one person shows signs of discomfort or pain. Staff we spoke to were able to show a clear understanding of the nature and types of abuse, and the kinds of things they need to look out for. They were able to say what action they would take in the event of witnessing or suspecting abuse. Staff records we looked at showed that recruitment procedures are robust, so that people can have confidence that staff employed to work at the home are fit for their jobs. The Annual Quality Assurance Assessment shows that some staff have done safeguarding training: the training plan shows that further training for other staff is scheduled. We have not made any safeguarding referrals or received any complaints in respect of this service. Care Homes for Adults (18-65 years) Page 5 of 10 We looked around the home. We saw that peoples rooms are very individual, with personal possessions, pictures, ornaments, family photographs etc. very much in evidence. There are ample toilet and bathing facilities and people have the specialist equipment they need. Shared spaces include a recently refittted kitchen, comfortable lounge, dining room, and pleasant garden with patio and seating areas. The home is furnished, decorated and maintained to a high standard. Staff work hard to keep it clean, tidy and fresh, safe and homely. We saw that sufficient numbers of staff were on duty to meet residents assessed needs. This is normally three per shift with the Manager supernumerary when on duty. The Manager told us that staff retention in the service is good, with low turnover so that support workers are familiar faces to the people using the service. Two vacancies have been recruited to but not yet filled, while waiting for clearance from the Criminal Records Bureau (CRB). As reported above, recruitment processes are appropriately robust: files we looked at contained required documentation. Vacancies are currently being covered by regular agency staff, to promote continuity of care. Training is organised centrally by the Langstone Society. We saw the training plan which showed that statutory training has been provided and that further training is scheduled as required. The organisations commitment to training is shown by the high number of staff holding qualifications at NVQ level 3. We saw minutes of regular staff meetings and supervision is scheduled at appropriate intervals. Staff said they felt generally well supported. Relocation of personnel in the company means that the previously registered manager has moved to another post in the organisation. The current Manager has worked at the home for several years: she told us that she is currently working towards gaining qualification at NVQ level 4 (as is another senior staff member) and that her application to register with the Care Quality Commission will be submitted shortly. Staff said that the manager is approachable and that the team works well together. We saw records of visits required under Regulation 26 (Care Homes Regulations 2001); these were done regularly, though not every month. Quality assurance in the home needs developing so that information gained from activity is collated and analysed, then reported on and shared with all interested parties. We sampled records relating to health and safety in the home. We saw that essential equipment has been checked and serviced regularly and that a workplace risk assessment is in place. Stores of cleaning materials and other potentially hazardous materials were secure. These things show that the service takes positive action to ensure people living and working in the home stay safe. What the care home does well: Peoples needs are thoroughly assessed so that their care and support can be planned properly. Good use is made of person-centred approaches in peoples care planning. This helps to ensure that they get their support in ways that suit them best. Plans are reviewed regularly, so that important information is kept up to date. Careful risk assessing helps to ensure they get the support they need to stay safe. Particular efforts are being made to meet peoples communication support needs, so they Care Homes for Adults (18-65 years) Page 6 of 10 can actively make choices and decisions about their lives. People get the support they need to do things they value, go to places they like and keep in touch with the people who are important to them. They enjoy their meals because they get to choose things they like to eat and drink. Peoples personal and healthcare needs are generally well met. They get the support they need from staff and a range of other professionals to help them stay healthy and well. Staff work hard to ensure that people enjoy the benefits of living in an environment that is comfortable, homely, safe and clean. The service provides sufficient staff to ensure that people get the support they need. Recruitment and selection procedures are robust, to ensure that people are fit for their jobs. Staff are generally well trained and supervised to ensure that they have the knowledge and skills and get the support they need to do their jobs well. The home is generally well run for the benefit of people using the service. Regular maintenance and checking of important equipment helps to ensure that people living and working at the home stay safe. People using this service continue to experience excellent outcomes. What they could do better: 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 2. Care Homes for Adults (18-65 years) Page 7 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 8 of 10 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, 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 6 Develop the use of person-centred approaches: build on good work already done to make peoples agreed goals more specific and clearly measurable. This is to ensure they have all the support they need to achieve the things that are important to them. Index and cross reference risk assessments and care plans, so that important information can be found quickly and more easily Develop Quality Assurance measures in the home so that information gained from monitoring activity is collated and analysed. Report on the findings and share this with all interested parties. This is to show how the views of people using the service have underpinned it review and development. 2 9 3 39 Care Homes for Adults (18-65 years) Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial 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 10 of 10 - 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. 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