Care Home: 54 Brookvale Road

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What the care home does well People have access to information about the home so that they can make an informed choice about whether to move in. People are treated with respect and staff have a good understanding of promoting dignity so that people feel valued. People are encouraged to maintain and develop their independence as part of a meaningful lifestyle. Staff receive training opportunities so that they are equipped to meet the needs of people who live in the home. The service has policies and procedures in place to listen and respond to peoples concerns and complaints and to safeguard them from risk of harm. The home is being well managed for the benefit of the people who use it. People are supported to keep in touch with friends and relatives so that they do not lose relationships that are important to them. Positive comments received from people who live in the home indicate that the staff team are friendly and respectful and understanding of peoples individual needs. Menus are well planned and a range of food is offered that people enjoy. What has improved since the last inspection? We were told that the arrival of the new manager has created a "more settled" home. What the care home could do better: Recording the testing of some health and safety equipment will make sure that any faults can be investigated promptly. Key inspection report Care homes for adults (18-65 years) Name: Address: 54 Brookvale Road 54 Brookvale Road Olton Solihull West Midlands B92 7HZ     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: Julie Preston     Date: 0 7 0 5 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 28 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 54 Brookvale Road 54 Brookvale Road Olton Solihull West Midlands B92 7HZ 01217081553 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Solor Care West Midlands Limited Name of registered manager (if applicable) Mrs Elizabeth Brown Ms Heike Groom Type of registration: Number of places registered: care home 3 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: 3 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) 3 Date of last inspection Brief description of the care home The service provided at Brookvale Road consists of a domestic three bedroomed house situated in a residential area of Olton in Solihull. The service is registered to provide accommodation and support three adults with learning disabilities. 54 Brookvale Road is in a road of similar properties and is within walking distance of local facilities. Solihull town centre is accessible by bus or train, as is Birmingham City Centre. Each Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 3 Brief description of the care home service user has single bedroom accommodation. The rest of the house, consisting of a lounge, dining room, kitchen, bathroom, and shower room is shared on a communal basis. There is an office that is also used as a staff sleep in room. Information about fees and charges may be received by contacting the home directly. Care Homes for Adults (18-65 years) Page 5 of 28 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: The focus of inspections undertaken by the Care Quality Commission is upon outcomes for people and their views of the service provided. This process considers the homes capacity to meet regulatory requirements, national minimum standards and focuses on aspects of service provision that need further development. Before we visited the home we looked at their Annual Quality Assurance Assessment (AQAA) which provides information about the way that the service are meeting standards and identifies how they plan to maintain and improve outcomes for people. We also reviewed information about complaints and notifications regarding the protection of vulnerable adults. Our visit took place over one day and was unannounced. We were able to meet the home manager and a number of staff who work with the people who use its services. We also spoke to two of the three people about their experience of living in the home. Care Homes for Adults (18-65 years) Page 6 of 28 Two people were case tracked. Case tracking involves talking to people about the care they receive, looking at their records and talking to the staff who support them. This helps us focus on outcomes for people who use the service. We looked at staff training records, policies and records relating to health and safety, quality assurance and medicines management. We spoke to two members of staff to get information about the training they receive and how they are supported to meet peoples needs. We looked around the building to make sure that it was warm, clean and comfortable. There were no immediate requirements made as a result of our visit. This means that there was nothing that needed to be done urgently to ensure people remained safe and well. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? 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 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 8 of 28 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 9 of 28 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 are provided with accessible information about services and facilities, before moving in so that they can be confident that the home is suitable for them. Evidence: The home has a statement of purpose and service user guide that are made available to the people who live there. These documents contain important information about the services and facilities provided in the home. We were not able to look at the statement of purpose as it is being reviewed in light of the Health and Social Care Act 2008. The service user guide is presented in plain language with accompanying photographs which show rooms in the home, local facilities such as shops and pubs and the staff team. People keep their service user guide in their bedroom. One person told us that he had enjoyed making the guide and thought it contained a lot of useful information. The people living in the home have done so for many years. There are no vacancies Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: and no plans for anyone to move out, therefore we did not measure against key standard 2 at this visit. Care Homes for Adults (18-65 years) Page 11 of 28 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. There are effective systems of care planning and risk assessment in place, which should ensure that peoples needs are understood and met. People receive excellent support to make choices and decisions about their lifestyles. Evidence: We looked at care plans and risk assessments for two people who live in the home. These documents contain important information about the way people need and prefer to be cared for and the safeguards in place to protect them from taking unreasonable risks. The records were clearly written and explained how the person should be supported with regard to personal and health care, spiritual and cultural needs, communication, mobility, social and leisure needs and day to day living. There was evidence that the records had been reviewed on a regular basis so that Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: they remained relevant to peoples current needs. The three members of staff that we spoke to demonstrated knowledge of each persons individual needs, which indicates that care records had been read and understood. Records about people who live in the home were kept securely with the exception of some personal records that had been pinned up in the dining room. This means that the information could be read by anyone and had not been kept confidential. From observation of records and discussion with people who live in the home it was evident that they are encouraged to maintain and develop their independence by taking reasonable risks within their day to day lives. People have their own front door keys, shop and cook for themselves and spend time with friends without staff support. Risk assessments had been completed to make sure that these activities did not place people at unreasonable risk of harm. One person told us, I have a lot of freedom and that is very important to me. Another said, The staff help me to help myself. House meetings take place on a regular basis of which records are kept and made available to people who live at the home. We saw that issues for discussion included refurbishment of the premises, activities, menus and health and safety matters. Action plans completed by staff showed that peoples views had been listened to. Staff at the home have made considerable effort to present information to people in a way that meets their communication needs. For example, we saw that photographic menus were in place and minutes of meetings contained pictures to assist people to understand the content. Care Homes for Adults (18-65 years) Page 13 of 28 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 who live in the home experience a meaningful lifestyle that promotes their independence and reflects their personal choices. Evidence: We looked at activity plans and daily records for two people to see if they had regular opportunities to do things that they enjoy. Each person had a record of the activities they like and those that they dont like. The daily records that we looked at showed that people take part in a range of activities both at home and in the local community, such as going to the library, shopping, meals out, local walks and visiting local places of interest. Some people have bus passes, which they make frequent use of to access community based activities. There were risk assessments in place to support people spending time outside the home without assistance from staff. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: People told us that they make choices and decisions about how they spend their days and that routines within the home were flexible. For example, on person said that if he had had a late night, breakfast the following morning would be offered much later than the norm. The home supports people to keep in touch with their friends and families. Care plans that we looked at described how people should be supported to maintain this contact and it was evident that people had been enabled to stay in touch with friends they had made before they moved into the home. One person commented, I can make phone calls whenever I want to. We looked at menus and the records of food that people eat to make sure that a varied and healthy diet is offered that meets peoples needs and preferences. People told us that they had a choice of meal every day and that they went shopping for food each week. Care Homes for Adults (18-65 years) Page 15 of 28 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. There are effective systems in place to meet peoples personal and health care needs. Medicines are well managed so that people receive their medication in a planned and safe manner. Evidence: We looked at personal and health care records for two people. They contained clear information about peoples needs and had been recently reviewed to make sure that they were accurate and up to date. The two members of staff that we spoke to were able to describe how they supported people with their personal and health care, which indicates that they had read and understood individuals care plans. The records we looked at showed that people had regular appointments with healthcare staff and that the outcome of the contact had been recorded so that staff had up to date information about peoples health. Some appointments had not been dated making it difficult to establish when they had taken place which could lead to Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: people receiving inconsistent health care. One person told us, The staff know what help I need and they let me get on with things. The people who live in the home are all male and the staff rota showed that there are a number of male staff to assist with personal care. Male staff are always on duty overnight. We looked at the way medicines are managed in the home to check that this was being done safely. Medicines had been securely stored and we were told that all medicines were audited each week. This should ensure that errors are spotted quickly and investigated promptly. A report from the local pharmacy in January 2010 showed that there were no issues that needed to be improved upon with regard to medicines management. Some people are able to manage their own medication. This had been planned for and we saw records which showed that potential risks had been identified and safeguards put in place to reduce them. We were told, I like sorting out my own tablets. The home is clearly supporting people to maintain their independence in this area. Care Homes for Adults (18-65 years) Page 17 of 28 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. There are effective procedures in place to listen to peoples complaints and safeguard them from possible harm. Evidence: The home has a complaints procedure that is made available to the people who live there. We looked at the procedure which is presented in plain language and photographs to assist people to understand the content. Two people told us that they were confident staff would listen to them and take action to address any concerns they raised. There have been no complaints made to us or to the home within the last twelve months. Some people living at Brookvale Road demonstrate behaviour that means staff must work with them in a specific way to reduce the risk of them harming themselves or others. Guidelines were in place which had been written by health care professionals to instruct staff how to do this safely. The staff we spoke to were able to describe how they recognised triggers and warning signs that would lead to their intervention to safeguard people appropriately. The staff training matrix showed that a regular programme of safeguarding training and refresher training is provided so that staff keep up to date with their responsibilities for promoting the safety and well being of people living in the home. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: There have been no safeguarding referrals made within the last twelve months. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is warm, clean and well furnished. This makes a pleasant environment for people to live in. Evidence: Brookvale Road is situated in the Olton area of Solihull, close to local shopping amenities and public transport routes. This is important to the people who live there as they make regular use of these facilities. The home is not easily identifiable as a care home and is in keeping with other properties in the street. We looked around the shared areas of the home, which include a kitchen, dining room and lounge. All of the rooms were clean, warm and well decorated. Some damage to the stair and dining room carpets was noted, however the home had taken action to rectify this so that people were not placed at risk of tripping and falling. Internet access is provided in the dining room. One person told us, I love going on the computer, I can keep in touch with friends. Each person has their own bedroom, which contains lockable space for personal belongings. The rooms we saw had been decorated and furnished according to individuals tastes. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: There is a large rear garden with garden furniture and two sheds. We were shown the woodcraft workshop a person had set up in one of the sheds. This person told us, I like making things in here. There were no unpleasant odours within the home which indicates that good cleaning routines are in place. Care Homes for Adults (18-65 years) Page 21 of 28 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 are supported by a trained team of well established staff who have good understanding of their needs. Evidence: We asked people about the qualities of the staff who work with and were told, The staff are really good and They help me do things for myself. This is important to me. The rota showed that there is a core team of five staff of which four are senior support staff. Maintenance tasks are completed by a designated team. Up to two staff are on duty at each shift with a member of staff sleeping in overnight. We were told that the current staffing levels meet peoples needs at present. The homes Annual Quality Assurance Assessment (AQAA) stated that three staff have completed National Vocational Qualifications in care. A rolling programme of training is provided to the staff team so that they have opportunities to refresh their knowledge of social and health care issues. This should make sure that people are supported by a competent and trained team of staff. There have been no new staff employed since our last visit in 2007 when the outcome Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: in this area was judged as good. Therefore we have not measured against this key standard at this visit. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being well managed and peoples health and safety is promoted and protected. Evidence: The homes manager has over twelve years experience in social care, having qualifications that are relevant to her work and completing regular updates in mandatory training. The manager has responsibility for another care home in the area. Four senior staff are therefore employed to undertake the day to day running of Brookvale Road in her absence. One person told us, Since (the manager) has been here, things have really settled, they are really good. There are systems in place to review the quality of care and service provided within the home. A representative of the registered provider visits the home each month in order to compile a report on the quality of care and service. We looked at some of the reports and found that where issues for improvement had been identified the manager Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: had prepared an action plan to describe how she had achieved this. Records showed that care plans, risk assessments, financial and medication records had been reviewed on a regular basis. People told us that they were confident that they would be listened to by the staff team if they had concerns or complaints. This indicates that the home are taking quality issues seriously for the benefit of people who live there. A number of checks are made to make sure that peoples health and well being is protected. We looked at some records that show this has happened. The fire alarm system had been tested and serviced on a regular basis to make sure that it was working properly. People had taken part in fire drills so that they had opportunities to practice leaving the building in the event of an emergency. We were told that the emergency lighting had been tested but the test results had not been recorded. This could mean that there is a delay in responding to any faults and may place people at risk of harm if the system fails. Training records showed that all staff have taken part in health and safety, infection control, fire safety, first aid and food hygiene training. This should contribute towards promoting peoples health and safety. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 1 42 13 The emergency lighting system must be tested and a record of each test maintained within the home. To ensure the system remains in working order so that faults can be responded to promptly for the ongoing health and safety of people living in the home. 15/07/2010 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 10 Information about people who live in the home should be securely stored to make sure that it remains confidential and accessible only to those who need to read it. Health care records should be clearly dated so that people continue to receive a consistent service which meets their needs. 2 19 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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