Care Home: 73 Commonside

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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. Work is going on to develop the ways in which people`s communication support needs can be better met, so they can more 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. People`s opinions are actively sought, so they can be confident their views are listened to and taken seriously. 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: Good practice recommendations made following this inspection can be found at the end of this report. Random inspection report Care homes for adults (18-65 years) Name: Address: 73 Commonside 73 Commonside Pensnett Brierley Hill, Dudley West Midlands DY5 4AJ 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: 0 4 0 6 2 0 1 0 Information about the care home Name of care home: Address: 73 Commonside 73 Commonside Pensnett Brierley Hill, Dudley West Midlands DY5 4AJ 0138474588 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Toni Elizabeth Quinn Type of registration: Number of places registered: Conditions of registration: Category(ies) : Commonside Care Ltd care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 6 The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service: 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 category: Learning Disability - Code LD Date of last inspection Brief description of the care home 73 Commonside is registered to provide accommodation, care and support for up to six people with a learning disability. The home is located in Pensnett, which is situated between Kingswinford and Dudley. The neighbourhood is a mixed commercial and residential area, well served by public transport. The house fronts directly onto a fairly Care Homes for Adults (18-65 years) Page 2 of 11 Brief description of the care home busy road. There is limited parking at the side of the house and in the nearby side streets. A number of shops and other local amenities are within walking distance of the home. The house is a two-storey property with bedrooms on both floors (four single and one double) On the ground floor is the kitchen, a separate dining room, a lounge extension, laundry and conservatory. Bathing and toilet facilities are ample. The home is well maintained and has a generous sized, attractive rear garden. Ramped access is provided from the lounge extension to the patio area in the rear garden. The service should be contacted directly for current information about fees and charges. Care Homes for Adults (18-65 years) Page 3 of 11 What we found: This services last key inspection was on 15 May 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 (AQAA). We made a visit to the home and met people who use the service, and members of staff. The Manager was away on leave on the day we visited, so we spoke to her on the telephone afterwards. We also received written responses to questionnaires we sent to people who use the service and staff at the home. We looked at records including personal files, care plans, staff records, previous inspection reports, safety records, and other documents. 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 also. 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 care they need. 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 person-centred so that the individual concerned is always at its focus. It is recommended that this work be continued and developed, to ensure that people get the support they need in the ways that suit them best. It is also recommended that care plans include goals with outcomes that can be clearly measured. This is to ensure that people are supported to achieve the things that are most important to them. We directly observed staff asking residents about what they wanted to do and what they would like to eat and drink. We saw the minutes of residents group meetings that take place regularly. People told us they were looking forward to going away on holiday soon. They showed how they had chosen where to go and the brochure they had picked the holiday from. We also saw that one of the residents who has communication support needs had a best interest meeting to make decisions about some treatment needed. In the Annual Quality Assurance Assessment, the Manager told us that she and her deputy had recently done some training in communication passports, aimed at improving the ways in which peoples decisions and choices can be supported. Records show that people enjoy a range of activity opportunities. Some attend local day centres regularly. The care team works hard at promoting peoples independence, according to each persons individual abilities. They are involved in the day to day running of the house, according to their wishes and capacity. Those that can do jobs around the house including keeping their rooms clean and tidy, laundry, food preparation and shopping. Outside the house staff support them to use local facilities so they can be a part of the community in which they live. Records showed that activities included going swimming, shopping for personal items, trips to the cinema, circus, theatre and to see Care Homes for Adults (18-65 years) Page 4 of 11 live music concerts. They go out for meals and have takeaways, and like to go to the large local shopping mall at Merry Hill and go for coffee. The AQAA shows that people have their own front door keys, open their own post and vote in elections. We saw that the home operates a three week rolling menu that has been put together in discussion with the residents. In the kitchen we saw that peoples likes and dislikes were posted on the notice board. We saw that food stocks were ample and included fresh fruit and vegetables. We saw people having lunch together in the dining room. This was a relaxed and unhurried affair. People told us that they liked their food and could have what they wanted. Records of the meals people had eaten showed that they enjoy a balanced and nutritious diet with plenty of choice and variety. 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. We recommended that the local Health Facilitation Team be contacted about updating these. However, it should be acknowledged that when we spoke to the Manager subsequently she told us that action was already in progress with peoples GP practices with regard to monitoring residents health and annual checks. We looked at the arrangements for administering and storing medication. The home currently uses the Lloyds Monitored Dosage System (MDS).We saw that the Medication Administration Record had been completed appropriately. The medication file contained sample signatures and information about prescribed medicines. We noticed that some of the creams had not been labelled with the date of opening, in line with accepted good practice. Also that there were creams stored that had passed their expiry date and should have been disposed of appropriately, though these did not appear to be in current use. We noted that some written protocols were in place for PRN (as required) medications, but not for all. This needs to be reviewed, so that all current PRN medication is supported with a written protocol, preferably signed by the prescribing doctor. This is to ensure that staff have clear guidance about the circumstances in which such medicines should be given and appropriate dosages / limitations. We also noted that staff recorded the temperatures in the medication store and medication fridge each day. However, staff on duty were unaware of the acceptable range of temperatures or action to take in the event of this being exceeded. We spoke to the Manager about this and recommended that staff be given clear guidance, to ensure that the efficacy of all medication stored is maintained at all times. We recommended that she takes advice from the local pharmacist and makes arrangements for regulating the temperature in the store (e.g. air contitioning unit) should this be required. We saw copies of the homes complaints procedure on peoples personal files. It should be acknowledged that this is more relevant for some people that others. Residents with high communication support needs rely on staffs vigilance to notice changes in behaviour, demeanour or body language as indicators that they may be unhappy or Care Homes for Adults (18-65 years) Page 5 of 11 concerned. Those who were able said that they knew who they could talk to if they were upset or worried about anything. The Manager told us that no complaints have been received during the past 12 months. We have not received any complaints about this service either. In the Managers absence we were unable to access staff records. Returned staff surveys all show that checks were carried out with the Criminal Records Bureau and references were obtained before staff started work, and this is confirmed in the Annual Quality Assurance Assessment. Previous reports also show recruitment practice is satisfactory. Available training records showed that staff have completed safeguarding training. We talked to staff on duty about this. They were able to show their understanding of the nature and different forms of abuse, and of things they need to look out for. They could also say what action they would take in the event of witnessing or suspecting abuse. We have not received any safeguarding referrals about this service during the past year. The residents proudly showed us around their home. We saw that their rooms are very individual, with peoples possessions, pictures, ornaments, family photographs etc. very much in evidence. People enjoy the good range of shared spaces available including a dining room, lounge, conservatory, and a pleasant garden. The home is furnished, decorated and maintained to a high standard. Staff and the residents work hard to keep it clean, tidy and fresh, safe and homely. As reported above, we were not able to access staffs personal files in the Managers absence. The care team is stable, with low staff turnover, and no use of agency personnel, promoting continuity of care for residents. We saw the training matrix which shows staff have completed mandatory training. Staff responding to surveys said they received an induction that covered very well what they needed to know to do their jobs. Also that they were given training that is relevant to their role, helps them understand and meet peoples needs, and keeps them up to date with new ways of working. They said that ways of sharing information in the home always worked well. Also that their manager gave them enough support and met with them regularly to discuss how they are working. In the Annual Quality Assurance Assessment the Manager told us that all staff except one hold qualifications at NVQ 2 or above, and have done the Learning Disability Awards Framework (LDAF) training. The Annual Quality Assurance Assessment shows that the Manager has many years experience in her chosen field. She holds the Registered Managers Award (RMA) and a nursing qualification for working with people with learning disabilities (RNMH). Staff on duty said they felt part of a good team and that management personnel were actively involved in day to day support of the residents. They said they were comfortable raising any matters of concern with the Manager or senior staff. The AQAA shows that systems are in place for monitoring and quality assurance of the service. We saw evidence of monitoring activity including residents questionnaires. We spoke about this to the Manager and recommended that all information gained as a result of monitoring activity be collated and analysed. This should be reported on and the findings shared with all interested parties. This is to show how the views of people using the service underpin its review and development. 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 Care Homes for Adults (18-65 years) Page 6 of 11 assessment is in place. The fire risk assessment was due for review. What the care home does well: 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 11 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 11 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 say are important to them. Review protocols for all PRN as required medication to ensure that these are current, and provide staff with clear guidance about the circumstances when such medication should be given. Ensure that all creams and lotions are labelled with the date of opening and disposed of when expiry dates have been reached Review arrangements for monitoring and regulating the temperature in the medication store. Take advice from the local pharmacist and ensure that staff have clear guidance about what action to take if acceptable temperatures ranges are exceeded. Collate and analyse information gained in quality assurance and monitoring activity. Produce a report of the findings Page 9 of 11 2 20 3 20 4 20 5 39 Care Homes for Adults (18-65 years) Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations and share this with all interested parties. This is to show how the views of people using the service underpin its review and development. 6 43 Review the homes fire risk assessment and update as necessary Care Homes for Adults (18-65 years) Page 10 of 11 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 11 of 11 - 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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