Care Home: 76 Holland Street

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What the care home does well This home is due to close in the near future. The people who live there are being supported to move into alternative accommodation after their needs have been assessed and they have been consulted. We saw that the staff are providing people with a good level of support through this process. The home is being managed by a manager who has come from another home until the home closes. The staff are working alongside some staff who are employed by the new provider, so that people in the home can get to know them in order for the transition to their new properties to be as smooth as possible. People receive a good level of support to attend activities and day centres. There are good arrangements to make sure that people`s health needs are met. People are consulted and involved in plans for their future. Where people need further support to make their preferences known, they are supported to use the services of advocates. There are good arrangements for making sure that people in the home and their representatives are able to make complaints. What has improved since the last inspection? We found that the home has met the requirements made in the last report. There are now improved arrangements for making sure that appropriate action is taken should someone who lives in the home go missing. We saw that care plans have been updated and reviewed. In order to make sure that people move to suitable placements where their needs will be met, people`s needs have been reassessed. We found improved risk assessments on people`s files. These help to make sure that people are safe whilst being supported to be as independent as possible. The care plans which we sampled contain better detail of the activities in which people have taken part and the choices which they have made. There are improved arrangements for making sure that people are encouraged and supported to eat a healthy diet and that appropriate action is taken promptly when people`s weights change to one which may indicate that they are becoming less healthy. The staff training matrix shows that staff are now better trained to undertake their roles. There are improved arrangements for the management of the home. We found evidence of more clear delegation of tasks and improved monitoring of records and practice. What the care home could do better: Since the home is closing in the near future, the plans are for the staff to continue to support people as they move on to other accommodation. Staff are aware of the need to learn from the experiences of people who have already moved out and to make appropriate changes so that the outcomes for people yet to move out are as positive as possible. Key inspection report Care homes for adults (18-65 years) Name: Address: 76 Holland Street Holland Street, 76 Sutton Coldfield West Midlands B72 1RR     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: Christine Lancashire     Date: 3 0 0 3 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 26 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 26 Information about the care home Name of care home: Address: 76 Holland Street Holland Street, 76 Sutton Coldfield West Midlands B72 1RR 01213542789 01213550832 Telephone number: Fax number: Email address: Provider web address: Katymeakin@Birmingham.gov.ukwww.birmingh am.gov.uk Social Care and Health Name of registered provider(s): Name of registered manager (if applicable) Gillian Charmaine Gayle Type of registration: Number of places registered: care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is: 22 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) 22, Physical disability (PD) 22 Date of last inspection Brief description of the care home The home is a large two-storey building of modern design and appearance. It is set within its own grounds occupying a corner position. The home is located in a residential road in Sutton Coldfield with good access to shops and transport links. The gardens at the rear of the home are spacious and secluded. There are parking facilities to the front and rear of the building. Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 0 22 22 0 9 0 2 2 0 0 9 Brief description of the care home The home provides accommodation and care to adults who have a learning disability. Some people have additional physical disabilities and behaviour that may challenge. Each person has a single bedroom. The home is arranged over four different living areas. On the first floor people are supported to live more independently and are involved in meal planning and household tasks. This part of the home is known as minimal care. The amount people pay to live at Holland Street is worked out for the individual with their social worker. The items not covered by the fee include clothing and toiletries. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We visited the home on a weekday, without telling anyone that we would be visiting. We looked round communal areas of the building. We talked with six members of staff who perform various roles. We also met seven people who live in the home. Before the inspection we had asked for information about how the home runs in a questionnaire called an Annual Quality Assurance Assessment. The manager provided this information. On the day we looked at the records which the home keeps in respect of three people who live there, so that we could find out how they are being supported and kept safe. We looked at other records which the home is required to keep. These include the staff training records, rotas, menus, safety records and minutes of meetings. We used this information to write this report. Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? We found that the home has met the requirements made in the last report. There are now improved arrangements for making sure that appropriate action is taken should someone who lives in the home go missing. We saw that care plans have been updated and reviewed. In order to make sure that people move to suitable placements where their needs will be met, peoples needs have been reassessed. We found improved risk assessments on peoples files. These help to make sure that people are safe whilst being supported to be as independent as possible. The care plans which we sampled contain better detail of the activities in which people have taken part and the choices which they have made. There are improved arrangements for making sure that people are encouraged and supported to eat a healthy diet and that appropriate action is taken promptly when peoples weights change to one which may indicate that they are becoming less healthy. The staff training matrix shows that staff are now better trained to undertake their roles. There are improved arrangements for the management of the home. We found Care Homes for Adults (18-65 years) Page 7 of 26 evidence of more clear delegation of tasks and improved monitoring of records and practice. 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 26 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 26 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. Peoples needs are assessed prior to admission to and discharge from this home. Evidence: This home is due to close in the near future. There have been no recent admissions. We sampled the files of two people living at the home and saw evidence that their needs had been addressed so that the home could be sure that they could meet their needs prior to admission. The people who live in the home are currently being prepared to move into alternative accommodation and the records in the home show that their needs are being reassessed. Their opinions and preferences in terms of future accommodation have also been recorded so that they can be taken into account when planning the moves. We saw booklets on files which detail the preferences of the person, such as the type of accommodation they would like to live in and the adaptations they would need. The information also contains details of the support staff they would need to enable them to live life as independently as possible and the other people they would prefer to live with. This shows that peoples needs are being assessed and their views are being Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: taken into account before they move. Care Homes for Adults (18-65 years) Page 11 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and personal goals are reflected in their care plans. They are encouraged to participate in decisions about their lives and are supported to take risks as part of an independent lifestyle. Evidence: We saw that the information gathered in the initial assessment has been used to form the basis of the care plans which staff use to make sure that they are providing care which meets peoples needs and suits their preferences. We sampled two of these plans and saw that they show where people have been consulted about their content. They have been updated on a regular basis and altered to meet the changing needs of the people concerned. We saw that the plans include risk assessments and details of the measures which are taken to reduce the risk when people participate in a range of activities of their choice. Since the people at this home are planning to move on to other accommodation, the staff have worked with other relevant professionals to make sure that there is as Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: much information as possible about what each person needs and prefers. We spoke to three people who live in the home. One told us about how he has been involved in making plans for his new home. These include choosing furnishings from a catalogue. Staff showed us items which they had purchased for people according to the choices which they had made. They provided examples of a range of areas in which people had made choices. The files also contained copies of correspondence from advocates in relation to the plans for people, helping them to obtain the accommodation of their choice. This shows that people are helped to access support from outside agencies so that their views are properly represented and the best outcomes are obtained. People at this home use a variety of methods of communication, including formal systems such as makaton. Most people have their own specific methods of communication and the staff demonstrated that they are good at communicating with people. Staff who will work with the people after they have moved home are working alongside the homes staff so that they will be skilled in communication and know the people well, before they move home. Care Homes for Adults (18-65 years) Page 13 of 26 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 are supported to take part in appropriate activities and to maintain links in the local community. They have appropriate relationships and their rights are respected. They are supported to have a healthy diet and enjoy their mealtimes. Evidence: The manager told us that people are encouraged to take part in a range of activities of their choice. We sampled peoples files and found records of activities such as jigsaws, day centres, skittles and meals out. The walls in the corridors have photographs of people enjoying themselves at celebrations and in various locations. Various religious and cultural events are celebrated in the home. Poeple told us that they were looking forward to Easter. The records show that visitors are welcomed and the sampled files showed that staff support people to keep in contact with their relatives and friends. The records show Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: that, as plans are made for people to move to other homes, the importance of being near to familiar people and facilties is taken into consideration. The menus show a variety of meals which appear to be well balanced in terms of nutrition. These are prepared using knowledge of peoples needs and preferences. We saw evidence of nutritional monitoring on peoples files. People are weighed on a regular basis and staff encourage people to eat a diet which will assist them to reach and maintain a weight which is considered to be healthy. There is evidence of good practice in the preparation and serving of food and the home has 4 stars from the environmental services. People told us that they enjoy the food. Care Homes for Adults (18-65 years) Page 15 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal support in the way they prefer and require so that their physical and emotional needs are met. People are protected by the homes practices in dealing with medicines. Evidence: The records which we sampled contain good details of peoples health needs and include records of monitoring in a variety of relevant areas. People are supported to use a range of healthcare services in the community. The records show that they attend appointments with various health care professionals including dentists, chiropodists and GPs. The records show that the manager and staff are aware of the kinds of symptoms which may prompt the need for an appointment. The records show that people have a range of different needs in terms of personal care and manual handling. Staff have received appropriate training and there is a range of suitable equipment in the home, which meets the specific needs of individuals. Staff told us that care has been taken to make sure that people will have Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: the right equipment when they move. There is suitable, secure storage for the medication and we saw that sampled records had been completed appropriately. All staff who administer medication are suitably trained. Care Homes for Adults (18-65 years) Page 17 of 26 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. This home has systems to ensure that the views of the people who live there are listened to and acted upon and for making sure that people are well protected. Evidence: This home has a policy and procedure for dealing with complaints and the details for making a complaint are in the homes Statement of Purpose and service user guide. The manager told us that staff also explain how to make a complaint to people living in the home. People are also supported to use advocacy organisations. We sampled files and saw evidence that advocates had been involved in helping people to secure the accommodation which they wanted for the future. The records show that staff have received training in recognising the possible signs of abuse and the action to take should they have any concerns. The local procedures for safeguarding people are in the office. This means that there are good arrangements for making sure that people are kept safe. Care Homes for Adults (18-65 years) Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people at this home live in a clean, safe and comfortable environment where there are good arrangements for infection control. Evidence: This home is due to close in the near future. We looked at communal areas and found that they are in a reasonable state of repair and decoration. There are sufficient aids and adaptations to meet the needs of the people who live in the home. There are procedures in relation to infection control and we saw staff using gloves and aprons when needed. The areas which we saw appeared to be clean and free from unpleasant odors. Care Homes for Adults (18-65 years) Page 19 of 26 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 adequate numbers of appropriately trained and competent staff so that their needs are met. They are protected by the homes recruitment practices. Evidence: We sampled staff files and found that staff are recruited through a standard procedure which includes checks through the Criminal Records Bureau and taking up references. This helps to protect the people who live in the home. The rota shows a good level of cover and we saw that there were enough staff on duty on the day of our visit. Staff are working alongside staff from the provider who will take over once people have moved. Some of the present staff team will also move to the new provider. This means that people in the home will have continuity through what could be a stressful time. It also provides the new staff with an opportunity to get to know the people they will be working with and to learn their preferred methods of communication. Staff told us that this arrangement is working well. People in the home showed us that they knew who would be supporting them after their move. The training records show that staff are trained to at least NVQ level 2. They also receive training in additional areas to meet the needs of the people in the home. For Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: example, staff have received training the technique used in the administration of specific medication for one person. We saw the minutes of staff team meetings and staff confirmed that they receive supervision on a regular basis. The staff we spoke with had clear plans for the future and were positive in their outlook. Care Homes for Adults (18-65 years) Page 21 of 26 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 people in this home benefit from a well run home where their views underpin self monitoring, review and development. Peoples health, safety and welfare is promoted. Evidence: The home is due to close in the near future and is currently being managed by the manager of another home. The manager is supported by senior staff within the home. Staff told us how they have worked to coordinate the move out of the home, making sure that all the people who live there have somewhere suitable to move to. They provided good examples of how peoples views have been taken into account in the process. At the same time, there have been changes to the staff team as staff have moved on and new staff have joined from the new service provider. Staff said that they have felt well supported during this difficult time. We saw minutes of staff meetings which show that there is clear delegation of tasks and planning of activities. The records show that the managers monitor records, policies and procedures. We saw that the action plan following the last inspection report has been implemented and the standard of management has improved. The Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: manager continues to let us know about relevant events in the home. We saw evidence that planning is based on review of past practice and improvements are made to take account of this. For example staff told us about the changes which have been made to the way in which people are helped to move on, after looking at the experiences of people who moved earlier. We saw evidence throughout the planning processes that the views of people who live in the home are sought at all stages and their view are valued and taken into account. The manager provided us with dates of the maintenance and servicing of equipment and tests relating to fire safety. We checked a sample of these at the inspection and found that relevant tests are up to date. This means that there are good arrangements to make sure that people who use the building are kept safe. Care Homes for Adults (18-65 years) Page 23 of 26 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 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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. 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