Care Home: 807 Pershore Road

What the care home does well People wanting to go and live in the home could visit several times and stay overnight if they wished before deciding if the home was suitable for them. Th people living in the home were very positive about the staff team saying they were available to offer support when needed. Relationships between the staff and the people living in the home were seen to be very friendly. People were fully involved in planning their futures and saying what should be included in their rehabilitation. They were actively encouraged by staff to take control of their lives. Staff spoke to us about the many people who had been successfully moved from the home to more independent living. Some of these people still returned to the home to see staff. The people living in the home were encouraged and supported by staff to develop skills in cooking, laundry, cleaning and how to budget their money in preparation for their move to more independent living. The people living in the home followed individual lifestyles and opportunities for personal development. People spoke to us about going to a variety of venues including colleges, day centres, voluntary work placements and allotments. Staff at the home encourage and support people to manage their own medication in a safe manner. Suitable complaints procedures are in place and the people at the home know how to raise their concerns with staff and the manager. Staff have previously been trained to recognise and report any suspicions of abuse so that people are protected from harm. Staff are provided with training to do their jobs. Almost everyone now holds National Vocational qualifications in care. The home was well maintained and offered people a comfortable environment. What has improved since the last inspection? The statement of purpose and service user guide for the home had been reviewed and included all the information people would need to enable them to decide if the home was suitable for them. Staff had undertaken further training in some topics to ensure they can support people effectively. The people living in the home had the use of a computer which gave them access to the internet as many other people do in their own homes. There had been some further improvements in the environment to ensure the home was kept well maintained and comfortable for the people living there. What the care home could do better: There must be comprehensive risk assessments in place for any identified risks that include strategies for managing the risks. This will ensure that the people living in the home are not exposed to any unnecessary risks. All the people living in the home should have up to date care plans that detail how all their support needs are to be met by staff. This will ensure the people living in the home receive person centred care in a way that suits them. There should be individual written guidelines for staff to follow for any PRN (as and when required) medication being administered to the people living in the home. This will ensure they receive their medication when it is needed. The smoking lounge should be redecorated and have new furniture so that it is kept to an acceptable standard for the people living in the home. Opened foods stored in the fridges should be dated when opened so that staff know when it is to be discarded. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 807 Pershore Road 807 Pershore Road Selly Park Birmingham West Midlands B29 7LR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Brenda ONeill     Date: 2 3 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: 807 Pershore Road 807 Pershore Road Selly Park Birmingham West Midlands B29 7LR 01214155684 01214155684 pershore@mind-birmingham.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mind in Birmingham care home 10 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 10 The maximum number of service users who can be accommodated is: 10 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: Mental disorder, excluding learning disability or dementia (MD) 10 Date of last inspection Brief description of the care home 807 Pershore Road is a large detached double fronted three storey, Victorian style property in Selly Park. The home was providing rehabilitation services as opposed to long stay placements for younger adults with mental health needs. Places were provided for time limited rehabilitation, and the people accepting a service at the home were expected to move on within eighteen months of being placed at the home. The home is well placed in terms of access to the local community, being close to a number of shops, pubs, park, Stirchley village and local bus and rail services. The front of the house has a well-maintained walled garden, which provides parking for Care Homes for Adults (18-65 years) Page 4 of 32 Brief description of the care home some cars, the rear garden is large and very private and is utilised by the people living in the home in the summer. The house feels spacious and homely; it appears to be a well established home with a clear philosophy of care that clearly suits the service user group. All bedrooms are of single occupancy and two have en-suite facilities. There are showering/bathing facilities on each floor and toilets are shared by no more than three people. There are also kitchenettes on each floor for the use of the people living in the home. Communal space comprises of two large lounges, one smoking and one non smoking and a large dining room which are all located on the ground floor. Also located on the ground floor are a laundry, main kitchen and small office. The service user guide was on site and detailed charges in the home as five hundred and sixty eight pounds twenty eight pence per week as the block contract price to Birmingham City Council adults and communities. In certain circumstances some individuals may be expected to contribute to their fee from their benefits. This would be explained and detailed in writing before any offer was made. Care Homes for Adults (18-65 years) Page 5 of 32 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 last key inspection at the home was carried out on May 19th 2008. This inspection was carried out over one day; the home did not know we were going to visit. The focus of inspections is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, standards of practice and focuses on aspects of service provision that need further development. Prior to the visit taking place we looked at all the information that we have received, or asked for, since the last key inspection. This included notifications received from the home. These are reports about things that have happened in the home that they have Care Homes for Adults (18-65 years) Page 6 of 32 to let us know about by law, and an Annual Quality Assurance Assessment (AQAA). This is a document that provides information about the home and how they think that it meets the needs of people living there. Two of the people living in the home were case tracked. This involves establishing individuals experiences of living in the care home by meeting them, observing the care they receive, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. We looked around some areas of the home to see if the environment was comfortable. We also looked at some care, staff and health and safety records. Where people who use the service were able to comment on the care they receive their views have been included in this report. We sent 5 Have your Say surveys to people who use the service, 6 to staff and 4 to professionals. Only two of the surveys were returned to us. These were from the people living in the home and these views have been included in this report. What the care home does well: What has improved since the last inspection? The statement of purpose and service user guide for the home had been reviewed and included all the information people would need to enable them to decide if the home was suitable for them. Staff had undertaken further training in some topics to ensure they can support people effectively. The people living in the home had the use of a computer which gave them access to the internet as many other people do in their own homes. There had been some further improvements in the environment to ensure the home was kept well maintained and comfortable for the people living there. Care Homes for Adults (18-65 years) Page 8 of 32 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 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 9 of 32 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 10 of 32 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. There was information available to help people decide if the home was suitable for them. Suitable admission arrangements are in place to help people to make an informed decision about the home and if they wish to live there. Evidence: There was comprehensive information available for anyone wanting to live in the home in the form of a service user guide. The service user guide included information about what support would be offered by the home and what would be expected of anyone going to live there. The assessment procedure for people moving into the home was undertaken over varying periods of time. Files included evidence that assessments had been undertaken prior to the individuals being admitted to the home both by staff at the home and the relevant professionals. The homes assessment asked question such as what sort of life do you want to achieve and what sort of support do you want from the service. Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: One individual spoken with was having some trial visits to the home and had stayed there the previous night. He said he had visited several times and liked the home as it was much more relaxed than being in hospital. He liked the people and was looking forward to moving in. Another person spoken with also confirmed he had several trial visits and had moved in quite recently. He was clearly quite anxious and was having a lot of support from staff and other professionals to try and help him settle. Staff were documenting all the pre admission visits people made to the home showing how they had been while in the home, what they had done and what support they had needed. This information helped staff to offer the appropriate support when people did move in. Care Homes for Adults (18-65 years) Page 12 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is scope for increasing the level of detail contained in care plans and risk assessments, so that staff have clearer information by which to support the people at the home. People are encouraged to make everyday choices and plan for their futures so that they can exercise control and responsibility over their lives. Evidence: The care plans in the home are called Essential Lifestyle Plans (ELP). These plans are completed by the people using the service and provide information about peoples needs and state broadly how they expect their needs to met. These plans are person centred and are a good way of encouraging people to take control of their rehabilitation. The files for two of the people living in the home were sampled. One person had only been living in the home for a few days. He did not have an ELP in place but there was an initial assessment record undertaken by staff. This gave some good details about Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: the persons preferred daily routines, his mental health, what he needed support with and what he liked doing in his spare time. There was also extensive information in social work and nursing reports giving details of the individuals history and why support was needed. These details would have enabled staff at the home to support the individual appropriately until he felt confident enough to complete his ELP. We were able to speak to the individual and he was clearly still settling in and finding moving into the home quite an anxious time. Staff were seen to offer support throughout the day and he was visited by his social worker who was also helping him to settle. He was very positive about the home saying staff were helping and that he got on well with the other people living in the home. The second file was for a person who had been living in the home for almost two years. He was now looking at moving out into more independent living. He had been to look at some properties but these were not suitable and was waiting for a further offer. His ELP gave some details about who and what was important to him, how he liked spending his time and what other people needed to know to support him. As at the last inspection these details were quite broad and gave little detail of what support was needed to meet the identified needs and ensure the individual was ready for more independent living. For example, no mention of what groups were attended or what support was necessary from staff to maintain good mental health. It was also evident from the individuals monthly evaluations that staff had been giving support with cooking and encouraging more activities. This was not mentioned at all in his ELP. The monthly evaluations for this individual gave a better picture of what support the individual was and had been receiving from staff and this was significantly more than was detailed in his ELP. The monthly evaluations of the ELPs summarised significant events and clarified plans for the coming month, indicating that peoples progress was being supported and monitored by staff. One of the files sampled included several risk assessments covering areas such as suicide, self harm, self neglect, aggression and violence. The details in the risk assessment generally covered such things as what has happened in the past, any specific triggers and what staff could do to minimise the risk. Some of the guidance that was in place for staff to follow to minimise risks needed to be further developed. For example, for aggression and violence it stated to contact the team this is not appropriate as if someone was being violent staff needed guidance as to how they would ensure the individual, the other people living in the home and the staff were kept safe immediately any persons behaviour became a concern. Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: The second file sampled did not have any specific risk management plans in place. There was a risk screening tool which identified what risks the individual had and what level these risks were deemed to be but there were no management plans for staff to follow to minimise the risks. The manager needed to ensure risk management guidelines were in place for staff for this individual as he was very new to the service and staff were still getting to know him. This could leave both the individual, the other people living in the home and the staff at risk of harm. The manager was not in the home during the inspection but this issue was discussed with her after. She addressed this very quickly and copies of the relevant risk assessments were forwarded to us. Discussions with the staff on duty showed they were aware of the needs of the people living in the home, their support needs and levels of independence. They were able to tell us how they knew when peoples mental health was possibly relapsing by changes in their behaviours. The people living in the home made decisions about their lives on an ongoing basis and were very involved in running their lives as they wanted. They were fully involved in the assessment process prior to moving into the home and their monthly evaluations once they were living in the home. They made decisions on a daily basis about what courses they attended, how they spent their leisure time, what they had to eat and when and if they saw their family and friends. All the people living in the home managed their own finances and could have staff support for this if it was required. Staff were seen to remind one person of a hospital appointment and ask if they wanted support to attend. The individual decided to go alone. All the people spoken with were very satisfied that they were able to run their own lives but knew staff would support them where needed. Care Homes for Adults (18-65 years) Page 15 of 32 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 encouraged to retain and develop their independence and to take control of their lives so that that they may be equipped for independent living in the future. Evidence: The aim of the home was to support and encourage people to move on to more independent living. The people living in the home were at various stages in this process. One person spoke to us about having been to look at some properties as he was now ready to live more independently. Another person who had recently moved to the home spoke to us about wanting to live more independently in the future but knew he was not ready for this yet. Staff spoke to us about the many people who had been successfully moved from the home to more independent living. Some of these people still returned to the home to see staff. Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: The people living in the home were encouraged and supported by staff to develop skills in cooking, laundry, cleaning and how to budget their money in preparation for their move to more independent living. The people living in the home followed individual lifestyles and opportunities for personal development. People spoke to us about going to a variety of venues including colleges, day centres, voluntary work placements and allotments. People spoke about having music lessons, doing IT courses and being members of support groups. People were seen to come and go throughout the day and some had visitors in the home including social workers and CPNs. Although people lead generally quite different lives they still enjoyed going out together on occasions and went for a meal, game of pool or bowling. Staff spoke to us about their rotas being altered to enable more activities to be undertaken. They spoke of encouraging people to do things that other people in the same age groups do such as staying out a bit later in the evening and going to night clubs occasionally. The people living in the home spoke very positively about the support they receive from staff and friendly relationships were evident. People were encouraged and enabled to maintain contact with friends and families if this was what they wanted to do. Records showed people receiving visits from friends and families, going out to see families and making and receiving phone calls from them. The people living in the home had regular meetings and were encouraged to run these themselves. Staff told us that no one was interested in chairing the meetings so it had been suggested that a former resident at the home who visited regularly should be considered. People were happy with this and this had now been agreed (detailed in the minutes of the meeting). The person who was going to chair the meetings would also be able to speak to people about moving on and his experiences which would be helpful for others. The meeting minutes showed that issues people raised were addressed and also that areas such as health and safety, activities and individuals responsibilities for cleaning were discussed. All the people living in the home were self catering. Support was given by staff when required. People spoke to us about shopping for their food and cooking what they liked. All those spoken with were satisfied that the budget they were allocated with for food was adequate. The home provided tea, coffee, sugar and milk for the people living in the home. We were told that there was a communal meal on Sunday which the staff cooked and once a week they had a take away meal. Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: Staff spoke to us about encouraging people to plan their menus weekly and samples of these were seen. However people did not always cook what was on their menus. People were being encouraged to eat healthily but staff acknowledged this could only be encouraged and they were well aware that some of the people living in the home could eat a lot more healthily. All the people living in the home had access to a kitchen in close proximity to their room, all had lockable food cupboards and fridge and freezer space. Care Homes for Adults (18-65 years) Page 18 of 32 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. Staff had a good understanding of the personal and health care needs of the people living in the home and ensured these were met whilst maximising their independence and control over their lives. Evidence: The people living in the home did not need any physical assistance with their personal care although some prompting was needed on occasions. At the time of the inspection all the people living in the home were male. Everyone was seen at some point during the day and their dress was seen to reflect their ages, personalities and cultures. All the people living in the home were registered with a G.P. and were encouraged to attend regular appointments when necessary. Staff support was available if necessary to help people arrange and attend appointments. One of the people living in the home spoke to us about having been to the doctors and was now going for an x ray. Staff were heard reminding him of this and asking if he wanted someone to go with him this was declined. Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: Records showed that people had regular input from mental health professionals and that staff contacted them for advice when necessary. There was evidence on daily records and monthly reviews that general appointments at clinics for blood tests and such like and that people had access to dentists and opticians when needed. Staff were encouraging people to be weighed regularly so they could monitor if people were gaining or losing weight which could indicate poor or unhealthy diets. Staff demonstrated a good knowledge of the health care needs of the people living in the home and of the importance of encouraging them to lead a healthy lifestyle. They also acknowledged that ultimately this was the decision of the individual. The people living in the home were very satisfied with the support they were getting from staff. They said they felt safe in the home and could speak to staff easily and ask for support when they needed it. All the people living in the home were encouraged to self administer their medication when it was safe for them to do so. People were gradually encouraged to do this and all were at different stages in the process. At the time of the visit no one was totally independent with this. Some people were making up their medication packs on a weekly basis with staff support and then administering these themselves. Others were doing this on a daily basis and others were having their medication administered by staff. People were seen to go to the office for their medication and were asked to check it with staff and ensure they were receiving what had been prescribed. We were told that all staff who were administering medication had received the appropriate training. All the medication was acknowledged when received into the home and signed for when administered. Balances of medication held in the home were checked regularly those checked were found to be correct. Where medication could be administered as and when necessary there were generally written protocols in place detailing when they should be given. However it was noted for one tablet this guidance was not there. We were told this had been a recent change and staff on duty were able to tell us when this was to be administered and that it should not be given after 6pm. However guidance did need to be put in place. Care Homes for Adults (18-65 years) Page 20 of 32 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. Suitable arrangements are in place for managing complaints and allegations of abuse so that people are kept safe from harm. Evidence: There have been no complaints to us about the home since the last inspection. There had been some complaints to the manager, made by people at the home concerning the conduct of another person living there. The complaint has been properly recorded and action had been taken to resolve the matter. Everyone at the home said they knew how to complain and indicated they felt their concerns would be taken seriously and followed up by the staff and the manager. People were very at ease with the staff and relationships were good which would give them the confidence to raise any issues. No safeguarding issues had been raised with us since the last key inspection and none had been lodged directly with the home. Staff on duty were very aware of how vulnerable some of the people living in the were and how easy it would be for them to be exploited by others. Staff were aware of how they should report any concerns they may have about peoples welfare. Staff confirmed they had either recently up dated their training in adult protection Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: issues or a date had been booked for them to do this. Staff also undertook other training to help them ensure people were kept safe, for example, self harm, personal safety and voices. Care Homes for Adults (18-65 years) Page 22 of 32 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 provided people with a safe, well maintained and comfortable environment in which to live. Evidence: A tour of the communal areas of the home was made and one bedrooms was seen. There had been no changes to the layout of the home since the last inspection, which was generally comfortable and well maintained. The AQAA detailed improvements in the home as new flooring in both lounges, hallways and stairs decorated, new carpet first floor landing, new shower installed top floor, shower on first floor replaced, laundry room redecorated, some bedrooms redecorated, new carpets in bedrooms 2 and 5 and new pictures and decorative items in communal areas. Installed PC and internet access for the people living in the home. All these improvements were seen and the home was generally very bright and comfortable. People were clearly very comfortable and the the ample communal space in the home enabled people to either spend time together or more privately. The home had designated smoking and no smoking areas. the dining room housed the computer Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: where people could access the internet if they wished. It was noted that the smoking lounge was in need of decoration and the suite needed to be replaced. This will ensure the lounge is kept to an acceptable standard for the people living in the home. There was a well laid out garden to the rear of the home that people were encouraged to help keep tidy. Everyone spoken to said that they were happy with their bedrooms and felt that staff respected their privacy. Everyone confirmed that they are encouraged to take responsibility for keeping their bedrooms clean. One bedroom was seen and the occupant had personalised this to his choosing. There were adequate numbers of toilets and bathrooms/showers throughout the home, No more than three people shared each bathroom and toilet and as stated earlier some new showers had been installed. There is a large kitchen on the ground floor of the home and smaller kitchenettes on the upper floors. These are all used by the people living in the home when self catering. The kitchens were well equipped and enabled people to self cater. It was noted that some of the foods stored in the fridge in the ground floor kitchen had not been dated when opened so that staff would know when it was out of date. The laundry was appropriately equipped and was accessible to the people living in the home. People were encouraged to do their laundry on specific days so that everyone does not try to use the machines at the same time. The home was generally clean. The people living in the home took responsibility for keeping their own rooms clean and tidy with the support of staff. The home employed a domestic assistant several days a week to clean the communal areas. Care Homes for Adults (18-65 years) Page 24 of 32 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. Staff are properly recruited and vetted to ensure that people are supported by suitable staff. Staff are provided with access to qualifications to help equip them to carry out their work. Evidence: There had been very little staff turnover at the home since the last key inspection which is very good for the continuity of support for the people living in the home. The acting manager was not on duty at the time of the inspection however the staff that were in the home managed the inspection with confidence and were very helpful. Both staff clearly knew the people living in the home well and relationships with them were seen to be good. The people living in the home were very comfortable in the presence of the staff. They told us staff were good and were available to offer support when needed. Rotas indicated and staff confirmed there were two or three people on duty throughout the day and one person sleeping in at night. Staff told us there had been some discussions about rotas being changed to allow more staff over lap to enable them to support people to undertake more activities. Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: As the acting manager was not on duty in the home staff records could not be accessed therefore recruitment procedures were not assessed at this inspection. However it is known that MIND had robust recruitment procedures, files were sampled at the last inspection and no requirements were made in this area. The AQAA indicated that nine of the ten staff employed at the home had an NVQ qualification. A copy of the staff training matrix was obtained. This showed that staff had undertaken some training since the last inspection such as, voices training, self harm, individuality of support and manual handling. Staff told us they were having much of their training updated and that they received adequate training to enable them support the people living in the home effectively. The training matrix did show some shortfalls in staff training in that some training was quite out of date. Speaking with the acting manager after the inspection she stated the matrix was not up to date. Care Homes for Adults (18-65 years) Page 26 of 32 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. Good systems are in place for involving people so that they can exercise some control over the management of the home. The health and safety of the people living in the home were well managed. Evidence: As at the last inspection the assistant manager was currently carrying out the day-today management of the home whilst the Registered Manager is on a temporary secondment within the organisation. The assistant manager was on training on the day of the inspection. The two staff on duty managed the inspection with confidence. Staff told us the registered manager is in the home quite often and that it is their understanding that he will soon be returning to the home on a full time basis. We should be notified of when the registered manager is going to return to the home. Birmingham MIND has various ways of involving people in the running of their services. Regular meetings are chaired and run by the people at the home. Comments Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: by people who attend the meetings indicate they feel their ideas are listened to and the meetings are purposeful. People are encouraged to take part in staff interviews and are able to take part in the same training as staff if they wish. People were fully involved in drawing up their own care plans and risk assessments and were enabled to determine their own lifestyles within the bounds of any risk assessments. One survey returned to us said: I like Pershore Road because it is close to my home town, the atmosphere is good and the peers are talkative and help each other out. The health and safety of the people living in the home and the staff were well managed. Staff received training in safe working practices. The AQAA indicated that the equipment in the home was serviced as required. The records for the in house checks on the fire system were sampled and found to be all up to date. Fire drills were being undertaken regularly, these involved the people living in the home and how the people had responded was recorded. Health and safety checks were regularly undertaken in bedrooms and communal areas and records of these were retained. Care Homes for Adults (18-65 years) Page 28 of 32 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 29 of 32 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 9 13 There must be 31/05/2009 comprehensive risk assessments in place for any identified risks that include strategies for managing the risks. This will ensure that the people living in the home are not exposed to any unnecessary risks. 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 All the people living in the home should have up to date care plans that detail how all their support needs are to be met by staff. This will ensure the people living in the home receive person centred care in a way that suits them. There should be individual written guidelines for staff to follow for any PRN medication being administered to the people. This will ensure they receive their medication when it is needed. The staff training should be updated so that it can be shown that staff have received all the required training to Page 30 of 32 2 20 3 35 Care Homes for Adults (18-65 years) carry out their roles effectively. 4 37 The Commission should be notified of what the ongoing management arrangements in the home are to be. This will ensure the home is being managed in the best interests of the people living there. Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 32 of 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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