Care Home: 98 Beeches Road - Lyndel Homes

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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 98 Beeches Road - Lyndel Homes 98 Beeches Road West Bromwich West Midlands B70 6HJ     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: Christine Lancashire     Date: 1 7 0 3 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 29 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 29 Information about the care home Name of care home: Address: 98 Beeches Road - Lyndel Homes 98 Beeches Road West Bromwich West Midlands B70 6HJ 01215800759 01215152544 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) : Mrs Delores Matadeen care home 9 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 9 The maximum number of service users who can be accommodated is: 9 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) 9 Date of last inspection Brief description of the care home 98 Beeches Road is a residential home providing 24-hour care and support for 9 people experiencing mental health difficulties. The property is an extended 3 storey, midterrace. This Edwardian building forms part of the Lyndel Care Homes Company. It is situated in a residential area close to West Bromwich town centre and has good transport networks. On the ground floor there is one double bedroom, lounge, kitchen, shower room including a toilet and wash hand basin, two additional toilets, and a two-roomed conservatory used as a dining and recreation area. Access from the conservatory leads to a paved courtyard. On the first floor there are four single bedrooms, one bathroom Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home with bath, toilet, wash hand basin and a small office. On the second floor are three single bedrooms and a shower room with toilet and wash hand basin. The home should be contacted directly for up to date information about the fees for this service. Care Homes for Adults (18-65 years) Page 5 of 29 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 carried out this inspection in order to measure the performance of the home against the key National Minimum Standards. Before the inspection we sent questionnaires to the people who use the service and to the manager so that she could provide us with information about how the home has been running during the past year. We arrived at this home on a weekday morning without telling anyone that we would be visiting that day. We toured the building, and met some of the staff and people who live in the home. We examined a sample of records about the people in the home, the staff, health and safety and quality monitoring. We looked at the records of the administration of medication. We used our findings to write this report. Care Homes for Adults (18-65 years) Page 6 of 29 Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The acting manager needs to complete relevant training and submit an application to become registered. The manager is planning further training for staff on the Mental Capacity Act and the Deprivation of Liberty Safeguards. Care Homes for Adults (18-65 years) Page 8 of 29 The manager has identified areas in which improvements could be made to improve the service to people. These include finding more creative methods to help people become more involved in planning their care plans and identifying the support they need. Staff training and audit check list to identify any gaps in the paper work required to assist in meeting the needs of the service user. Staff training to find different and creative methods to help service users to contribute to the development of their care plan and the ongoing review process. audit of the records. 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 29 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 29 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 and aspirations are assessed prior to coming to this home. Evidence: The home has a Statement of Purpose and service user guide. They provide useful information about the home for people considering moving in and their relatives. We saw that they have been updated to make sure that people have up to date information. The manager told us that there are plans to include pictures in the guides to make them easier for some people to understand. The manager told us that a comprehensive assessment is completed by social workers, which detail the needs of the person who is considering moving into the home. The manager undertakes an assessment, involving the person concerned and their representatives. This covers a range of health and social care needs and is used to make a decision about whether or not the home can meet these. The manager then offers the person an opportunity to visit the home, join current residents for a meal and move in on a trial basis. The person is welcome to involve their friends, family or Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: other representatives in this process. The manager told us that the aim is to encourage the person to share as much information as possible about their social, cultural and leisure interests as a base for helping them during their period of residence in the home. We saw evidence of this process on peoples files. Care Homes for Adults (18-65 years) Page 12 of 29 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 looked at sampled files and found that care plans have been developed using the information gained through the assessments. These provide staff with information about how to support individuals. The plans are well organised and contain evidence that people have been involved in forming their own plans and have been consulted when changes have been made. People have signed to say that they agree with their care plan. The plans include areas including communication, mobility and dexterity, personal safety, medical history, mental health, cognition, diet and weight, food and mealtimes, dental and foot care, religious observance, daily living and social activities and personal care. We saw risk assessments for general risks and more specific ones Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: such as manual handling. The plans have been improved since our last visit. Staff provide people with choices about their lives and decisions are recorded in files. People confirmed that the staff help them to make choices about how they spend their time and live their lives. We saw risk assessments on files and these show how people are supported to take reasonable risks so that their ability to have new experiences is not restricted unnecessarily. There are records of the measures taken in various circumstances, such as when there are trips outside the home, to minimise the risks to each person. Care Homes for Adults (18-65 years) Page 14 of 29 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: There are no rigid routines in this home. People may get up and go to bed when they want to. They decide how they spend their days. We sampled the files and found that people are supported to take part in activities. There is an activity plan and the activities are discussed at meetings of people in the home. People visit day centres and other places when they wish to do so. Staff told us that they organise activities in the house, such as exercises, painting and board games, but people are sometimes reluctant to engage in these. There are weekly trips to a social club where people play bingo and have a drink. People told us that they are usually happy to watch the Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: television or to spend time in their rooms. People may smoke in the shelter in the back garden. People are encouraged to maintain friendships and relationships with family members and other people in the community and visit their homes. The files contain details of people who are important to each person and staff explained how people are supported to have visitors. Staff make sure that each person follows a routine of their own choice. We saw that the files contain details of peoples religious choices and staff respect these. Staff encourage people to participate in daily living tasks such as making their beds, light dusting, laying the tables, and going shopping with staff. Staff told us that they encourage people to be involved in preparing their own meals but most people are reluctant to participate. The menus show a variety of meals which provide choice. The staff are aware of the need to provide healthy choices. People told us that they enjoy the food. Care Homes for Adults (18-65 years) Page 16 of 29 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. They are supported to retain and administer their own medication where appropriate and protected by the homes practices in dealing with medicines. Evidence: We saw records in the daily notes which show that staff provide personal care when needed and prompt people when necessary. People are supported to choose their own clothes and style of presentation and their cultural and religious preferences are respected. Each person is supported by a key worker, who co-ordinates their care and makes sure that they receive appropriate healthcare. The files contain details of peoples mental and physical health needs and how these need to be met. There are records of peoples involvement with various health professionals and these show that staff accompany people to appointments and hospital visits. Staff displayed a good level of knowledge about the needs of each person in the home. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: There are suitable arrangements for the storage of medication and for logging medication in and out of the home. Staff are trained to administer medication and we saw that the records are appropriately completed. The home uses the services of a pharmacist to make regular checks on the medication storage and records. Care Homes for Adults (18-65 years) Page 18 of 29 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, giving assurance that people are well protected. Evidence: The manager told us that she aims listen to and act on the views and concerns of service users and to encourage discussion and action on issues raised before they develop into formal complaints. The staff welcome comments and suggestions from people in the home and their representatives, friends and relatives. The manager aims to look into all comments or complaints as quickly as possible and to provide a satisfactory response. People who make a complaint are provided with feedback about the outcome and they are asked to sign to indicate that they are satisfied with the action taken. There is a procedure for handling complaints. This includes an informal and a formal stage. Details of how to complain are included in the Statement of Purpose and service user guide. All people in the home are provided with copies of these. Staff told us that people are also reminded at regular intervals about how to make a complaint. The manager told us that there have been no recent complaints. People told us that they are pleased with the care they receive. The CSCI has not received any complaints in relation to this home during the past Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: year. The records show that staff have received training in recognising the signs and symptoms of possible abuse and taking appropriate action. The manager has attended training for trainers in this area. Staff demonstrated a good level of knowledge in this area. Care Homes for Adults (18-65 years) Page 20 of 29 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 people at this home live in a homely, clean, safe and comfortable environment which is well maintained and where there are good arrangements for infection control. Evidence: We toured the building and found that the home was clean with no unpleasant odours. There have been several improvements to the environment since the last report. These include new carpet and furniture in the lounge, new flooring in the corridors and new furniture in other areas. The computer, which staff used to use in the lounge, has been moved to a more appropriate location, which improves confidentiality. We looked in some peoples bedrooms and found that they are varied. Most people have added personal items, but others prefer to have their room more plain. The manager started a programme of refurbishment in 2007. This included the creation of a wet room which makes it easier for people to shower, particularly those whose mobility is reduced. The heating system has been improved by the replacement of the boiler for one which is more energy efficient. Bed frames, mattresses and linen have been replaced. Double glazed windows have been fitted. The kitchen has been refitted and there is now safer floor covering and a new larder fridge. In the garden Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: there is new furniture and a covered area provides shelter for people wishing to smoke. Staff have received training in infection control and there are suitable arrangements for the disposal of clinical and other waste. The washing machine has a sluice cycle. This means that people are protected from the spread of infection. Care Homes for Adults (18-65 years) Page 22 of 29 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: The manager told us that there have been no changes in the staff team and the last time new staff were recruited was in 2004. This provides stability for the people who live in the home. A review of the homes recruitment policy and procedures was carried out in December 2007, so that there are suitable arrangements for the selection of staff. There are no outstanding recruitment issues. The rotas show adequate levels of staff cover at all times. Staff told us that the levels are increased when there is a need such as people needing to attend an appointment of an outing. When staff need to be found to cover for this is arranged so that other members of the team or staff from another home owned by the same person provide cover. This means that people are always supported by people they know. The records show that all staff hold the National Vocational Qualification (NVQ) in Health & Social Care Level 2 or above and five members of staff have completed level 3. The acting manager has completed level 4 and is due to commence the Registered Managers Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Award in the near future. Staff told us that they have regular meetings. The manager told us that these are sometimes held in two parts so that day and night staff have a chance to attend. These meetings are used to discuss the needs of people in the home and planned changes. Care Homes for Adults (18-65 years) Page 24 of 29 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 who live in this home benefit from from a well run home where their views underpin self monitoring, review and development. Their health, safety and welfare is promoted and protected. However, the acting manager needs to complete relevant training and submit an application for registration. Evidence: The registered manager for the service is the responsible individual. At previous visits she informed us she had delegated responsibility for the day to day running of the home to the acting manager. The registered person told us she was providing support to the acting manager to build up her confidence. She has since completed NVQ Level 4 and will be commencing the Registered Managers Award (RMA) in the near future. The rotas show the acting manager has full responsible for the day to day management of the home and the registered person provides on call support. The acting manager told us the registered person visits the home and is easily accessible Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: by telephone. An application has not yet been submitted to the commission for her to become the registered manager for this service. We saw that progress has been made in developing a quality assurance system for the home. This includes seeking peoples views and monitoring performance in a number of areas through internal auditing. The manager has identified several areas where the home has improved during the past year and also ways in which the home can be improved further so that it provides a better service to the people who live there. Details of who to contact in the event of an emergency are kept in the front of the folders containing information about the premises, equipment and appliances. The manager provided us with information about the dates of safety checks on appliances and fire detection and fighting equipment in the home. We checked these against a sample of records and found them to be up to date. The members of the staff team are aware of the need to follow safe working practices. We saw risk assessments concerning people, tasks and the environment. This means that there are good arrangements for making sure that people who use the building are kept safe. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 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 1 37 The person who is in day to day charge of the home should complete suitable training and submit an application for registration as manager. Care Homes for Adults (18-65 years) Page 28 of 29 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. 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