Care Home: Albert Road (8b) (Hightrees)

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CARE HOME ADULTS 18-65 Albert Road (8b) (Hightrees) Harborne Birmingham West Midlands B17 0AN Lead Inspector Kulwant Ghuman Key Unannounced Inspection 29th January 2009 10:30 Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Albert Road (8b) (Hightrees) Address Harborne Birmingham West Midlands B17 0AN 0121 428 3423 F/P 0121 428 3423 ruth.gavin@sbpct.nhs.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Accord Housing Association Ltd Ms Ruth Gavin Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd February 2008 Brief Description of the Service: 8B Albert Road, Hightrees, is a purpose built care home, which accommodates five men, who require care and support as they have a learning disability and some behaviour that challenge the service. The home is situated within a residential area of Harborne, and is close to local amenities, and transport links. The home offers off road parking for approximately four cars. The home has three ground floor bedrooms, a communal lounge, dining room, kitchen, and shower room. On the first floor are a further two bedrooms, a staff sleep in room/office, and a bathroom. The home is suited to people with full mobility to be able to access the accommodation on the first floor. The first impression of the home is very positive. Accommodation is spacious, bright and homely. The home has a stable staff team who understand and can meet the needs of the people accommodated and provide individualised plans of activity to positively engage people inside and outside the home. The service users guide had not been updated since Accord had become the sole provider of services. For up to date information about the fees the reader may obtain more up to date information from the care service. The reports of previous inspections are available in the home. Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This inspection was carried out one day in January 2009 by one inspector. The home did not know that we were going to visit the home. 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 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. One person living in the home was ‘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 people’s care helps we understand the experiences of people who use the service. We looked around some areas of the home. A sample of care, staff and health and safety records were looked at. When we visited the home we collected five surveys that the staff had helped the people living in the home to complete and one survey that had been completed by a member of staff. Where people who use the service were able to comment on the care they receive their views have been included in this report. Due to the communication needs of people living here it was not possible to ask them for their views on the home, so time was spent observing care practices and staff interaction. We spent some time talking to two of the people living in the home and they showed us their bedrooms. At the time of the inspection two people remained in bed and we did not see them and one person was not feeling too well although he was seen in the Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 6 lounge. Some of the people living in the home were feeling unwell due to an infection that they and some of the staff had contracted. We had not received any complaints about the home. The home had not received any complaints directly to them either. There had been some incidents between two of the people living in the home and these had been appropriately referred to Health and Social Care. No concerns about the care provided in the home had been raised with us. Since the last inspection Accord Housing had become the sole provider for this home. What the service does well: The home is well maintained, comfortable and decorated in a style that the people living in the home were happy with. Bedrooms were individualised and included items that showed what the occupants of the rooms were interested in. People who were able to manage keys were able to lock their bedroom doors. This meant that they were able to keep their bedrooms private. The people living in the home said the home was nice and clean. The staff team did not change very much and this meant that the people living in the home knew the people who were helping them with their needs. The people living in the home were given some responsibilities such as managing the picture rota in the entrance hall and keeping bedrooms tidy. This ensured that they had a role in the running of the home. Care plans and risk assessments were detailed so that the staff knew how to help the people living in the home and how to deal with the challenging behaviours sometimes shown by the people living there. Medicines were given to the people living in the home at the right times and people were helped to attend medical appointments ensuring their medical needs were met. There were good relationships between the staff and the people living the home so that the people living there were comfortable about telling the staff how they were feeling. There were healthy menus in place and this meant that the people living in the home were encouraged to eat healthily. Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 7 Individual holidays were arranged for the people living in the home. The individuals chose where they wanted to go and did not have to go as a group meaning that individuals wishes and choices were being promoted. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People thinking about moving into the home have the information they need so they can make a choice as to whether or not they want to live there. EVIDENCE: There was a service user guide in each persons bedroom except one who did not want it in his room. His service user guide was kept on his file. The service user guide was written in a way that the people living in the home could understand. It included the relevant and required information so that people thinking about moving into the home would have the information they need to make a choice as to whether or not they want to live there. The service user guide and statement of purpose had not been updated since Accord became the sole providers for the home. This should be done as soon as possible so that people will know who the home is owned by and what the current costs are for living there. Since the last inspection no one had left the home and no one had moved in. The standard relating to assessment was not looked at during this visit however, at the last inspection the manager had shown that she was fully Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 10 aware of the admission process and the appropriate steps had been undertaken to ensure that the individuals needs could be met in the home. Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff have the information they need in individual’s care plans and risk assessments to enable them to support them with their needs in a safe way. The people living there are supported to make choices about their lives enabling them to live their lives in the way they choose. EVIDENCE: The records of one person living in the home were looked at in depth and some records were looked at for another person briefly. The AQAA told us that there were holistic and comprehensive care plans in place with appropriate risk assessments in place. The records looked at reflected this. The care plans showed how staff were to support the person to meet their needs and achieve their goals. Care plans had been reviewed regularly and updated where the person’s needs had changed so staff knew how to support Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 12 them appropriately. For example, one person had a tendency to eat too quickly and the risk assessment showed how to encourage the individual to slow down by encouraging him to have a drink or wipe his mouth. However, when spoken to the staff were not completely sure of what they could or could not do if the person was choking. Other risk assessments covered areas such as their medication, using the kitchen, behaviours, being out in the community and going on holiday. This meant that the people living in the home were safe. Care plans and risk assessments were updated regularly ensuring that any changes in needs were planned for and the staff knew what to do. There were regular key worker meetings where the individuals needs were discussed and plans looked at in respect of their health, contact with families and the activities they wanted to do. In this way the staff discussed the issues that were pertinent to the individuals and what they were going to do in respect of them. We saw that people were given choices through the day such as when to get up. Some people were still in bed when we arrived to carry out the inspection. Others had got up and had their breakfast. One person was seen to ask for a cup of tea during the day and indicated by picking up the telephone that they wanted to speak to a relative. Choices were also available regarding the food they ate and what they did. It was nice to see that one individual was able to have a lie down on the sofa in the lounge with a blanket. This showed that the people living in the home considered the home as theirs and were not always sent to their bedrooms to lie down as might be done in an institution. There was a picture rota in the hallway of the home so that the people living there knew which staff were on duty during that day and when. This helped to reassure some of the people living in the home. One of the people living there took responsibility for ensuring that it was updated daily. The picture rota also identified where the people living in the home were at any particular time of the day. There was a keypad lock on the front door. At the last inspection it was recommended that this be reviewed to ensure it was needed and did not restrict the people living there. The manager said that it had been reviewed and not having a lock on would pose a risk particularly for one person living there. The documentation did not show that it had been reassessed. The implications of the Mental Capacity Act were discussed and the manager told us that one of the individuals knew the code but others did not. She was concerned that one person continued to be at risk. It was important that the reasoning for the locked door was recorded and that individuals knew why it was locked. Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The people living in the home experience a meaningful lifestyle and are supported to keep in touch with the people important to them including people of their own age groups and of different genders. The people living there are offered a varied diet that ensures their individual health needs are met. EVIDENCE: The AQAA told us that two of the people living in the home attended college and all attended a day centre. At the time of this inspection the people living in the home were all at home as there had been an infection in the home. One of the people living in the home assisted a staff member to cook a cake on the day of the inspection. The individual also told us that he had helped to make a Christmas cake for the home. Individuals were assisted and supported to manage their own personal care and tidy their bedrooms. They helped to prepare some food, washed up and took their clothing that needed washing to Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 14 the laundry. This showed that the people living in the home were involved in every day living tasks and their time was occupied in a meaningful way. It was evident that they were members of the local community as they went shopping, swimming, eating out in the pub and for walks and to the cinema in the same way as other people of similar ages in the community were. The activity planner was available in the dining area and the people living in the home referred to it on several occasions during the day so that they could remember what they had decided to do that day. Everyone living in the home had had a holiday that suited their needs. Some had been abroad last year and others had stayed in England. Plans were being made for holidays this year. One person said he wanted to go to Vegas whilst another was going to Portugal and another to Ireland. The people living in the home were helped to budget for holidays that met their individual needs and interests. There is fitness equipment available in the home for individuals wanting to lose or maintain their weight. One individual had bought some exercise DVDs but told us he didnt like doing the exercises but enjoyed watching the DVDs. The home helped individuals manage their diets. There were two menus available in the home. One was for maintaining weight and one was for reducing weight. There were choices available at meal times and what people had to eat was recorded on the daily records. These records showed that fruit and vegetables were eaten regularly. We were told that the manager used these records to monitor that people were having at least five portions of fruit and vegetables a day. Special dietary needs could be met. One individual was diabetic and the food was monitored to ensure it met his needs. The food records showed that the meals were varied and nutritious. Contact with families was promoted as far as possible. Individuals were able to keep in contact via the telephone, visits to relatives homes and relatives were welcomed to Hightrees so that they could maintain the relationships that were important to them. Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The people living in the home were being supported to have their personal and health needs met in a way that they wanted. The management of medicines was good ensuring that they received their medicines as prescribed. EVIDENCE: Care plans sampled detailed how individuals were to be supported to meet their personal care and health needs. The people seen during the inspection were well dressed in clothes that were appropriate to their age, gender, the weather, what activities they were doing and what they liked to wear. Each person had an individual health action plan. This showed what support a person needed to stay healthy and what healthcare services they used. Individuals were taken for regular reviews of blood pressure and blood sugar monitoring where needed. Consultant input was organised where there were specific issues. Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 16 Records sampled showed that health professionals were involved in the care of individuals where needed. Staff followed the advice given by the health professionals to ensure that individual’s health needs were met. There were regular check ups with the dentist, optician and chiropodist. On the day of the inspection one of the people living in the home was indicating that his stomach was upset. It was nice to see that he was able to lie down on the sofa in the lounge with a blanket. This helped him to settle down for a while and staff were able to monitor him. Care plans sampled included details of the medication that the person was regularly prescribed and what medication they were prescribed to be used ‘as required’ (PRN). A protocol was in place for each PRN medication stating when, why and how much of the medication should be given to the person to ensure it was used appropriately. Care plans stated what the medication was for and any possible side effects so that staff were aware of these. Medication was stored in a locked cabinet. Two staff signed the Medication Administration Record (MAR) when giving medication to the person to double check that it was being given as prescribed. During a check of the MAR charts in use at the time of the inspection it showed that on some occasions the second signature was missing. As this was the homes procedure it was important that it was followed and any missing signatures were followed up. The pharmacist supplied the medication in blister packs using the monitored dosage system. The blister packs were sampled and these cross - referenced with the MAR charts indicating that medication had been given as prescribed. Some medication that was not suitable to be stored in a blister pack was stored in boxes in the cabinet. A check of some of these boxes showed that people had received their medication as prescribed. Creams had been dated on opening. Medicines were being booked in when they were received into the home and a returns book completed for any unused medicines. Most of the staff had completed training in giving medication so that people can be confident they will get their medication safely. Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements were in place to ensure that the views of the people living in the home were listened to and acted on and to ensure that they were protected from harm. EVIDENCE: There was an easy to read complaints procedure on the files of the people living in the home. The surveys returned to us told us that the people living in the home were happy and knew who to go to if they were unhappy about something. They told us that they felt that the people working in the home listen to what they say and take actions when needed. The home had not received any complaints and we had not received any complaints about this home since the last inspection. The AQAA stated that the people living in the home were encouraged during meetings and informal chats to disclose any concerns or complaints they may have. The people living there sometimes displayed behaviour that was challenging. Records included an individual reactive strategy that detailed the person’s target behaviours, what could trigger these, any early warning signs, what proactive steps staff should take so the behaviours did not occur, how to distract the person from behaving in that way and how staff should intervene if the person displayed the behaviour. Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 18 Staff completed charts to show what had happened prior to and following the challenging behaviours. On some occasions it was noted that the recording of what had happened before the behaviours was not detailed enough to give a true impression of what might have caused the behaviours to be triggered. Staff training records showed that staff had received training in managing behaviours. Records included an inventory of the persons belongings. These had been regularly updated when the person had bought new things. The records of the monies held on behalf of the people living in the home were looked at. They showed that the money was being spent appropriately. The balances were not checked as these had been recently checked by the owners representative. Receipts were kept of all purchases and these cross-referenced with what the record stated that the persons money had been spent on. A couple of incidents had occurred between two of the people living in the home and the matters had been referred appropriately to CSCI and Health and Social Care ensuring that any incidents could be monitored. Staff training records showed that staff had received training in adult protection and the prevention of abuse so they know how to keep people safe. Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 28 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in the home live in a safe, clean, homely and comfortable environment that meets their individual needs. EVIDENCE: During this inspection we only looked at some parts of the home. This included the communal lounge and dining area, three bedrooms, shower room, laundry and kitchen. The home was well decorated and furnished in a style that reflected the age of the people living there. Bedrooms were personalised and decorated according to individual tastes. Where people were able to use a key they had their own key for their bedroom so they could lock it if they wanted to. Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 20 Carpets in the communal areas were clean and gave a homely feel. Where there were wooden floors good use had been made of rugs to make it homely and comfortable. At the last inspection there had been some problems with the heating system. We were told that the home had not been cold this year and the heating system appeared to be working well. The home was clean and free from offensive odours throughout. Completed surveys suggested that the home was generally kept clean and comfortable. At the time of this inspection there had been diahorrea and vomiting in the home. Several of the staff were off sick. Environmental health had been involved and the infection was being managed well. Examination of the freezer in the kitchen found that several meat items had gone beyond their use by dates. The food had been bought fresh but they had not been dated on freezing. This meant that the quality and safety of the meat could not be guaranteed. It was important that fresh foods were dated when they were put into the freezer. There was an emergency call system in place in the home however there was no evidence that it had been serviced within the last twelve months to ensure that it was kept in good working order. Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were sufficient staff employed at the home to enable the people living there to live their lives as they wanted. Staff had the appropriate skills and knowledge to support the people living in the home safely. EVIDENCE: We were told that there had been no new staff employed in the home since the last inspection. One member of staff had transferred from another of the homes owned by the organisation shortly after the last inspection. The AQAA told us that eleven of the fifteen staff have National Vocational Qualification (NVQ) level 2 or above in Care. This exceeds the standard that at least 50 of staff have achieved this and ensures they have the skills and knowledge to work with the people living there. Three staff had completed NVQ level 3 and one was doing level 4. Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 22 The staffing rota showed that there were usually three staff and the manager on duty during the mornings and 4 staff on duty on the late shift. However, at the time of this inspection the home was struggling with staffing levels and there were two support staff and the manager on duty throughout the day. It was not possible to use staff from outside the home due to an infection in the home. The people living in the home did not appear to be unduly upset about not being able to go out. Staff were able to keep them occupied in the home although occasional trips to shops were organised. The staff team had been employed at the home for some time and this was good for the people living there as they knew the people who were helping them with their personal needs. Minutes of staff meetings showed that these were held regularly. This helps staff to know how to support the people living there and to keep updated with ‘best practice’ in social care. The recruitment process was not assessed during this inspection as there were no new staff in the home. Previous inspections showed that the recruitment process was robust. One member of staff completed a survey and this told us that they felt that they had received sufficient training to be able to carry out their job. During the inspection staff were asked what actions they would take if one of the people living in the home started to choke. Although the staff had some ideas about the actions they would take they were not sure of what they could or could not do. It was important that this issue was discussed and the decisions recorded. Some areas of training were discussed with the manager that it would be useful for the staff to undertake. These included the illnesses of old age, diabetes awareness and learning disabilities awareness. The manager was aware of these and had been in discussion with Accord about accessing this training. Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42 and 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management arrangements ensure that the people living there benefit from a well run home. Arrangements are in place to ensure that the health, safety and welfare of the people living there is promoted and protected. EVIDENCE: The manager of the home was on duty in the home at the time of this inspection. The home were managing on minimal staffing numbers due to an infection that had affected several of the staff in the home. The situation was being appropriately managed. The manager is a learning disability nurse and demonstrated that she is knowledgeable about the people living in the home and the service provided. Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 24 Good interactions were observed between the manager, staff and the people living there. There were regular staff meetings ensuring that staff had the opportunity to discuss issues arising in the home and to ensure that they were kept up to date with current good practices. The AQAA told us that staff were encouraged to take an active part in the running of the home and this was observed during the day. Since the last inspection Accord had become the sole provider. Previously they had been responsible for the building only. There were two reports available of the visits carried out by the providers representative. These needed to be carried out on a monthly basis to ensure that any issues were picked up quickly and resolved. We were told that monthly consultations would be starting with the people living in the home to look at how well the service was operating. The AQAA told us that improvement plans were undertaken 6 monthly where the team and service users identify positive improvements in the home. The manager will be conducting audits on another home and that homes manager would be carrying out audits on Hightrees. We looked at the records for the servicing of equipment in the home and found that everything was up to date apart from the servicing of the emergency call system. The fire checks were carried out regularly however on occasions the fire alarm checks were not being carried out on a weekly basis. The fire training for staff was carried out on an annual basis. It was recommended that this should be carried out every six months. The home had recently been inspected by environmental health and found to operating good hygiene practices. Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 X 27 X 28 4 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 4 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 3 3 2 X X 2 3 Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA42 Regulation 23 Requirement Arrangements must be in place to ensure that in the event of an emergency people can summon assistance. Timescale for action 01/04/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA1 YA9 YA20 Good Practice Recommendations The service user guide and statement of purpose should be updated to ensure that people have up to date information about the home. The manager must ensure that the reasoning for locking the front door is recorded to show the reasoning for limiting the liberty of the people living in the home. The staff must ensure that they follow the homes procedures on the administration of medicines. This will ensure that the people living in the home receive their medicines as prescribed. Staff must ensure that when completing the ABC charts accurate details are recorded. This will enable any trends in behaviour to be identified and acted on. Fresh food must be dated when it is put in the freezer. This will ensure the quality and safety of the food given to DS0000016966.V374058.R01.S.doc Version 5.2 Page 27 4 5 YA23 YA30 Albert Road (8b) (Hightrees) 6 7 YA35 YA42 8 YA43 the people living in the home. Staff must be informed of the first aid actions to be taken in the event of someone choking. Fire alarm tests must be carried out on a weekly basis and fire training should be carried out every six months to ensure that the equipment is kept in good working order and that staff know what to do in an emergency. The providers representative should carry out visits and prepare reports of the visit on a monthly basis. Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Albert Road (8b) (Hightrees) DS0000016966.V374058.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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