Care Home: Charlotte Street

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What the care home does well People`s needs are thoroughly assessed so that their care and support can be planned properly. Good use is made of "person-centred" approaches in people`s care planning. This helps to ensure that they get their support in ways that suit them best. Plans are reviewed regularly, so that important information is kept up to date. Careful risk assessing helps to ensure they get the support they need to stay safe. Particular efforts are being made to promote the opportunities people have for autonomy and independence , so they can actively make choices and decisions about their lives. People get the support they need to do things they value, go to places they like and keep in touch with the people who are important to them. They enjoy their meals because they get to choose things they like to eat and drink. People`s personal and healthcare needs are generally well met. They get the support they need from staff and a range of other professionals to help them stay healthy and well. Staff and people using the service work hard to ensure that they can enjoy the benefits of living in an environment that is comfortable, homely, safe and clean. The service provides sufficient staff to ensure that people get the support they need. Recruitment and selection procedures are robust, to ensure that people are fit for their jobs. Staff are generally well trained and supervised to ensure that they have the knowledge and skills and get the support they need to do their jobs well. The service is generally well run for the benefit of the people that use it. People`s views are actively sought to guide the way the service is developed. The Manager and staff team demonstrate a positive attitude towards the people in their care. Regular maintenance and checking of important equipment helps to ensure that people living and working at the home stay safe. People using this service continue to experience excellent outcomes. What the care home could do better: No requirements were made following this inspection. A small number of good practice recommendations can be found at the end of this report Random inspection report Care homes for adults (18-65 years) Name: Address: Charlotte Street 28 Charlotte Street Chuckery Walsall West Midlands WS1 2BD three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Gerard Hammond Date: 2 8 0 6 2 0 1 0 Information about the care home Name of care home: Address: Charlotte Street 28 Charlotte Street Chuckery Walsall West Midlands WS1 2BD 01922616925 01922722659 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Janice Hooper Type of registration: Number of places registered: Conditions of registration: Category(ies) : Caldmore Area Housing Association Limited care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 8 The maximum number of service users who can be accommodated is: 8 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 8 Date of last inspection Brief description of the care home Charlotte House is a detached domestic scale property situated within easy reach of Walsall town centre. The home is owned and managed by Caldmore Area Housing Association Limited, now part of the Accord group. It is registered to provide Care Homes for Adults (18-65 years) Page 2 of 11 Brief description of the care home accommodation and support for up to eight people with learning disabilities. The house is conveniently situated for local amenities and is well served by public transport. All bedrooms in the home are single and some have en-suite facilities. There is limited onstreet parking at the front and side of the house, and a secure and private garden area to the rear. Externally and internally the house is maintained to a high standard. The service should be contacted directly for current information about fees and charges. Care Homes for Adults (18-65 years) Page 3 of 11 What we found: This services last key inspection was on 02 July 2007, when its quality rating was 3 stars. This means that people using the service experienced excellent outcomes. The purpose of this inspection was to monitor compliance with essential standards of quality and safety against current National Minimum Standards. The Manager sent us an Annual Quality Assurance Assessment. This is a self assessment about how well the service is meeting outcomes for the people who use it, and provides some numerical information about it. We made two visits to the home and met people who use the service, the Manager and members of staff. We looked at records including personal files, care plans, staff records, previous inspection reports, safety records, and other documents. We saw that the home has a Statement of Purpose and Service Users Guide. These documents provide information about what the service provides and who it is for. This is to help people thinking about living at the the home decide if the service is right for them. The Manager told us that these documents are currently under review for updating in line with new legislation. We looked at peoples personal records to check that their strengths and support needs had been assessed. The files that we looked at contained a current assessment, providing a sound basis for planning peoples care and support. We saw that people have detailed care plans and risk assessments, so that staff have clear guidance about how to provide them with the support they need and help them stay safe. We saw that good use is made of person-centred approaches. This helps to make sure that people get supported in the ways that suit them best. Records showed that care plans are kept under regular review, so that important information is kept up to date. We saw minutes of formal review meetings. People also meet regularly and frequently with their named key workers, so that their views and opinions can be sought and taken into account. Their personal goals and aspirations are reflected in their care plans. We talked to the Manager about ways in which goal setting might be developed, so that the outcomes can be more clearly measured. This was raised merely as a matter of good practice, so that good work already being done might be built upon. Making goals tighter to include measurable outcomes and clear time limits could provide a clearer focus in helping people achieve the things they say are important to them. The service works very positively in supporting people to be as independent as their individual abilities allow. Routines are flexible according to peoples wishes. We saw that people have identified training days when they work with staff to develop new skills or maintain existing ones. Records showed that people are encouraged to manage their own medication if possible, using a phased approach to help them gain confidence and adjust to taking responsibility. People are also supported to take responsibility for greater involvement in managing their financial affairs. This includes paying bills and rent, accessing accounts and so on, with as much support as each person requires. People have their own front door keys with a special electronic fob for those unable to manage conventional locks. These are all examples of the positive action taken to promote and Care Homes for Adults (18-65 years) Page 4 of 11 support individual autonomy and independence. Peoples activity records show that they regularly attend local day centres, go to college and have placements at Links to Work. They use the local Gateway and other clubs in the area each week. People are encouraged and supported to pursue their own interests and hobbies. These include going fishing, playing snooker, sewing, going to the pub and out for meals. They may arrange their own activities: one person told us she was looking forward to going to visit her friend. This person used to be a resident at the home, but has since moved on to more independent living. Another said he had enjoyed going with a member of staff to see his favourite football team play. People get the support they need to stay in touch with family and friends, where this is possible. One person told us that she meets her mother at church each weekend. Other residents also regularly attend their chosen places of worship. The home operates a six week rolling menu, drawn up in consultation with the residents. Records of meals show that people enjoy a balanced and varied diet, with plenty of variety and choice. We looked at the food stocks in the house and saw that these were ample and included fresh fruit vegetables and salad items. People told us that that they liked the food they got and could have what they wanted. We directly observed interactions between residents and staff. We saw that support was given with warmth and friendliness, and in an appropriately respectful manner. People told us that they liked the staff and that they were good and kind. Staff spoke very positively about the people in their care. We saw that both were clearly comfortable and at ease in each others company. Records show that people are supported to keep medical and health related appointments, usually by their key workers. The Manager told us in the Annual Quality Assurance Assessment that people have received an annual health check with their GP. Records show that a range of other professionals have been directly involved in peoples care. These include the dentist, optician, chiropodist, continence advisor, district nurse, occupational therapist, physiotherapist, psychologist (behaviour support), dietician, and speech and language therapist. This shows that the service seeks advice and refers people appropriately, to ensure they get the support they need to stay healthy and well. We also saw that a new format has recently been provided for health action planning. In the AQAA the Manager told us that people in the home had recently been involved in the Expert Patient Programme, a six week course looking specifically at promoting healthier lifestyles. Following this a nutritionist has done some work with residents and staff to raise awareness and develop skills and knowledge relating to healthier eating. We looked at the Medication Administration Record (MAR) and saw that this had been completed appropriately. Medication stocks are audited daily, and two staff sign the record each time medication is administered. This good practice helps to minimise the risk of administration errors occurring. We recommended that protocols for all PRN ( as required) medication be reviewed to ensure that staff have clear guidance about the circumstances in which such medication should be given. Ideally these should be countersigned by the prescribing doctor. We also recommended that advice be sought from the local pharmacist about monitoring the temperature in the medication store. We saw that the pharmacist had recently completed an audit in the home, with no problems identified. The medication store was clean, tidy and secure. Care Homes for Adults (18-65 years) Page 5 of 11 We looked at the homes complaints record and saw that none have been received in the past 12 months. We have not received any complaints about this service either. In an independent report commissioned as part of the homes quality assurance activity, it is shown that all of the residents were able to identify whom they would approach if they wished to make a complaint. They all said they would be comfortable in approaching a member of staff about this. The home made one safeguarding referral following an incident between two of the residents. The record shows that this matter was dealt with and the issues resolved appropriately. We looked at staff records and saw that checks had been carried out with the Criminal Records Bureau (CRB) as part of robust recruitment procedures, before people started work at the home. The AQAA also shows that staff have all done safeguarding training. These things show that the home takes positive action to ensure that people using the service are protected from abuse, neglect and self-harm. We looked around the building and residents proudly showed us their rooms. We saw that peoples rooms are all individual and personal, with belongings, pictures, ornaments, family photographs, TV, music players etc. very much in evidence. There are sufficient bathing and toilet facilities to meet peoples assessed needs. A new bath lift has recently been purchased in order to give continuing support to peoples independence. Some rooms have en-suite facilities. Downstairs there is a comfortable lounge with adjoining conservatory / dining area. There is an additional quiet room upstairs for residents use. This contains a flat screen TV and computer and provides private space for visitors, small meetings and so on if required. There is a small garden and patio areas to the rear and side of the property. Staff and residents work hard to make sure the house is kept clean, fresh, and tidy so that people can enjoy living in a comfortable and homely environment. As reported above, we looked at staff files and saw that recruitment practices are appropriately robust. Files contained completed applications, written references, job descriptions and evidence of checks with the Criminal Records Bureau. This shows that the service takes positive action to ensure that people employed at the home are fit for their jobs. The Manager told us that all staff either hold qualifications at NVQ level 2 or above, or are actively working towards gaining these. We saw the staff training matrix, showing that training is organised systematically and delivered regularly. Individuals files we saw also contained workbooks showing they had been given a thorough induction. Staff records also show that they receive formal supervision regularly. The services Manager is appropriately experienced and qualified. She has worked at the home since 1991 and has 10 years experience of management roles. She became the registered manager in 2006. She is qualified to NVQ level 4 and holds the Registered Managers Award (RMA). Staff and residents say she is approachable, and has an open and inclusive style of management. We saw that residents were comfortable with her. She demonstrates a positive attitude towards continual development of the service for the benefit of the people that use it. The AQAA shows visits required under Reg.26 (Care Homes Regulations 2001) have been done each month. The Manager told us that Caldmore Housing is now part of the Accord group so policies and procedures are currently under review pending the services registration under new legislation. In the AQAA the Manager told us that the organisation plans to apply for the Investors in People award. Quality assurance activity has also Care Homes for Adults (18-65 years) Page 6 of 11 included the commissioning of an independent body to carry out a Participatory Appraisal . All of the residents took part in this exercise, which sought their views on a range of issues affecting them. We saw the report that followed this, and the Manager drew up an action plan subsequently. This shows that the service takes positive action to seek peoples views and act on them accordingly. We sampled records relating to health and safety in the home. We saw that essential equipment had been checked, tested and serviced at regular intervals. Workplace and fire risk assessments are in place, and staff complete an environmental inspection each month. The organisation also completes an annual health and safety audit. These things help to ensure that people living and working in the home are supported to stay safe. What the care home does well: Peoples needs are thoroughly assessed so that their care and support can be planned properly. Good use is made of person-centred approaches in peoples care planning. This helps to ensure that they get their support in ways that suit them best. Plans are reviewed regularly, so that important information is kept up to date. Careful risk assessing helps to ensure they get the support they need to stay safe. Particular efforts are being made to promote the opportunities people have for autonomy and independence , so they can actively make choices and decisions about their lives. People get the support they need to do things they value, go to places they like and keep in touch with the people who are important to them. They enjoy their meals because they get to choose things they like to eat and drink. Peoples personal and healthcare needs are generally well met. They get the support they need from staff and a range of other professionals to help them stay healthy and well. Staff and people using the service work hard to ensure that they can enjoy the benefits of living in an environment that is comfortable, homely, safe and clean. The service provides sufficient staff to ensure that people get the support they need. Recruitment and selection procedures are robust, to ensure that people are fit for their jobs. Staff are generally well trained and supervised to ensure that they have the knowledge and skills and get the support they need to do their jobs well. The service is generally well run for the benefit of the people that use it. Peoples views are actively sought to guide the way the service is developed. The Manager and staff team demonstrate a positive attitude towards the people in their care. Regular maintenance and checking of important equipment helps to ensure that people living and working at the home stay safe. People using this service continue to experience excellent outcomes. Care Homes for Adults (18-65 years) Page 7 of 11 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 8 of 11 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 9 of 11 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 Develop care plans so that all goals have outcomes that can be clearly measured and identified time limits. This is to ensure that people get the all the support they need to achieve the things they say are important to them Ensure that there is a current written protocol for all PRN as required medication. This is to ensure that staff have clear guidance about the circumstances in which this medication should be given Seek advice from the local pharmacist about monitoring the temperatures in the medication store and put this into practice as necessary. This is to ensure the efficacy of all medicines at all times. 2 20 3 20 Care Homes for Adults (18-65 years) Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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