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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Coriander Road Care Home 25 Coriander Road Bede Island Leicester Leicestershire LE2 7ER 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: Helen Abel Date: 0 7 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 30 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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 30 Information about the care home Name of care home: Address: Coriander Road Care Home 25 Coriander Road Bede Island Leicester Leicestershire LE2 7ER 01162991782 01162858697 coriander.road@macintyrecharity.org 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) : MacIntyre Care care home 4 Number of places (if applicable): Under 65 Over 65 4 0 learning disability Additional conditions: No additional conditions of registration apply. Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 30 A bit about the care home Coriander Road Care Home is situated close to Leicester City Centre and accommodates up to four younger adults who have learning disabilities. The property, which is owned by a housing association, consists of two adjoining houses. Each has two single bedrooms, a kitchen/dining room, a lounge, and a garden. The home is fully accessible to people and is convenient for local transport networks. Fees at the home range from £52.898-£69.927 yearly depending on care needs. No additional charges are made. Care Homes for Adults (18-65 years) Page 5 of 30 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 Care Homes for Adults (18-65 years) Page 6 of 30 How we did our inspection: This is what the inspector did when they were at the care home This inspection was a Key Inspection that focused on the key standards under the National Minimum Standards and the Care Standards Act 2000 for homes providing care for Younger Adults. The Inspectors spent time planning the areas to focus on before the visit took place. This was based upon information gained from reviewing the homes service history, the last inspection report, received surveys and the home’s Annual Quality Assurance Assessment (AQAA). Care Homes for Adults (18-65 years) Page 7 of 30 The residents living at 25 Coriander Road prefer to be called - people. The primary method of inspection used was case tracking that involved all four people living in the home and reviewing the care they receive through inspection of the written information available on their person centred plans. Discussions took place with people, staff, and the acting manager. The Inspector was not able to fully communicate with people at the home but used observation, and completed surveys as other evidence. Extracts from surveys have been included in this report. Our visit was unannounced and took place on the afternoon on the 7th of April 2009 and lasted around four hours. In addition policies and procedures and records in relation to people and staff recruitment, complaints and upkeep of the home were viewed. Care Homes for Adults (18-65 years) Page 8 of 30 Upon arriving at the home people were observed returning from trips out to the park, and day care services. People were seen in the two communal lounges, and in the dining area participating in arts and crafts activities, and standing in the front garden meeting and greeting neighbours. What the care home does well The service user guide (written information about the home) is presented with pictures. This ensures it is accessible to people. Link workers (staff) ensure peoples plans are drawn up with the involvement of the person together with family and friends. There are photographs, and pictures from a person’s life before and whilst living at Coriander Road in all peoples Care Homes for Adults (18-65 years) Page 9 of 30 plans. Person centred plans confirm in detail peoples health individual care needs. People attend regular foot and eye care, and treatment from their dentist. A comment from relative told us, They look after people very well. The service guide confirms- If you are not happy with anything we will listen to you and we will take action to put it right. A person had used the complaints procedure and this had been followed through with support by managers at MacIntyre. The homes communal areas are bright and cheerful in decor. There were photographs of people that live in the home, and pieces of artwork individually framed and displayed. People’s bedrooms were well maintained and attractive and reflected peoples lifestyles, hobbies and Care Homes for Adults (18-65 years) Page 10 of 30 interests. Male link support workers were matched up to males in the home and the same for the females. The Inspector observed a firm and friendly rapport between people and their link support workers, when they were being supporting around the home and pursuing their interests. What has got better from the last inspection What the care home could do better The homes complaints procedure should be updated and include current Commission contact details and be made available to people in the home and others. Care Homes for Adults (18-65 years) Page 11 of 30 To ensure a more enjoyable outdoor area for people, the garden area could be developed further in consultation with people that live at the home. Ensuring the protection of people at the home the registered provider should refer to the Criminal Records Bureau (CRB) website for current guidance around providing CRB certificates for inspection, and more regular staff checks. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Care Homes for Adults (18-65 years) Page 12 of 30 Helen Abel 33 Greycoat Street London SW1P 2QF 02079792000 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 13 of 30 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 14 of 30 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 . People receive a good assessment process. Evidence: The service guide and statement of purpose are two documents that contain written information for new people to help them to choose, and consider where to live. Both documents need updating. The acting manager confirmed this would be done soon. The service user guide is presented with pictures. This ensures it is accessible to people. New people received an information pack and an arranged visit to the home, to spend time with people that live at Coriander Road. The assessment criteria is set out in the homes written information- What must happen before I can move in- and with pictures. The home does not normally offer emergency admissions or respite care. Care Homes for Adults (18-65 years) Page 15 of 30 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 . People are consulted and participate in all aspects of life in the home. Evidence: Each person has a person centred plan (PCP), a support plan, a medication plan and a daily record held of there live at the home. Link workers are like a keyworker, a designated person who is responsible for staying in contact with the individual and anyone else involved. Link workers ensure the plans are drawn up with the involvement of the person together with family and friends. There were photographs, and pictures from a person’s life before and whilst living at Coriander Road, in all the people plans. The personalised plans bring the plan to life, and help the person to better understand their plans and make the persons goals a reality. The service guide confirms MacIntyres commitment to people living at the home around being treated respectfully, ability to choose and take control of their life, and around raising complaints and any dissatisfaction. These aspects were seen to be Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: included in people plans particularly with what they liked and did not enjoy around, food, leisure and any triggers/ positive focus for behaviour. All this information will help to guide support staff to assist people to have their changing needs and personal goals met. People in the home can make a list with support on the selection of new staff and the sorts of qualities they would want them to hold. This ensures people are consulted about the selection of staff that supports them, in their home. Surveys from people living at the home told us, I can express my unhappiness. My link worker has been working and supporting me for over 8 years so would be aware, if I am not happy. I have support plans in plans for all aspects of my support needs. I do make decisions about what I do. I also have a set timetable with my day care with college classes that I go to but if I really didnt want to on the day, I would let you know. One person was observed meeting and greeting neighbours as he stood outside in the front garden. Two people were busy adding to their scrapbooks of their lives with pictures, glue and scissors. One person was busy making an Easter card for a loved one. Care Homes for Adults (18-65 years) Page 17 of 30 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 pursue meaningful life’s and participate and contribute to the communities where they live. Meals are healthy, varied and reflect peoples choices. Evidence: Some of the people that live in the home have preferred names, these are respected and included in all plans. The person centred plans and daily records confirmed people at the home lead active lives. One person hobby is horse riding and goes regularly. There is a risk assessment in place to ensure any risks are minimised and the person is kept safe. There were lots of activities for physical activity and upon coming to visit people had just returned form a trip to the park and lunch out. People use local amenities and often go to local shops, open areas, and attend local college classes. One person went to the shops to help choose a lawn mower with a staff member. A person enjoys fishes and has a CD with marine life that is watched regularly, and there is a marine display Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: in the person’s bedroom. People are encouraged to pursue their own interest and hobbies. People had expressed their likes and dislikes around food and these were met by the cooking in the home. Records confirmed people had eaten their favourite foods such as hot curries, pitta bread and hummus, sausages, yoghurts and sometimes sherry. Staff confirmed advice was sought by the Dietician to ensure all people are offered a healthy diet. Care Homes for Adults (18-65 years) Page 19 of 30 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 . Peoples physical and all round healthcare needs are met. Evidence: The medication plans were well presented and included a photograph of the person and details of their medicines with a photograph of the medicine. This will help staff when dealing with peoples medicines. Staff have had training in dealing with medicines. Person centred plans confirm in detail people health individual care needs. People attend regular foot and eye care, and treatment from their dentist. Comments from relatives of people told us: They look after people very well. The staff always inform me of any problems (around health care). Care Homes for Adults (18-65 years) Page 20 of 30 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 . People have access to effective systems for being heard and staff responding to their issues. Evidence: The statement of purpose and service guide is due to be updated and needs to include the Care Quality Commissions (CQC) regional contact details. The service guide confirms- If you are not happy with anything we will listen to you and we will take action to put it right. A person had used the complaints procedure and this had been followed through by managers at MacIntyre. Peoples plans set out any support required around verbal and physical aggression and how this will be dealt with by staff. This information was seen to be in easy read text and protects the rights of people. Spending money held for two people was sampled and found to be in order. There are rigorous systems in place to safeguard people’s money and financial affairs. Support staff and the acting manager confirmed they had received training around mental capacity act, deprivation of liberties and protecting vulnerable adults. This learning for support staff protects people at Coriander Road. Care Homes for Adults (18-65 years) Page 21 of 30 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 . Peoples bedrooms reflect their needs and lifestyles and the home is kept clean, tidy and comfortable. Evidence: 25 Coriander Road is a two storey semi-detached house. It is connected to 27 Coriander Road, which is also a McIntyre home. There are two house vehicles shared between the number 25 and 27 Coriander Road enabling people to access local facilities. Regular maintance checks are carried out on the homes vehicles. The homes communal areas were bright and cheerful in decor. There were photographs of people that live in the home and many pieces of artwork framed and displayed. People’s bedrooms were well maintained and attractive and reflected peoples lifestyles, hobbies and interests. One Link worker had spent lots of time working with the person to ensure the bedroom reflected their lifestyle with patterns, colours and different materials. The bathrooms and corridors looked plain and drab and need redecoration. The assistant manager confirmed this would be dealt with over the next few months. This will ensure people live in a homely and comfortable home. Surveys from some people that live in the home confirmed,” The home is clean most of the time. Staff work hard to keep everywhere clean. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: One survey from a relative carer said The staff need help with the garden to keep it up to standard. The Inspector observed the garden is connected to next door with a fence around it and a patio area and seating area. It looked very basic in presentation and needs some maintenance. The laundry are was found to be clean and well organised with appropriate cleaning equipment. This ensures the home is kept clean and hygienic. Care Homes for Adults (18-65 years) Page 23 of 30 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 tell us they are well supported by trained and supervised staff. Evidence: People that live in the home told us, I have 1-1 support each evening Monday to Friday. I have support plans in place explaining how I like to be supported. Yes, staff help me with day to day stuff, and help me get the best out of life, they listen to my needs and meet them where and when possible. Relatives and carers told us,The staff are very good. I am very pleased with my relatives care. Staff are always friendly and happy to visit me, as well as making me welcome when I visit the home. Staff are very respectful of my relative at all times. My relative is happy and gets the support he needs, and has a good social life. Staff recruitment checks were found to be in order with all the required checks completed before new staff start work. The Inspector reminded the acting manager that the original Criminal Records Bureau (CRBs) certificates for all staff should be made available for inspection for up to three years. For good practise long serving staff should have CRB checks every 3 years. Advice was given for MacIntyre to refer to the CRB website for current guidance. Staff receive regular team meetings, support and professional guidance. Staff told the Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: Inspector they had received mandatory training and felt well supported. Male link support workers were matched up to males in the home, and the same for the females. The Inspector observed a firm and friendly rapport between people and their link support workers when they were around the home, and pursuing their interests. Care Homes for Adults (18-65 years) Page 25 of 30 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 . People benefit from a well run, safe home. Evidence: The acting manager is awaiting registration with the Care Quality Commission (CQC) to become the registered manager of this service. Record keeping was found to be good with all records required accessible and up to date. Large easy read person centred plans are being developed with people and are ongoing. This ensures plans are reflect peoples changing needs. Health and safety checks are confirmed completed in the homes annual quality assurance assessment (AQAA). A staff member has some responsibilities for health and safety checks throughout the home and records confirmed these took place regularly. Water temperatures are controlled in the home with thermostatic valves. Staff still check water temperatures whenever people bathe. The acting manger confirmed new Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: water temperature testing equipment is in the process of being obtained. These safety measures will ensure people are not at risk from hot water temperatures. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes  No  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 28 of 30 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 Description 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 Description 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 22 The homes complaints procedure should be updated and include the current Commissions contact details and be made available to people in the home and others. Ensuring the protection of people at the home the registered provider should refer to the Criminal Records Bureau (CRB) website for current guidance around providing CRB certificates for inspection, and regular staff checks. 2 34 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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