Care Home: Fallings Heath House

What the care home does well The service has good systems in place to identify people`s needs. Whenever possible people who live at the home are involved in decisions about their lives and the care and support they receive.Staff ensure that the principles of respect, dignity and privacy are put into practice for people living at the home and their rights are upheld. There are good and safe systems in place for the storage and administration of medicines, giving confidence that people receive the medicines that they are prescribed. People are supported by staff to raise concerns and are protected by appropriate policies and procedures which keep them safe. The home has an experienced manager who provides effective leadership for the home. The manager demonstrates that she has a desire for the service to provide specialist care for people with a learning disability and as a result of this wishes to continue to develop the home. The home has knowledgeable and friendly staff who have provide care and support for people living at the home. What has improved since the last inspection? It is positive that a decision has been made that the home will remain under the ownership of Walsall Council for at least eighteen months. This decision means that more permanent staff arrangements can be put in place. The refurbishment of the home has commenced with people moving into the first of the newly refurbished units with completion of the second refurbished unit in May 2009. A more definite decision for the future of the home has also given the Manager confidence to apply to become the registered manager, this again provides the home with more stability. What the care home could do better: There are no requirements as a result of this inspection. We did advise that staff check the accuracy of the prescription before it is sent to the pharmacy for dispensing. We also advised that all staff checks are retained within the home and are transferred from the council who undertake staff recruitment. Key inspection report Care homes for adults (18-65 years) Name: Address: Fallings Heath House Walsall Road Darlaston West Midlands WS10 9SH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Amanda Hennessy     Date: 3 1 0 3 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 25 Information about the care home Name of care home: Address: Fallings Heath House Walsall Road Darlaston West Midlands WS10 9SH 01215686297 01215267023 dudleys@walsall.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Walsall Metropolitan Borough Council Name of registered manager (if applicable) Mrs Lynn Jones Type of registration: Number of places registered: care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 16 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) 16 Date of last inspection Brief description of the care home Fallings Heath is a purpose built, single storey building which now provides accommodation and personal care for up to thirteen people who have a learning disability and may have additional complex needs. The Registered provider is Walsall Metropolitan Borough Council. The home is located in Darlaston, on the outskirts of Walsall, close to local shops, pubs, a post office and other amenities. The home is divided into three units, although only two units are currently occupied. Each unit Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 16 Brief description of the care home provides a lounge, dining area and kitchenette. All bedrooms are single with ensuite facilities provided in two of the three units. There is parking available and an enclosed garden to the rear of the building. As no information on fees is provided within this report the reader is advised to contact the service direct for this information. Care Homes for Adults (18-65 years) Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means that people who use this service experience good quality outcomes. This was an unannounced inspection which means that neither the provider nor the service knew that we would be visiting. Time spent visiting the service was seven hours. The Home manager was present throughout the majority of the visit. The previous inspection of this service was undertaken on 14th April 2008. The inspection included a review of information supplied by the Manager called An Annual Quality Assurance Assessment (AQAA) which provided information about the service, policies and procedures at the home, information about people who live at the home and its staff. The inspection included the observation of care experienced by people living at the home, talking with staff and managers on duty, looking in detail at all aspects of care for two people with complex needs, viewing their rooms and discussing their care with staff. This process is known as case tracking. Care Homes for Adults (18-65 years) Page 6 of 25 We had a look around the home and records about the safety of equipment and the building were checked. We looked at how the service has responded to any concerns, how it protects people from abuse and how staff are recruited and trained. We also looked at the number of staff available to care and support people who live in the home. Care Homes for Adults (18-65 years) Page 7 of 25 What the care home does well: What has improved since the last inspection? 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 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 8 of 25 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 9 of 25 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. Relevant and required information is available about home to enable people to make an informed decision that the home is suitable to meet their needs Evidence: There have been no new admissions to the home for several years. We have been told that when the refurbishment is completed and all people who currently live at the home have settled in their new rooms there is a possibility that new people may come to live at the home both on a short term and long term basis. The Manager has told us that she will update admission policies and procedures including the statement of purpose and service user guide to ensure that all changes are identified. Care Homes for Adults (18-65 years) Page 10 of 25 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 whenever possible participate in all aspects of the home and have a plan of care that reflects their assessed and changing needs and reflects their personal goals. Evidence: People have a comprehensive support plan their identifies all the care and support that they need. Our previous inspection also found that support plans were comprehensive and it is positive that they have continued to develop and improve care planning. Staff confirmed that support plans are regularly updated and that they have also had advice and support from the person centred planning team to help develop Essential Lifestyle plans for individuals which reflect their needs, choices and capabilities. It is also positive that these Essential Lifestyle plans are in easy read and pictorial formats to assist people who are able to be, be involved in the drawing up and review of their plan of support. We did advise that staff ensure that all reviews and additions to support plans are dated to ensure that staff are aware which are the most up to date care instructions. Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: It was positive to see how staff advocate on behalf of people living at the home to ensure that they are treated as an individual and not as a person who has a learning disability. Staff we spoke to told us about a need for confidentiality which gives confidence that people who live at the home can have confidence that information about them is handled appropriately and when possible confidences are kept. Care Homes for Adults (18-65 years) Page 12 of 25 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 have the opportunity to makes choices about their life and live a full and purposeful life. Evidence: Peoples interests and needs are recorded within their Essential Lifestyle plan. We found that they are given the support to maintain and develop social, emotional, communication and independent living skills whenever possible. Routines are based around individual needs such as the time that they get up and go to bed or have something to eat. We found that people have a wide variety of social opportunities, including shopping trips, swimming, visits to the library and dancing, two people living at Fallings Heath also attend day centres. Staff told us: people here go out a lot. One relative said she goes out more than I do. The manager told us that they have been developing peoples independent living skills. We were told that most people have a bus pass and are registered with ring Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: and ride meaning that they can now go out more independently. We were told that one person attends church weekly independently using ring and ride.The home also has its own mini bus which is also used to take people out. We were told that visitors are able to visit the home at any reasonable time and that people also visit their friends and relatives outside the home. The home has a four week menu and shows that at least three different choices are available. Staff told us that even though most people who live at Falling Heath have no verbal communication they are able to tell them by using non verbal signs what they want or do not want to eat. Staff also told us that if people do not want the choices available an alternative will always be provided. Snacks such as fruit, crisps and biscuits are also available as people want. Staff told us that the new kitchenettes will give people greater independence and now enable people to make their own breakfast and other snacks for themselves or show staff what they want. Care Homes for Adults (18-65 years) Page 14 of 25 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. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: The home has good systems in place for the promotion of peoples health. Care records showed us that a range of health care services are accessed for the people living at the home including chiropody, dentistry and the optician and dependent on their clinical need. It is also positive that whenever possible staff support people to visit their doctor and dentist surgeries and other local services. whenever possible. One person whose care records we looked at also had regular visits from their Epileptic Nurse Specialist, it was positive to see that staff have contacted her to seek further advice in relation to changes in the persons epileptic seizures. The storage and administration of medicines at the home is undertaken by trained care staff and is done both safely and appropriately. There are appropriate records to show that people have had their medicines when required. Medicines are checked every month and staff order required repeat medicines. We told staff that they have a responsibility to check the accuracy of the prescription before it is sent to the pharmacy to be dispensed, which is not currently undertaken. The new bedrooms Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: have a lockable medicine cabinet in their bathrooms and we discussed ways that medicines could be stored in individuals own rooms. Care Homes for Adults (18-65 years) Page 16 of 25 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 are listened to and can feel assured that the home will act in their best interests and protect them from harm. Evidence: People who live at this home have limited verbal communication making it more difficult to raise concerns or make complaints. It was positive therefore that all staff made us aware that they need to advocate on behalf of people living at Fallings Heath. One staff member told us: you can tell they are not happy and if for example you sit quietly with x you can usually find out what has upset her. We have had no complaints about the home. The Manager told us that they had had ten issues raised. There was an appropriate record of all concerns raised no matter how minor and actions that have been undertaken as a result of the concerns made. All staff we spoke to had a good knowledge of what is abuse and how they should protect people from harm. For example one person explained, by looking for signs, if they are withdrawn, crying more than usual, looking sad, and if I notice bruises when getting up, I would check the accident forms in case they had had a fall the previous day and tell the person in charge about the bruise(s). Systems for the management of peoples monies and valuables are good. There is an appropriate record of all financial transactions with receipts available and two signatures obtained to confirm the transaction. Care Homes for Adults (18-65 years) Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is a clean and homely place to live with facilities that meet the needs of people who live there. Evidence: The home is currently undergoing refurbishment. The refurbishment of Cherry unit is now complete and the refurbishment of Fern unit will be completed in May 2009. Four people will live on both Cherry and Fern units. The refurbishment has made bedrooms bigger (all are single occupancy) and each person has a large ensuite toilet and shower. The newly refurbished units will also have a more spacious bathroom with a specialist bath that is suitable for people with mobility difficulties and a lounge/dining room and adjoining kitchenette. We were told that people living at the home were able to choose the colour and soft furnishing of their bedroom. There are also suitable aids and adaptations for people with disabilities. We found that areas of the home visited were clean spacious and homely. Care Homes for Adults (18-65 years) Page 18 of 25 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. The service has knowledgeable staff who understand and meet peoples needs. Evidence: The Manager told us that she is now able to recruit permanent staff which was not possible when the home was identified for closure. We have been told that almost half of the current staff are agency staff, although the majority of agency workers are allocated to the home on a full time basis. Staff were observed to be attentive, patient and respectful, with good eye contact with people in their care. Staff spoken to were knowledgeable about peoples needs and were all clearly interested in their work. As one staff member said: I love my job. Personal training plans are in place for all staff. Staff told us that they have good training opportunities. It is also positive that the home more than 50 of its care staff holding or undertaking National Vocational Qualifications (NVQ) despite having such a high dependence on agency care staff. In addition agency staff we spoke to also told us that they have been supported to undertake their NVQ by the home. Staff recruitment is completed by the personel department within the council. The manager then retains copies of records within staff files at the home. There was no record of any references for the most recently appointed member of staff, although other checks such as the criminal records check, application form and health Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: declaration were available. The manager told us that she would ensure that the personel department forward this information to her. The manager also obtains proof that all agency staff have had required pre employment checks, which is good practice. Supervision and support offered to staff is good. Examination of staff records confirms that regular supervision sessions are taking place. Good training and supervision practices give confidence of appropriately skilled and informed care staff providing support and care to people who live at the home. Care Homes for Adults (18-65 years) Page 20 of 25 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has effective leadership and appropriate health and safety practices to keep people safe. Evidence: Fallings Heath House is managed by Susan Jones and she has applied to us to be the registered manager of the home. The manager has considerable experience caring for people with learning disabilities and has previously managed other learning disability homes. The Manager is supported by other senior staff who all have delegated responsibilities. The manager ensures that peoples equality and diversity is respected. The manager told us that: all care staff have attended training to promote equality and diversity in their work. individuals needs and disabilities have been taken into account with the design of the newly refurbished units such as lower work surfaces and colours used for people with a visual disability. There is a mix of female and male staff to assist people who live at Fallings Heath to respect peoples choice about the gender of staff providing them with personal care. The manager has told us that they look at peoples religious beliefs and provide opportunities for them to worship if they wish. There is a Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: wide age range of people living at Fallings Heath and they try to meet individuals needs in respect of age appropriate activities and mixing with others of a similar age and who share similar interests. The home returned their Annual Quality Assurance Assessment (AQAA) when required. The AQAA was comprehensively completed and identified ongoing developments that will continue to improve the care and support that people who live at the home receive. The manager has been auditing the home and has told us how she has been developing the service. The Manager said that she is continually looking at ways to more effectively involve people with complex communication needs to gain their views on the home and the care that they receive. Systems for the management of peoples monies and valuables are good. There is an appropriate record of all financial transactions with receipts available and two signatures obtained to confirm the transaction. The Manager has confirmed that health and safety checks are being performed at the required frequency and she regularly audits this.Staff receive mandatory training which gives assurance that staff will know what to do to keep people safe. Care Homes for Adults (18-65 years) Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 20 The prescription ishould be returned to the home before it is sent to the pharmacy so that the service is able to confirm the accuracy of the prescription before it is dispensed. A copy of all staff checks are available within the home to give assurance that all required checks have been returned. 2 34 Care Homes for Adults (18-65 years) Page 24 of 25 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. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 25 of 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!