Care Home: Glebelands

What the care home does well People have the information they need to help them decide if the service provides what they are looking for. People`s needs are assessed, so that their care and support can be planned properly. They have detailed care plans so that staff have clear guidance about supporting them in ways that suit them best. Residents are looked after by a familiar group of staff. They get on well and are treated with warmth and friendliness. Staff support people to do as much for themselves as they are able, so as to encourage their independence. Residents are able to do things they value, go to places they like, and keep in touch with the people who are important to them. Staff recognise and respect their different needs, and support them to be part of the local community. People get the support they need to stay healthy and well. Important checks are carried out on staff before they start work at the home: this is to make sure that they are fit for the job. People benefit from being looked after by a staff team that is stable, well qualified, trained and supported. This means that they have the knowledge and skills and get the support they need to do their jobs well. Residents enjoy living in a home that is comfortable, safe and welcoming. The home is generally well run, and people say that they feel happy speaking to the Manager or staff about any issues. Important checks are carried out regularly on essential equipment, to make sure that everyone in the home stays safe. What has improved since the last inspection? Clear efforts have been made to meet the requirements and recommendations we made when we last inspected the service. Information about what the service provides (and to help people raise any concerns they might have) has been updated and produced in picture format also. This helps to make things easier to understand for people who have difficulty reading. People`s risk assessments have been reviewed and updated, to make sure they get the support they need to stay safe. The ways in which people`s concerns and complaints are recorded has improved. It is now easier to see how things have been dealt with. The policy for paying for meals that people have when they are out in the community has been made clear. People who paid for meals by mistake have been repaid. Staff have had refresher training in fire safety, and continue to be offered regular training opportunities. This is to make sure they have the knowledge and skills they need to do their jobs well. Work continues to make care plans "person-centred". This helps to ensure that their focus is the individual concerned, so that they get the support they want. What the care home could do better: Care plans could be further improved by developing some goals with outcomes that can be clearly measured. Reviewing these regularly would help to show what is working and what might need to be changed. Doing this well would help to make sure that people get the support they need to achieve the things they say are important to them. Arrangements for regular consultation with people using the service still need improvement in some areas. This needs to be done systematically to make sure that everyone is consulted regularly, using methods that suit each individual best. Some more work needs to be done to develop individuals` Health Action Plans. This is to make sure that they get all the support they need to stay healthy and well. Arrangements for formal supervision of staff need to improve. This is to make sure that they get all the support they need to do their jobs well. Key inspection report Care homes for adults (18-65 years) Name: Address: Glebelands Kempton Way Off Heath Farm Road Norton, Stourbridge West Midlands DY8 3AZ     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: Gerard Hammond     Date: 1 8 0 6 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 28 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 28 Information about the care home Name of care home: Address: Glebelands Kempton Way Off Heath Farm Road Norton, Stourbridge West Midlands DY8 3AZ 01384813590 01384813591 Mandy.A.Jones@dudley.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Chadd Housing Association care home 18 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: 18 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) 18 Date of last inspection Brief description of the care home Glebelands is registered to provide accommodation, care and support for up to 18 adults with learning disabilities. The home is situated in a residential area close to Stourbridge town centre. The area is well served by public transport. The service is provided through a partnership of the Churches Housing Association of Dudley District (CHADD) and Dudley Metropolitan Borough Council (MBC) Social Services Department. The property is owned and managed by CHADD and the care staff are employed by Dudley MBC. The home is a two-storey building, divided into four flats with some extra shared spaces. Two of the flats can house four people, and the other two have space for five. All bedrooms are single occupancy. Each flat has its own laundry, lounge, Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 18 Brief description of the care home dining area and kitchen. There are bathing and toilet facilities (including level access showers) on both floors. There is an assisted bath on the ground floor in flat 2. Each flat has its own private entrance with a secure entry phone system. There is a large shared room on the ground floor; this has ample seating, and a television, computers and pool table for peoples use. This room is used for meetings, parties and other activities. There is a passenger lift and stairway providing access to the first floor. People can also enjoy relaxing in the enclosed courtyard or out in the garden. There is space for parking at the side of the building. The service should be contacted directly for current information about fees and charges. Care Homes for Adults (18-65 years) Page 5 of 28 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: This is the homes first key inspection of the current year 2009-10. We last inspected the service on 28th May 2008. We collected information from a number of places to help us make the judgements found in this report. The Manager sent us a completed Annual Quality Assurance Assessment (AQAA). This is a self-assessment about how the service is doing, and gives us some numerical information about it. We went to the home and met with all the residents, the Manager and staff on duty. We sent out written surveys to people who use the service, their relatives and also to staff that work at the home. We spent a day visiting Glebelands. We looked around the home and read some records. These included personal files and care plans,staff files,health and safety records, previous inspection reports, and other documents. Thanks are due to the residents, Manager and staff for their help and co-operation throughout the inspection process. Care Homes for Adults (18-65 years) Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: Care plans could be further improved by developing some goals with outcomes that can be clearly measured. Reviewing these regularly would help to show what is working and what might need to be changed. Doing this well would help to make sure that people get the support they need to achieve the things they say are important to Care Homes for Adults (18-65 years) Page 7 of 28 them. Arrangements for regular consultation with people using the service still need improvement in some areas. This needs to be done systematically to make sure that everyone is consulted regularly, using methods that suit each individual best. Some more work needs to be done to develop individuals Health Action Plans. This is to make sure that they get all the support they need to stay healthy and well. Arrangements for formal supervision of staff need to improve. This is to make sure that they get all the support they need to do their jobs well. 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 28 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 28 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 have the information they need to decide if the service is right for them. Their strengths and needs are assessed, so their care and support can be planned properly. Evidence: We saw that the home has a Statement of Purpose and Service Users Guide. These documents provide information to help people decide if the service can meet their needs. When we last inspected the home, we recommended that this information should also be made available in other ways. We saw that versions have now been produced using pictures and photographs, to make them easier to understand for people who might have difficulty reading. One person moved into the home during the last 12 months since we last visited. He came to stay for a short time. The home this person lived in closed down, so he stayed at Glebelands while he got some help to find another place. He has now moved to a new home. We looked at some peoples personal records to see if their strengths and needs had been assessed properly. This has to be done to make sure that the home has the important information it needs to plan peoples care and support. All the Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: files we looked at contained a detailed assessment. These were all current and had been reviewed to make sure they were kept up to date. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care needs are reflected in their care plans, so that they get the support they need in ways that suit them best. Evidence: We spoke to people and looked at some personal files, so that we could see how their care and support is managed. The files we looked at all contained detailed care plans, so that staff have clear guidance about how to support people in the ways that suit them best. Plans were supported with risk assessments, and we saw that these had been reviewed recently. This is important, to make sure that people get the support they need to stay safe. A lot of work has been done to make individual plans person-centred. This provides valuable information about the things that are really matter to each person. Some of the people we spoke to are working towards moving on to a more independent style of living. Their plans reflect this, so that they are getting the support they need to help them prepare to move. One person said, Im really looking forward to moving. Staff Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: are helping me to get ready. He is waiting for some work to be done to the property so that he can move in. Another person showed us some information about places she is going to look at to help her decide where she wants to live. The people who live at Glebelands have a wide range of abilities, strengths and support needs. The work already done to make their care plans more person-centred has helped to develop staffs understanding of each person as an individual. As mentioned above, people who want to move to more independent living are getting the support they need to achieve this goal. We talked to the Manager about developing goals with all of the people who live at Glebelands. The care plans we looked at included some goals, but it is not clear how these are being evaluated. We suggested that key workers should review individuals goals regularly (perhaps monthly) and discuss these with the person concerned. Also that goals set should be clearly measurable. This is so that it is possible to see what has been achieved, what is working and what might need to be changed. Doing this on a frequent basis makes sure that people are getting the support they want to achieve the things they say are important to them. We saw evidence that people are consulted about how the home is run and supported to take part in day-to-day things. We saw staff asking people about what they wanted to do, about going out and about what they wanted to eat and drink. People told us that they take turns to do jobs around the flats they live in. We saw that there were rotas for household tasks in each of the flats we visited. We also saw people helping with washing up and setting table. We saw minutes of the residents meetings held on each flat. These meetings are held to discuss matters of common interest such as menu planning, household chores, holidays, group activities and so on. When we last visited the home we noticed that the records of these meetings varied from flat to flat: this continues to be the case. We talked to the Manager about this, and agreed that this should be taken up with senior staff on each flat. It is important to acknowledge that a group meeting may not be the best way of consulting with some people. Individuals levels of learning disability, communication support needs and attention span may all affect their capacity to take part effectively. It is clear that staff actively seek peoples views, but recording of this needs to improve. We recommend that the process of consulting with people be reviewed, and clearer systems put in place to show how and when their views have been sought. This is particularly important for those people with complex care and communication support needs. The outcomes of such consultations should be clearly recorded. In this way it should be possible to see clearly how the decisions that affect peoples lives have been reached. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to do things they value, go to places they like and keep in touch with the people who are important to them. They like the food they get and enjoy their mealtimes. Evidence: We asked people about the opportunities they have to do the things they like. We also looked at their personal files to see how these things are planned and managed. We saw that people have structured activities during the day at local centres, if they wish to attend. We also saw records of people being supported to access facilities in the local community. These included shops, pubs, theatre. the cinema, hairdressers and so on. One person told us about a play he had been to see the previous evening. He said it was really good, I enjoyed it very much. Another said he enjoyed watching football and liked to go and see his favourite team play. At home people get involved in looking after their own flats, with support from staff. They are encouraged to do as Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: much for themselves as they are able, to maintain or develop their independence skills. As well as helping to keep the flat clean and tidy, people are supported to get involved with preparing and cooking food and looking after their clothes (laundry, ironing etc.). At home some people get involved in gardening, including growing things to eat, making cakes and relax just watching favourite television programmes and films on DVD. We saw that one resident enjoys knitting, and also takes part in a sewing group. The Manager advised that arrangements are in hand to obtain a new vehicle, to provide people with other opportunities for accessing community facilities. People aleady do this using public transport, with support as needed. Peoples records showed that had opportunities to go on day trips to places they wanted to visit. People we spoke to told us about the plans they were making to go on holiday. One person said they were looking forward to going to Cornwall, two others said they would be going to Barcelona in the near future. Going away for extended periods does not suit everybody, as some people do not cope well with unfamiliar environments for any length of time. Staff support these people to go on short excursions or day trips. Individuals we spoke to and records we looked at show that people are supported to keep in touch with their families and friends. This is through regular telephone calls and visits, either at Glebelands or relatives homes. One person told us he went to stay with his family on a regular basis, another told us that he was able to see and keep in touch with his girlfriend whenever he wanted. Another said he was looking forward to moving to his own place, so that he could be nearer to his friends. The Manager told us that each flat has a separate budget allocated for shopping for food. We saw that each flat had its own menu plan and that these were put together after discussions with the people living there. Records showed that people enjoyed plenty of variety and choice in their meals. Staff keep a record of things they have introduced and note in particular if people liked them or not. We saw information and prompts on each flat to encourage healthy eating practices. We looked at the food stocks and saw that these were plentiful and included fresh produce. We saw plenty of fresh vegetables and fruit available for people to eat when they wanted. People we spoke to told us they enjoyed their meals and could have what they liked. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People get the support they need to stay healthy and well, and are cared for in ways that suit them. Evidence: During our visit we were able to meet with most of the people currently living at Glebelands. We saw that they were all well dressed in clean clothing of good quality. What they wore reflected their individual personalities, and was appropriate to their age and gender. We could also see that they had received the support they needed with their personal care and hygiene. We saw and heard staff interacting with them. Many of the staff have worked at the home for a good number of years. This helps to promote continuity of care. We saw people approaching the manager and members of staff for support. They treated them in a respectful way, with warmth and friendliness. It is clear that they are comfortable in each others company. People told us that they like the Manager and staff that look after them. As we reported above, people all have detailed care plans, so staff have clear guidance about how they like to be supported. We looked at peoples records to see how their healthcare is planned and managed. We saw that they had been supported to keep important medical appointments. We Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: also saw that people were referred to other professionals for advice and support where this was necessary. We talked to the Manager about Health Action Plans. It is clear that a lot of good work already goes on in this area. The efforts being made to promote healthy eating is a good example of this. Senior staff on each flat supervise arrangements to support individuals health care. Health action planning involves doing an assessment of peoples healthcare needs and making a plan to support them to stay healthy and well. Its focus is on what can be done to actively promote good health, rather than reacting just when problems arise. It is a particular recommendation of the Government White Paper Valuing People (2001). We recommended that the Manager continues in her efforts to liaise with the local Community Nurse (Learning disabilities) Team to develop this further. This recommendation is made merely as an opportunity to develop existing good practice. We looked at the arrangements for managing peoples support with their medicine. The home uses a monitored dosage system provided by a local Pharmacist. Most medication is dispensed in blister packs. The Pharmacist had recently checked on how things were being done. This was generally satisfactory, and the one recommendation she had made had been dealt with when we visited. We looked at the medication administration record (MAR) and saw that it had been filled in properly, and that people had been given their medicines at the right time. We saw that arrangements for managing medication are working well. The store for this was clean and tidy, and secure. Care Homes for Adults (18-65 years) Page 17 of 28 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 can be confident that their concerns are listened to, taken seriously and acted upon. The service supports people to stay safe from abuse, neglect and self-harm Evidence: When we last inspected the home, we had some concerns about things to do with managing complaints, and safeguarding (adult protection). We talked to people using the service, the Manager and staff on duty to find out if things are better now than they were before. It is clear that the Manager has taken up the issues we raised as matters of priority. We saw that the home now has an easy read version of the complaints and safeguarding procedures. Both of these were on display and readily available to people in the home. Some of the people we spoke to could tell us what they would do if they had any concerns. They said they knew to whom they could speak, and most said this would be a member of staff or the Manager. We were able to witness this directly during the day we visited the home. It has to be acknowledged that formal procedures have little relevance to a number of the people who use this service. This is because of individuals communication support needs and levels of learning disability. These people rely on the vigilance of the staff team to notice changes in behaviour or demeanour as indicators that they are unhappy. Staff were able to demonstrate their sensitivity to this. Information in peoples person-centred plans provided further guidance in this area. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: We looked at the complaints record. We saw that this showed when concerns were raised, what action was taken and by whom, and how matters were resolved, if appropriate. We saw copies of minutes of residents group meetings. These showed where matters had been raised and follow up action taken. We have not received any complaints in respect of this service. When we last inspected the home we noticed that some people had paid for meals for staff and themselves during activities out in the community. There is a clear procedure covering this, and it appears that the problem arose because this had not been followed correctly. The Manager completed an audit of peoples financial records to check how often this had happened. We saw that this had been done: each person who had paid for meals by mistake got the money repaid to them. The Manager said that she has made sure that staff are clear about the policy. She said that spot checks on this are now done by senior managers and herself, to make sure this is being followed. We talked to staff on duty about safeguarding (adult protection). They were able to show us that they understand the nature and different ways that people can suffer abuse. They knew what action they should take in the event of witnessing or suspecting that abuse had taken place. It was also clear that they understand that people with limited verbal communication have ways of showing if they are distressed. They know that they have to look out for things such as unexplained marks or injuries, changes in behaviour or responses to particular individuals, and so on. We saw that incidents (involving difficult behaviour by residents) that might put others at risk had been referred appropriately under agreed local procedures. Behavioural management plans were put in place, and specialised support obtained to deal with this. Where appropriate, referral had been made to an Independent Mental Capacity Advocate (IMCA) to ensure that individuals rights were properly represented, and decisions made in their best interests. We also looked at staff records. We saw that checks had been carried out with the Criminal Records Bureau (CRB) prior to employment. This shows that the service takes action to ensure that people are fit for their jobs. Staff records also showed that they had received training in the protection of vulnerable adults from abuse. Care Homes for Adults (18-65 years) Page 19 of 28 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. People who use this service enjoy living in an environment that is comfortable, clean and homely. Evidence: We looked around the home with the Manager. The building is divided into four selfcontained flats, two on the ground floor and two on the first floor. Two flats have space for five people, the other two have space for four. Each flat has its own openplan kitchen and dining area, and domestic scale washing machine. People are encouraged to use these as much as possible, according to their individual abilities and support needs. We were able to see most peoples bedrooms. All of the rooms we looked at were individual. They contained peoples possessions and personal effects. These included televisions, radios and music players, family photographs, pictures and ornaments. The rooms were comfortably furnished and clean. We saw that all of the flats were roomy and gave the people living in them a comfortable and homely place to be in. There are enough toilets and bathrooms in the home to meet peoples needs. When we last inspected the home we recommended that shower spray attachments be provided in each bathroom. We saw that these have now been fitted for anyone that Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: wants to use them. We also saw that bathroom seals in need of attention had been replaced. Shared spaces in the home include a large communal lounge area on the ground floor. This gets used for parties, social gatherings, activities and large meetings. There are plenty of chairs for this. There is also a large new flat screen television on the wall, and a screened area that houses two computers for people to use. On the wall is a notice board for posting information about activities and other things of interest for the homes residents. In the foyer is a picture board with photographs of the staff on duty. This is so that people know who is at work each day. In the centre of the building is an enclosed quadrangle with paving, seating and potted plants. This gives people a pleasant space to sit and relax in. At the back of the home is a large enclosed garden with lawns and flower beds. A wooden outbuilding (The Retreat) in the garden offers extra space for activities and sensory stimulation. There is a greenhouse in the garden too; a number of people in the home get involved in gardening, having a go at growing things to eat, potting plants, and so on. We saw that the home was generally well maintained and decorated throughout. The Manager said that repairs and maintenance are referred to the property owners. She told us that things she asks for usually get done quickly. People we spoke to said they liked living at Glebelands. We received seven surveys from people who use this service and all of them said that the home is always fresh and clean. When we looked around the home we saw that the staff and people living there work hard to keep it clean and tidy. Care Homes for Adults (18-65 years) Page 21 of 28 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. Selection and recruitment of staff is done thoroughly, to make sure people are fit for their jobs. Staff are well trained and qualified, so that they have the knowledge and skills they need to do their jobs. Arrangements for formal supervision need to improve, to make sure that staff get all the support they need to do their jobs well. Evidence: We looked at staff records to see how people are recruited, trained and supervised, and spoke to staff on duty. Files we saw contained completed applications, two written references and evidence of checks with the Criminal Records Bureau. These things show that the service takes action to make sure that the people it employs are fit for their jobs. We received nine surveys from staff. Their responses showed us that they are very positive about the job they do, and in particular about the people they look after. Some voiced their frustration about not having enough staff to do all the things they would like with the residents. We saw that there were sufficient staff on duty to meet peoples assessed needs. However, the quality of their activity opportunities could be improved if there were more staff available on a regular basis. Turnover of staff is low, and this helps to promote continuity of care. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Care staff are employed by Dudley Metropolitan Borough Council and their training is organised centrally. Information provided by the Manager in the Annual Quality Assurance Assessment (AQAA) shows that 84 of the staff team has a qualification at NVQ level 2 or above. The Manager said that a lot of work has been done during the past twelve months to achieve this. The team has in-house assessors to support staff working towards these qualifications. She said that she is trying to get an Internal Verifier on the team to promote this further. This could provide an excellent opportunity for staff development. We saw the chart that the Manager uses to keep informed about this, and to request training when it is due. We saw that this is done systematically, and that requests for places on relevant courses of training had been requested at appropriate times. Staff all confirmed that they are given training that is relevant to their roles. They said their training helped them understand and meet the individual needs of service users, and to keep up to date with new ways of working. Each flat is overseen by a senior worker or Practice Supervisor, who has specific responsibilities for day to day matters in the unit. Staff told us that felt generally well supported. We looked at staff supervision records. Some staff are not meeting formally with their supervisors as frequently as recommended by National Minimum Standards. We spoke to the Manager about this and recommended such meetings be scheduled more systematically. This is to ensure that staff get all the support they need to do their jobs well. We did see that staff group meetings take place regularly, and that staff have received an annual appraisal (performance and development review) Care Homes for Adults (18-65 years) Page 23 of 28 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 is generally well run for the benefit of the people who live there. Positive action is being taken to find out what people think, so that planning the service can be properly informed. Regular checking of essential equipment helps to ensure that peoples health and safety are protected. Evidence: We talked to the Manager, people who use the service and staff, to help us make a judgement about how well the home is run. The Manager is appropriately qualified and experienced to run the home. Much of the day-to-day management of each flat is delegated to the senior staff (Practice Supervisors). The Manager demonstrates a positive attitude to providing opportunities for her staff to develop professionally, and places real value on the team of staff she has to support her, as well as her own line manager. People say that she is approachable, and we were able to directly observe residents seeking advice and support from her. It was clear that they were comfortable doing this. The Manager told us that she also receives good support from the Chief Executive of Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: the organisation that owns the property. We saw the records of the regular visits that she makes to the home. We saw that there is a system in place to monitor the quality of the service that people receive. This is done by through questionnaires to residents, members of their families and other professionals involved with the people who use the service. We saw the report that had been produced following this exercise last year. Comments included Glebelands is a very welcoming place and a lovely environment. Two local councillors commented that the home is a pleasure to visit. We sampled some records relating to health and safety matters around the home. These included checks on the fire alarm and fire-fighting equipment, checks on gas and electrical appliances, and servicing of other essential equipment in the home. We saw that these things are being done routinely, and written records kept to show when jobs had been done. These things help to show that due care and attention is taken to make sure that people get the support they need to stay safe. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 6 Agree goals that have measurable outcomes with each person using the service, and evaluate these regularly. This is to make sure that people get all the support they need to achieve the things that are important to them. Review the arrangements for regular consultation with people using the service. Ensure that records show clearly how people have been consulted and how decisions have been reached. This will help to ensure that the views of everyone who uses the service have been listened to and acted upon. Seek support and advice from the local Community Nurse (Learning Disabilities) Team to develop peoples Health Action Plans. This is to ensure that people get all the help they need to stay healthy and well. Ensure that staff have regular formal supervision, and keep written records of each meeting. This is to ensure that staff get all the support they need to do their jobs well. 2 7 3 19 4 36 Care Homes for Adults (18-65 years) Page 27 of 28 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. 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