Care Home: Handsworth Development

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What the care home does well Through comprehensive documentation and the recording of detailed information, the service and each member of staff will be aware of the person`s needs prior to admission. People benefit from up-to-date comprehensive care plans and new initiatives introduced at the service. The people were spoken with and it was established that they were satisfied with their care. The comments were that: `The care is fantastic they cannot do enough`. `Yes I know what`s in my care plan they let me read it`. `I get looked after very well`. `The staff always encourage me to speak up`. The peoples` quality of life will be enhanced because of the availability of activities and outings, and individualised opportunities offered to them. Medication practices were adhered to and people received their medication in a safe manner. People were able to express their concerns and these were acted upon. The environment, monitored at this inspection, had been maintained to the required standards to provide a well maintained, safe environment. The robust staff recruitment processes regarding the checking of staff will contribute towards the protection of the people. People were satisfied with the staff. The comments we received from the people were: `The staff are lovely`. `The staff are nice`. `The staff are all right, some better than others, and I like some better than others`. An experienced registered manager was in post. This will contribute to the effective organisation and operation of the service.Extensive quality assurance systems were in place that should assist the manager and owners to measure the service against the expected outcomes. What has improved since the last inspection? The service had complied with the requirements listed in the last inspection report. Supervision took place on a regular basis and is planned to occur throughout the year. Fire practice and drills did occur. What the care home could do better: The service should continue to strive to find and introduce more innovative practices. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Handsworth Development 63-65 St Joseph`s Road Handsworth Sheffield South Yorkshire S13 9AU     The quality rating for this care home is:   three star excellent 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: Ivan Barker     Date: 1 0 0 6 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. 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. 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. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI 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 27 Information about the care home Name of care home: Address: Handsworth Development 63-65 St Joseph`s Road Handsworth Sheffield South Yorkshire S13 9AU 01142548291 01142690381 none 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) : Northern Counties Housing Association Ltd care home 12 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 12 This registration also includes 8 places at 101, 103, 105, 107 Hall Road, Sheffield S13 9AH. This registration includes 3 places for people who are over 65 years can reside at the home. This registration includes 8 places for people with an additional physical disability (PD). Date of last inspection Brief description of the care home Handsworth Development provides a service for 12 adults with learning and physical disabilities. Four people live at one bungalow, and two people live in each of the four adjoining bungalows nearby. The bungalows are all purpose built, and are situated in the Handsworth residential area of Sheffield, which has good access to public transport and shops. The bungalows are all easily accessible to wheelchair users, have single bedrooms and large landscaped gardens. Each bungalow has a car parking area. Fees range from £310.00 to £369.00 per week. Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home A statement of purpose and service user guide, giving information about the home, are available to current and prospective people and their representatives in suitable formats. Care Homes for Adults (18-65 years) Page 5 of 27 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: three star excellent 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: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Only a limited number of the National Minimum Standards were examined at this inspection (with the emphasis on the key standards) and the previous requirements. The person present at the inspection was: Care Homes for Adults (18-65 years) Page 6 of 27 D Bentley manager. Within this site visit, which occurred over a 5 hour and 40 minute period we examined requirements relating to the previous inspection, toured the building, case tracked 2 people (case tracked means looking at the care and service provided to specific people living at the home; checking records relating to the health and welfare, care plans and other records; by talking to people; viewing their accommodation as well as communal living areas). We also spoke with other people and staff and examined assessments, care plans, risk assessments, menus, complaint files, staff files and quality monitoring documents. The history of the service was examined prior to this site visit. This included the AQAA (Annual Quality Assurance Assessment) which is a self assessment document, telephone contacts, letters and notifications. People who use the service will be referred to within this report as people. What the care home does well: Through comprehensive documentation and the recording of detailed information, the service and each member of staff will be aware of the persons needs prior to admission. People benefit from up-to-date comprehensive care plans and new initiatives introduced at the service. The people were spoken with and it was established that they were satisfied with their care. The comments were that: The care is fantastic they cannot do enough. Yes I know whats in my care plan they let me read it. I get looked after very well. The staff always encourage me to speak up. The peoples quality of life will be enhanced because of the availability of activities and outings, and individualised opportunities offered to them. Medication practices were adhered to and people received their medication in a safe manner. People were able to express their concerns and these were acted upon. The environment, monitored at this inspection, had been maintained to the required standards to provide a well maintained, safe environment. The robust staff recruitment processes regarding the checking of staff will contribute towards the protection of the people. People were satisfied with the staff. The comments we received from the people were: The staff are lovely. The staff are nice. The staff are all right, some better than others, and I like some better than others. An experienced registered manager was in post. This will contribute to the effective organisation and operation of the service. Care Homes for Adults (18-65 years) Page 8 of 27 Extensive quality assurance systems were in place that should assist the manager and owners to measure the service against the expected outcomes. 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 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 9 of 27 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 10 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Through comprehensive documentation and the recording of detailed information, the service and each member of staff will be aware of the persons needs prior to admission. Evidence: The manager advised that the prospective persons assessment from the care managers was always hand delivered. On receiving this assessment, the manager then undertook their own assessment. Following this assessment the person was invited to visit the service for 1 or 2 separate days or a weekend. During these visits, the person was further assessed to consider if this service could meet their needs and how the person interacted with other people. Both assessments were examined and found to be very comprehensive and easy to reference and provided a considerable amount of information for care plans to be drawn up. Care Homes for Adults (18-65 years) Page 11 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from up-to-date comprehensive care plans and new initiatives introduced at the service. Evidence: On examination of the care plans, it was found that the care plans were extensive and detailed all aspects of the care needs of the individual. These included the social, mental and physical interventions. The care plans were up-to-date and had been evaluated on a 6 monthly basis. It was discussed that the information contained within the plans showed evidence of there being evaluations more often than 6 monthly. However the review records did not reflect this. It was agreed by the manager that she would discuss it with her staff and ensure that they updated the review record as well as the entries within the care plan. There was also a care plan formulated on a Compact Disc (CD), so that the person could understand the care plan. This care plan was also in paper form. The care plans Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: are checked and signed by the people. The manager explained that they had created a new initiative within the documentation. This document was particularly outcome focused and planned objectives to be achieved on a 12 monthly basis. For example: one of the outcomes, for an individual was that within 12 months, they would be able to walk unaided. It was discussed with the manager this was a particularly good initiative and this could be further developed by setting shorter term goals. We were then shown the Commitment statements which were drawn up by the staff and the people. These statements detailed what the person could expect from the staff and the service. Each statement was individualised to each particular person. These statements were displayed or were available within the individuals rooms. Some had been placed in picture frames and hung on the wall. The people were spoken with and it was established that they were satisfied with their care. The comments were that: The care is fantastic they cannot do enough. Yes I know whats in my care plan they let me read it. I get looked after very well. The staff always encourage me to speak up. Care Homes for Adults (18-65 years) Page 13 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The peoples quality of life will be enhanced because of the availability of activities and outings, and individualised opportunities offered to them. Evidence: On discussing the activities for the people, the manager advised that as part of the assessment process, the persons liked and disliked were recorded. This was observed by us. There was no activity programme displayed, however it was evidenced that some people visited a luncheon club, a swimming pool for hydrotherapy, cinema, public houses and the market. The manager advised that they looked at the aspirations and dreams of the person and various things had been organised specifically for them. For example: A make up and photography session had been organised for one individual, sailing and flying lessons had been organised for other individuals, ice skating on wheelchairs for other people. Some individuals had been Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: away on holiday in Tenerife. These were all achieved after discussions with the person. Evidence of these events were shown to us. The service had a minibus which was available at any time, and several members of staff were able to drive this bus. Therefore they were able to respond, on a daily basis, to any requests to go out into the local community. Each house had accommodation for 2 to 4 individuals. Regarding the meals, the staff were aware of the individuals likes and dislikes, and undertook to shop and cook for each unit. If people were able and wished to, they would accompany the staff on the shopping trip. The manager advised as part of the induction programme for staff, she undertook a cooking competency on the member of staff, to establish their capability of cooking food. Should the individual not be able to undertake the task, then further training was introduced. On discussing this with the staff, they supported the information given by the manager. All staff had a food hygiene certificate. Care Homes for Adults (18-65 years) Page 15 of 27 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. Medication practices were adhered to and people received their medication in a safe manner. Evidence: The people had the opportunity to access the Primary Care facilities, which include GP and dental services etc. During the inspection, the community pharmacist attended the service to undertake her inspection of the meditations. Following her inspection she gave us verbal feedback of her findings. She advised that she had found no problems with the storage, ordering, administration and disposal of the meditations. She also advised that she had checked the use of the controlled drugs (CDs) and Temazepam and there was the safe practice of double signature recording system for these medications. She also identified that there was a best interest flowchart in operation, which she had reviewed. The manager provided evidence of the best interest flowchart. The chart indicated Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: several levels of intervention, for example diversionary action, prior to raising the issue with the GP and requesting medication. On examination of the Medication Administration Records (MARS) all the sections were found to be completed. Care Homes for Adults (18-65 years) Page 17 of 27 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 were able to express their concerns and these were acted upon. Evidence: The complaints procedure was printed within the Service User Guide. A copy of the guide was available to people and visitors. Within the information there was reference to referring complaints to us. The manager agreed to review the documentation. Any complaints which had been raised had been addressed by the manager of the service. Evidence was seen to support this. There had been no complaints received by us regarding the service prior to or during the visit. The service had policies and procedures regarding Safeguarding Adults. These policies and procedures were available to staff. The training records of the staff were examined and it was established that staff had attended training on Safeguarding Adults. Care Homes for Adults (18-65 years) Page 18 of 27 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 environment, monitored at this inspection, had been maintained to the required standards to provide a well maintained, safe environment. Evidence: On touring the building it was observed that the rooms had been personalised to individuals tastes. The rooms contained pictures, posters and included items which would be found in a younger persons room. Each room contained the necessary aids for that individual. For example: Overhead hoists were provided for some individuals to access the bathrooms. Also within each room was the Commitment statement, as previously described in this report. All the individual units were clean, well maintained, well decorated and odour free. The atmosphere within each of the units was warm, friendly and relaxed. Each of the units had a small garden and a garden shed. The manager, the staff and the people explained how much the people enjoyed undertaking projects within the Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: garden. Care Homes for Adults (18-65 years) Page 20 of 27 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 robust staff recruitment processes regarding the checking of staff will contribute towards the protection of the people. People were satisfied with the staff. Evidence: On examination of the staff on duty and on the rotas, it was established that the staffing was as follows. A. M. 6 care staff. P. M. 6 care staff. Nights. 3 care staff. Plus the manager and the administrator. Caring for 12 people. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: We asked for clarification that 3 staff on nights, each within a separate unit, were able to care for 12 people. It was explained to us, by the manager, that the low dependency levels of the people within each of the units and the fact that each member of the staff carried a phone, on their person during the night, so they could be easily contacted for assistance, protected both the staff and the people. On observing the people it was clear that they had low dependency needs, and the staff during the day, did carry the phones in their pockets. Therefore the explanation given by the manager was accepted. On examination of the staff training records, the staff had received training in fire, moving and handling and other clinical training. Also training had occurred regarding fire drills and fire practice. On examination of 3 staff files, it was established that all the files contained all information required within Schedule 2, which is a section of the Care Homes Regulations 2001. The comments we received from the people were: The staff are lovely. The staff are nice. The staff are all right, some better than others, and I like some better than others. Regarding the previous requirement relating to the need for supervision. This had taken place on a regular basis and further sessions were planned for the remaining year. Care Homes for Adults (18-65 years) Page 22 of 27 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. An experienced registered manager was in post. This will contribute to the effective organisation and operation of the service. Extensive quality assurance systems were in place that should assist the manager and owners to measure the service against the expected outcomes. Evidence: The registered manager stated that she had 18 years experience in the provision of care and 9 years experience in management. She also advised that she had attained the Registered Manager Award equivalent to the NVQ level 4. Regarding Quality Assurance, the manager advised that the team leaders undertook some quality monitoring. We were shown evidence of a monitoring sheet, which had been completed by one of the team leaders. The sheet consisted of standards, a column, with Y (Yes) or N (No) to be completed, and a column for comments. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: The manager then monitored the sheets, which had been completed by the team leaders, and also undertook her own evaluation of the service. Monitoring records completed by the manager were observed by us. Regulation 26 documentations, which are a record of the registered persons monthly visits, were completed on a monthly basis, evidence of these were seen at the visit. Regulation 37 notices, which are documents that are sent to the Commission regarding untoward occurrences, including falls, accidents etc; have been received by the Commission. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 Care Homes for Adults (18-65 years) Page 26 of 27 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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