Care Home: Hurst Green Road

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What the care home does well People are given information about the home, before they move in so that they can decide whether they want to live there. Records that explain how people like and need to be cared for are well written and understood by the staff team so that people`s needs are met. The staff team have made a lot of effort to present information to people in formats that they understand. Medicines are well managed so that people receive their medication safely. People have lots of opportunities to make choices and decisions about their lives. The home is good at helping people stay in touch with friends and relatives so that people do not lose contact with those who are important to them. Staff have training to help them understand how to offer care to people and meet their needs. There is a good system of employing new staff so that people who live in the home do not have unsuitable staff working with them. People who live in the home said good things about the staff team and enjoy their company. We were told that staff are very good and brilliant. The home is being well managed so that people`s health and safety is protected. What has improved since the last inspection? This was the first inspection that the home have had since they became newly registered with the commission, however the service remains the same. What the care home could do better: Some information about people who live in the home is not kept securely so that individuals can be sure that their privacy is always respected. Agency staff work in the home on occasions. The information that the home receive about these staff members does not always include details of their training and qualifications so that it is evident that they have the right skills to work with people who live at Hurst Green Road. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hurst Green Road 9 Hurst Green Road Knowle Solihull West Midlands B93 8AE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Julie Preston     Date: 1 9 0 2 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: Hurst Green Road 9 Hurst Green Road Knowle Solihull West Midlands B93 8AE 01564776460 01564776460 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) : Solihull Care Trust care home 4 Number of places (if applicable): Under 65 Over 65 0 0 learning disability sensory impairment Additional conditions: 4 4 The maximum number of service users to be accommodated is 4. 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) 4 Sensory Impairment (SI) 4 Date of last inspection Brief description of the care home Hurst Green Road offers care, support and accommodation to up to four adults with a learning disability. Each person has their own bedroom. Shared space includes a kitchen with dining area, a spacious lounge and there are bathrooms on both floors of the home. Fees range from 870.24 to 1220.90 a week. People pay a contribution from their welfare benefit. Care Homes for Adults (18-65 years) Page 4 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: 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 visit to this home took place over one day. People who live there and the staff team did not know that we were coming. During our visit we case tracked two people. Case tracking means that we meet and talk to people and the staff that support them, look at records about their care, the way their medicines are looked after and look at the home they live in to make sure that it meets their needs. Case tracking helps us understand the experiences of people who live in the home. We also talked to the manager, the assistant house leader and other staff about the support they give to people and looked at records that explain how to help people stay Care Homes for Adults (18-65 years) Page 5 of 27 safe and well. We looked around the home to make sure that it was clean, warm and a pleasant place for people to live. Notifications that the home send us about events that may affect the well being of people who live there were also looked at as well as information about complaints. This helps us understand how people are being listened to and how their health and safety is protected. The home sent us their Annual Quality Assurance Assessment (AQAA). This contains information about the way that the home are meeting national minimum standards and the plans there are for improvements to the service for the benefit of the people who live there. The AQAA also provides us with statistical information about staff training, complaints and safeguarding. 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 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 Care Homes for Adults (18-65 years) Page 7 of 27 7535. Care Homes for Adults (18-65 years) Page 8 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 9 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to information about the services and facilities provided in the home and their needs are assessed before they move in, so that they can be confident the home is suitable for them. Evidence: The home has a statement of purpose and service user guide. These documents provide people with information about the services and facilities provided in the home. We were told that the service user guide is being updated by a Speech and Language Therapist and some of the staff team so that it is more accessible to people who do not read. Since our last visit in 2007, one new person has moved into Hurst Green Road. We looked at this persons records which showed that a full assessment of their needs had been completed before a place in the home was offered. It was evident from the records and from talking to staff that the person and their advocate had been fully involved in the move. Staff had spent time with the person in various settings to Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: assess their needs and to enable the person to get to know them. The records also showed that the person had visited the home on several occasions as part of their transition, to have meals and to meet the other people who live at Hurst Green Road. The persons placement at the home had been reviewed one month after they moved in to make sure that it continued to be suitable for his specific needs. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are effective systems of care planning and risk assessment in place, which should ensure that peoples needs are understood and met. People receive good support to make choices and decisions about their lifestyles. Evidence: We looked at care plans and risk assessments for two people who live in the home. These records give information about the type of support that people need to carry on with their day to day lives. The records were clearly written and explained how the person should be supported with regard to personal and health care, spiritual and cultural needs, communication, mobility, social and leisure needs and day to day living. There was evidence that the records had been reviewed on a regular basis so that they Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: remained relevant to peoples current needs. The two members of staff that we spoke to demonstrated knowledge of each persons individual needs, which indicates that care records had been read and understood. One record describe the need to make hourly checks on a person whilst they were sleeping. There was no written rationale for this practice and staff were unable to confirm that this was necessary for the person to promote their well being. From discussion with people who live in the home, staff and from observation of house meeting records it was evident that people have regular opportunities to make decisions and choices about their lifestyles. People had planned weekly activities, menus and taken part in domestic chores as part of their daily routines. This indicates that people are being involved in the running of their home and are making decisions about their lifestyles. Records about people who live in the home were kept securely with the exception of some personal records that had been pinned up in the kitchen. This means that the information could be read by anyone and had not been kept confidential. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home experience a meaningful lifestyle that promotes their independence and reflects their personal choices. Evidence: We looked at activity plans and daily records for two people to see if they had regular opportunities to do things that they enjoy. Each person had a record of the activities they like and those that they dont like. The daily records that we looked at showed that people take part in a range of activities both at home and in the local community, either in small groups or on their own, with the support of staff. Activities included going food and clothes shopping, meals out in pubs and restaurants, dance classes at a local community centre, cake making and trips out to places of interest. One person told us that they liked making Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: cakes at home and helping with the evening meal. Designated day care staff work during weekdays alongside the residential staff team so that there are more staff available to assist people to go out and do things they enjoy. Weekly planning meetings take place so that people are consulted about what they would like to do each day. We saw records which showed that each activity had been evaluated. Staff told us that this was useful to plan further activities for people who may not be able to express a preference due to their communication needs. One person showed us a total communication file, which had photos of him taking part in a range of tasks and activities. The person told us that the photographs helped him choose what he would like to do. The home are clearly making effort to present information to people in a way that enables them to make choices and decisions. The home supports people to keep in touch with their friends and families. Care plans that we looked at described how people should be supported to maintain this contact so that they do not lose relationships that are important to them. We looked at menus and the records of food that people eat to make sure that a varied and healthy diet is offered that meets peoples needs and preferences. People told us that they had a choice of meal each day and that they went shopping for food each week. The home has drawn up guidance to support people to plan their own menus and choose healthier options as part of a healthier lifestyle. We saw records which showed that people use photographs and Makaton signs to plan their weekly choices. This is reflective of peoples communication needs and enables them to make real choices about what to eat and drink. 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. There are effective systems in place to meet peoples personal and health care needs. Medicines are well managed so that people receive their medication in a planned and safe manner. Evidence: We looked at personal and health care records for two people. They contained clear information about peoples needs and had been recently reviewed to make sure that they were accurate and up to date. The records we looked at showed that people had regular appointments with healthcare staff and that the outcome of the contact had been recorded so that staff had up to date information about peoples health. Some people who live at the home have specific health care needs. The staff training records that we looked at showed that they had received training to assist them to meet the persons identified needs to promote his health and well being. Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: We looked at the way medicines are managed in the home to check that this was being done safely. Medicines had been securely stored and we were told that all medicines were checked by staff each week. This should ensure that errors are spotted quickly and investigated promptly. The assistant house leader told us that there had been no mistakes in handling medicines within the last twelve months. Staff records showed that they had received accredited training in the safe handling of medicines and had a competence based assessment every six months from a registered nurse. This should ensure that people receive their medication in a planned and safe manner. From looking at the medication records of two people it was evident that medicines had been given as prescribed. 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. There are effective procedures in place to listen to peoples complaints and safeguard them from possible harm. Evidence: The home had received one complaint since our last visit. The details of the complaint and the action taken to address it had been clearly recorded. We were told by people who live in the home that they knew who to speak to if they were not happy. One person said that the staff team would always listen to anything that they were unhappy about and do their best to sort it out. This indicates that the home are listening to people and taking appropriate steps to ensure that concerns and complaints are dealt with promptly. The home has a procedure for safeguarding vulnerable people and staff have received training in this area. The staff that we spoke to demonstrated effective knowledge of their role in safeguarding vulnerable people for their ongoing protection. There have been no safeguarding issues raised within the home since our last visit. 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. People live in a clean and comfortable home which is furnished and equipped to meet their needs and promote their independence. Evidence: Hurst Green Road is situated in the Knowle area of Solihull and looks no different to other properties locally. There is off road parking space at the front of the home and private gardens at the rear. We looked around the shared areas of the home, which include a kitchen with dining area and a spacious lounge. All of the rooms were clean, warm and well decorated. The bedrooms that we looked at were clean and comfortably furnished according to each persons taste. People told us that they were happy with their bedrooms and that they chose how their rooms looked. One person said that he had chosen new furniture for his bedroom and was pleased to have had his room redecorated. We were told that there is a maintenance programme for redecoration and refurbishment and that two bedrooms had been redecorated since our last visit. The home has an infection control policy and we saw that cleaning schedules were in Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: place to make sure that the environment remained hygienic. There were no unpleasant odours that may indicate poor cleansing routines. COSHH (Control of Substances Hazardous to Health) products were securely stored to reduce the risk of people coming into contact with substances that could harm them. 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. People are supported by a trained team of well established staff who have good understanding of their needs. The home operates a robust system of recruiting staff for the ongoing protection of the people who live there. Evidence: We asked people about the qualities of the staff who work with and were told that the team are very good, nice and brilliant. The staff that we spoke to this visit were knowledgeable about peoples needs and clearly know them well. The staff rota showed that up to five staff members are on duty each day to support the people who live in the home. A waking night staff is employed and there are on call systems in place so that lone workers have access to senior staff for advice in the event that this is needed. The staff that we spoke to felt that current levels met the needs of people living at Hurst Green Road. There have been no new staff appointed since our last visit in 2007 when we looked at the homes procedures for checking that new staff were suitable to work with Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: vulnerable adults. Solihull Care Trust has a policy for the recruitment and selection of staff which is unchanged since our last visit and was judged to be good at that time. We were told that the home employs some regular agency staff to cover shifts. Solihull Care Trust take responsibility for checking the suitability of this group of staff before they begin work in the home, however information about agency staff members training and qualifications had not been made available to the manager so that he could determine that they had the necessary knowledge and experience to work with adults with a learning disability. Solihull Care Trust operates a rolling programme of staff training so that the staff team have regular training updates to assist them to meet the needs of people who live in the home more effectively. The Annual Quality Assurance Assessment (AQAA) that we received stated that more than half of the staff team had completed or were working toward National Vocational Qualifications in care. This should contribute to the deployment of a well trained team of staff for the benefit of people who live in the home. 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. The home is being well managed and peoples health and safety is promoted and protected. People are confident that their views and opinions are listened to and respected by the staff team. Evidence: The home has a new manager who is due to submit an application for registration to the commission. This person has eleven years experience in social care and is a registered learning disabilities nurse. In the managers absence the home is run by an assistant house leader, who is also a registered learning disabilities nurse. Both the manager and house leader were present at this visit and were able to answer our questions confidently, demonstrating a commitment to continuing to improve outcomes for people who live at Hurst Green Road. There are systems in place to review the quality of care and service provided within Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: the home. We saw that care plans and risk assessments had been reviewed on a regular basis and health and safety checks had been made. The home completed a quality assurance audit in November 2008 at the request of commissioners within Solihull Care Trust. This meant that the home had to evidence how they were meeting national minimum standards. The home had not received feedback from the audit at the time of our visit. We were shown copies of reports made by a representative of the Care Trust (called Regulation 26 reports) that commented on the standard of care provided in the home. The most recent report stated that there were no issues that needed to be addressed for the well being of people living at Hurst Green Road. A number of checks are made to make sure that peoples health and well being is protected. We looked at some records that show this has happened. The fire alarm system had been tested and serviced on a regular basis to make sure that it was working properly. People had taken part in fire drills so that they had opportunities to practise leaving the building in the event of an emergency. We saw evidence that regular health and safety checks are completed, which are reported to the registered provider should concerns arise. Training records showed that all staff have taken part in health and safety training. This should contribute towards promoting peoples health and safety. 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 1 6 Observations of people during the night should only take place in accordance with their assessed needs to make sure that they do not experience unnecessary disruption whilst sleeping. Information about people who live in the home should be securely stored to make sure that it remains confidential and accessible only to those who need to read it. Consideration should be given to gathering information about the qualifications and training of agency staff employed to work in the home so that it is clear that those staff have the required skills to work with adults with learning disabilities. 2 10 3 34 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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. 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