Care Home: Inglewood Rest Home

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What the care home does well The staff team were seen to be knowledgeable regarding the personal and emotional needs of the people using the service. We saw that staff were warm in their approach and they respected their privacy and dignity by asking if the person wanted support. Since our last inspection the people have been empowered by the provider/manager and staff to be more independent in their lifestyles. More people now take responsibility for their finances. A small number of people using the service are supported and encouraged to go into the community independently. Arrangements were in place for the continued health care needs of the people at the service. This was evidenced during the inspection when a general practitioner visited upon request. Her comments to us were positive she `felt people were safe and well cared for`. The service continues to further recognise the needs of people at the service, the new format of the care plans were detailed, informative and well presented. The service provided an exemplary Quality Assurance Assessment system ensuring that the care and training provided ensured that the needs of people using the service were being met in a manner to suit individuals. What has improved since the last inspection? The service has reviewed and developed a new format for the care plans. The provider has been approved as the registered care manager. The provider has developed her skills further with meetings with Walsall council to explore the funding arrangements. This knowledge can be used and passed to any person or families enquiring about a placement. Training is seen as a priority to provide a good service staff need to have the option to develop their skills. senior team leaders were taking the National Vocational Qualification (NVQ) level 4, others were enrolled on a `Team leadership` course. This will further enhance their skills. What the care home could do better: This report made only one recommendation to ensure the seam in the lounge carpet did not prove a hazard. Key inspection report Care homes for older people Name: Address: Inglewood Rest Home 11 Banks Street Willenhall West Midlands WV13 1SP     The quality rating for this care home is:   three star excellent 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: Wendy Grainger     Date: 1 9 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 Older People Page 2 of 24 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 Older People 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 Older People Page 3 of 24 Information about the care home Name of care home: Address: Inglewood Rest Home 11 Banks Street Willenhall West Midlands WV13 1SP 01902631099 01902631099 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Inglewood Residential Home Ltd Name of registered manager (if applicable) Mrs Davinder Kaur Type of registration: Number of places registered: care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 20. The registered person may provide personal care and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category (OP) 20 Date of last inspection Brief description of the care home Inglewood is a care home providing personal care and accommodation for 20 older people. It is situated in close proximity to Willenhall Town Centre, a bus route, and the local park. The home has a small garden to the front and rear of the property. The home has two lounges, one overlooking the rear of the home. The dining room is central to the building. From the information provided at the time of the inspection the current fees were £338.98- £350 the service does not have top up fees. The reader Care Homes for Older People Page 4 of 24 Over 65 20 0 Brief description of the care home may wish to contact the service for up to date information for the current fees. Care Homes for Older People Page 5 of 24 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was carried out by one inspector who used the National Minimum Standards for Older People, the outcomes for people using the service, completed Have your say surveys from relatives, staff and people using the service as a basis for the inspection. Prior to the inspection we had sent out to the service an Annual Quality Assurance Assessment (AQAA). This is a self assessment tool it had been completed and returned to us within the timescale. The completion of the AQAA is a legal requirement and it enables the service to undertake a self-assessment, which focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service.We had received completed Have your say surveys this is a survey to obtain an overall view of peoples experience living at the service, relatives, and other professionals. Care Homes for Older People Page 6 of 24 We were welcomed into the service by one of the people who use it, we were asked to sign the visitors book while the staff were busy. We saw night staff who gave a detailed hand over to the day staff. This enables information about the people using the service to be shared. The provider is also the registered manager for the service. Prior to her attending the service we were provided with the Statement of Purpose, service users guide, completed surveys by relatives, professionals who visit the service, people using the service and the complaints process. On arrival we had the opportunity to speak to the night staff, who confirmed their training and experience. We had the opportunity to speak to people when they came into the communal areas, we observed breakfast being served this was prepared by the catering staff based on the choice of individuals. Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Older People Page 8 of 24 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 24 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 24 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. People would not be admitted to the service without a full assessment of their personal and emotional needs, ensuring that their needs can be met. Evidence: Inglewood is registered to offer care and support to twenty older people, The care manager is also the provider, she has the experience and qualifications to assess prospective people prior to admission. The Statement of Purpose, Service Users Guide, surveys completed in 2009 by people using the service, stakeholders, families and professionals were readily available to any person entering the service. The recently redesigned brochure was a good representation of the service, being colourful and clearly laid out and easy for people to handle. We evidenced the service users guide and complaints process in peoples bedrooms. We were told by one person that she had been assessed in hospital before she came to the home. I was asked if I wanted to come to see the home on a visit but I did not, I am happy here its good. Following an assessment if it was felt that the Care Homes for Older People Page 11 of 24 Evidence: pacement would not be suitable the provider has a list of homes in the area that families may wish to contact. The manager has had meetings with other professionals to further her knowledge on the funding process to enable her to provide information to families. We sent surveys to the people using the service these are Have your say about the service received comments included Since I have been here its the happiest I have ever been, Ive come somewhere where I can rest and enjoy myself for the rest of my life, I am glad I came here I can go out if I want to. Care Homes for Older People Page 12 of 24 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements were in place for the continued health, personal care and emotional needs of the people. The well audited medication system ensured that people were protected. Evidence: The completed AQAA told us that the service had a new format for the care plans. The new care plan formats we saw were exceptional in their content including risk assessments, health needs, including medication and medication reviews, moving and handling, and personal likes and dislikes. The plans were reviewed on a monthly basis by a staff member not allocated as the persons key worker. This provides a fresh out look to ensure that needs are being met. We identified that within the two care plans tracked that the people and their families had been involved in the discussions about the plan. The care provided recognised peoples choice and dignity, privacy was seen to be respected, people told us that they did not object to a male carer He is very good to me, He is so nice and I can ask him to do things. Arrangements were in place for the continued health care of individuals. We observed Care Homes for Older People Page 13 of 24 Evidence: a general practitioner at the service she told us that she did not mind signing the medication record to identify a change She felt safe and that everything was satisfactory and the people were well cared for. We evidenced in records where one person had attended her general practitioner independently. We observed the medication procedure for the morning drugs administration, the system used gave us no cause for concerns. From the discussions and records we saw that medication was audited three times a month, the senior team leader and provider take the responsibility for auditing. Night staff spoken with confirmed the training records that they had received training for the safe handling of medication, although it was rarely part of the night care provided. If pain medication was requested they would seek advice from the person on call before administering. During the day we observed the staff to be friendly, observant of needs required, sensitive to dignity, the morning staff and the afternoon shift each had the role of stimulating people. People responded to the staff and we were told by one person that she had won at Bingo, this was the choice of the people this morning. The Have your say surveys returned by the people and the relatives told us that My carer is very good, I know that if I need help someone is available 24 hours, I am looked after well, Each person is treated as an individual the ethos of Inglewood is that it is their home the standard of care is good, The staff are very welcoming and friendly, The manager is very approachable she listens and reacts to any concerns or requests. Care Homes for Older People Page 14 of 24 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by the flexible relaxed provision of activities. The routines are based on choice and meals provided are appropriate to meet the peoples needs. Evidence: The completed AQAA told us that since the previous inspection the service had invested in new games and an alternative improved activity programme. The service we saw has a proposed activity plan for the morning and afternoons. The programme is based on the choice of the people, as was evidenced during the morning session, which would have been a film and quiz but the people chose Bingo. One person told us that she had been a winner and showed us the prize of chocolate. During the afternoon we saw staff and people enjoying a Karaoke session we had been told by one person in the morning that this was her favourite activity. The service had a Christian Fellowship visit the service on a three monthly basis, on a weekly basis people told me that they can go to the local Salvation Army for a chat and refreshments, transport if needed was arranged. We were told by a number of people about the barge trip arranged for the following day, each person was looking forward to it and the lunch at a pub. One person told us that she was on the waiting list but would go next month when it is arranged again. One comment recorded in the Have your say survey was that was it possible to have Care Homes for Older People Page 15 of 24 Evidence: more evening events and outings. We saw the menus for the week and month, they demonstrated a daily choice for people. We saw an entry of a Try something new day, this is perhaps a meal different to the person culture for example mild curry if successful it would be incorporated into the four weekly menu. People told us that they had the choice of a full English breakfast, bacon sandwich,or cereal and toast or porridge. This was confirmed when speaking to people after breakfast. The catering staff have NVQ qualifications and a nutritional qualification certificate. The catering staff carry out a kitchen audit, which includes a fortnightly dining room audit. This audit is undertaken to ensure that people have a clear access and sufficient room in the dining room. Changes can however be made if mobility difficulties are observed before the audit. Care Homes for Older People Page 16 of 24 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 using the service were protected by robust policies, staff training and awareness. People were made aware of the complaints process and had access to it. Evidence: The completed AQAA told us that the service has an open culture for people using the service to raise any concerns or a complaint. Each of the people have been given a copy of the complaints process, which is kept in their bedrooms. This was evidenced when looking around the service, and confirmed by people when discussing issues in general. The Have your say surveys from relatives and people confirmed that each one was aware of the process, which is displayed in the entrance and documents. A staff member told us that they were aware of the process and felt that the people were protected from any form of abuse by the training received and committed staff team. Staff records identified that an Abuse-Protection of Vulnerable Adults (POVA) refresher training was undertaken in March 2009. The team leaders and the provider had attended a more detailed training course. Care Homes for Older People Page 17 of 24 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, 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. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides a clean, fresh and homely environment for the people living there. Evidence: The completed AQAA we received told us that the service had been decorated in parts since the last inspection. The dining room and lounge carpet had been changed to match the blue dining room chairs. The maintenance person had on his record to ensure the seam in the lounge carpet is secured. The seam without attention could be a potential hazard to people and staff. During the inspection decorating of the corridor was taking place. Warning signs were in place for the people using the corridor. Bedrooms were personalise to suit individual peoples taste with memorabilia, photos and furniture. The provider to protect the people will obtain plastic covers for the bath hoists seats. The service was not ultra modern it was however homely and a credit to the housekeeping staff who maintained a fresh clean environment for the people using the service. Care Homes for Older People Page 18 of 24 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. 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. A well trained and constant staff team support the people using the service. Evidence: The staffing levels were satisfactory to meet the needs of the people using the service. The service has a good staff retention this provides consistency for the people who require support. The service has robust recruitment procedures. no person was employed without the relevant checks such as a Criminal Records Bureau (CRB) Protection of Vulnerable Adults (POVA) two references, application form, identification. The majority of the staff had achieved the National Vocational Qualification (NVQ) level 2. Eleven of the staff have NVQ level 3, two of the team leaders are completing NVQ level 4. Three of the team leaders are enrolled on NVQ in Team leading to further enhance their knowledge and experience in their role. Records we saw identified that all the staff had been on the mandatory training required during 2009, this included the Mental Capacity Act and Deprivation of Liberties. All the staff have recently undertaken fire safety training including the use of a fire extinguisher. Staff training protects and provides an understanding to the needs of the people using the service. In house surveys seen told us that My relative is happier than she has ever been , this is a comfort as we live so far away. I have been to the home and worked with the staff for training, staff have a professional and caring approach towards the people. Care Homes for Older People Page 19 of 24 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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 using the service are cared for by a well managed staff team and supported by an experienced qualified manager. The service is operated to the best interest of the people. Evidence: Inglewood provides care and support to twenty older people, there is a well trained and supported staff team with an experienced and qualified manager- provider. Recently registered as the manager the provider has achieved NVQ level 4 and the the Registered Managers Award. She also undertakes all the training provided to her staff team; plus other training that ensures she has the appropriate knowledge to assist families with funding arrangements. We were provided with an impressive audit system used at various times over a week, month or bi-monthly. We evidenced supervision session recorded. We spoke to staff who confirmed that supervisions were useful but the manager had an open door policy that they could use if necessary. Comments in the stakeholders surveys told us The standards and quality Care Homes for Older People Page 20 of 24 Evidence: of care delivered to all the people who live at the home are exemplary, the care is always consistent well done to all the staff, I have always been happy with the service from Inglewood any instructions left at the visit are followed up. The fire records were current, the service has a contingency in place in the event of an emergency and evacuation. Records provided evidence for up to date servicing of equipment used in the service. We checked at random a small selection of the funds held on behalf on individuals. The records and monies were accurate. We were provided with a comprehensive, detailed AQAA, we used this document as part of the inspection and found it to be accurate. The service had exceptional audits in place for the entire service, staff, risk assessments and assessments. We evidenced the interaction between her and the people at the service, who use as everyday a shorter version of her first name. The manager has a very relaxed style of management, staff demonstrated demonstrated during the inspection, respect for her, skills and management style. The manager has developed over a period of time as provider and manager a robust recruitment process. The service has a good staff retention this provides consistency for the people who require support. The service has robust recruitment procedures. No person was employed without the relevant checks such as a Criminal Records Bureau (CRB) Protection of Vulnerable Adults (POVA) . The staff spoken to were very aware of the need to safe guard all the people from any form of abuse via the training they had received, and supervisions session with the manager. We were told by staff both day and night staff and that they would not hesitate to raise a concern. A number of the staff have been at the service for a number of years, this demonstrates their commitment to the people they care for. Care Homes for Older People Page 21 of 24 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 Older People Page 22 of 24 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 19 To ensure the safety of the people, visitors and staff the seam in the lounge carpet will need attention. Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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