Care Home: Intelligent Care

What the care home does well Residents said that staff treated them politely, were supportive and friendly and that their privacy and dignity was respected. They also said said the quality of care and support provided was good and that staff supported them to lead as independent a life as they can. Regular checks (audits) were carried out by the registered manager to ensure an adequate quality of service is provided to residents. The home was being effectively managed. What has improved since the last inspection? The home now has a registered manager. The manager has addressed the requirements made at the last inspection in October 2008. For example areas such as staff training and how residents medicines are stored have improved. Such changes has resulted in improvements to the care and support that is provided to residents. The environment of the home has continued to be maintained to a good standard. What the care home could do better: To maximise the protection of residents at the home it is required that as part of the evidence of proof of staff identity a recent photograph of each member of staff is kept at the home. The registered manager has identified the need to develop an increasingly person centred approach to care planning and care records. He had developed and hoped to shortly introduce a new format for care plans, risk assessments and care records generally. The AQAA document referred to above also identifies ways how the manager and his staff seek to improve the quality of the service provided to residents at the home. Key inspection report Care homes for adults (18-65 years) Name: Address: Intelligent Care 102 Park Road Bolton Lancashire BL1 4RQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Michael Murphy     Date: 2 4 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: Intelligent Care 102 Park Road Bolton Lancashire BL1 4RQ 01204386186 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Jamil Mohammed,Miss Nusat Khan Name of registered manager (if applicable) Mr Jamil Mohammed Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following categories of service only. Care home only - code PC, To people of the following gender:- Either Whose primary care needs on admission to the home are within the following categories: - Mental disorder, excluding learning disability or dementia - Code MD The maximum number of people who can be accommodated is: 6 Date of last inspection Brief description of the care home Intelligent Care is a privately owned organisation that provides residential services in a care home called Queens Park View that is situated in a residential area of Bolton close to Bolton School. Queens Park View is a large three-storey Victorian style property with mature gardens to the front and back. The front of the property overlooks Queens Park which is a very popular landmark of Bolton with the home being located near to the town centre in a quiet residential road set back in an elevated position. Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 6 3 0 1 0 2 0 0 8 Brief description of the care home The building has been fully refurbished with a large lounge, a further lounge/dining room and a kitchen. There are six bedrooms, two of which have en-suite facilities. The other bedrooms have washbasins with vanity units and all bedrooms have TV points. Toilets and showers are available on the ground and first floors. There is limited car parking to the front of the home and on street parking is also available. The Statement of Purpose says that the aim of Intelligent Care is to provide client centred rehabilitative care for people between 18 and 65 years of age who have mental health problems with the intention of enabling them to live independently or semi independently within the community. The home is currently registered for male and female service users. A Service User Guide, Statement of Purpose and a leaflet style brochure that describe the homes services is available in the home and the provider gives other information Care Homes for Adults (18-65 years) Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection included an unannounced visit to the home on the 24th of September 2009. During the visit we talked to residents, staff and the registered home manager. We also looked at documents and records the home have to keep such as residents care records, medicine records, written policies and other records. Before the inspection, we also asked the home manager to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home sees the service they provide the same way that we see the service. We felt this form had been completed in sufficient detail and provided useful information. Care Homes for Adults (18-65 years) Page 6 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 25 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Existing residents living at the home had only been admitted following a full assessment of their care and support needs. This was important to ensure the home was suitable for them. Evidence: There had been one admission to the home since the last key inspection in October 2008. This person had a detailed pre-admission assessment completed by the registered manager. All residents who had been admitted to the home had been appropriately assessed prior to admission to the home. Specifically before residents were admitted to the home an assessment of their needs was carried out in consultation with the resident and their relatives by relevant health and social care professionals such as doctors (including psychiatrists, other mental health care workers and social workers). The reason for such an assessment was to help the prospective resident decide how appropriate living at the home would be and enable the person carrying out the assessment to determine if the home would be able to meet the prospective residents needs appropriately. The initial assessment helped to form the plan of care to be Care Homes for Adults (18-65 years) Page 9 of 25 Evidence: followed after admission to the home. The six residents care records inspected at the last inspection contained detailed pre-admission assessments. Residents spoken to said they were actively supported by their care managers in the pre-admission process and that their views were important in the process. Trial visits to the home were regarded as an important part of the pre-admission process and enabled prospective residents to meet residents and staff at the home before a choice is made about entering the home more permanently. Care Homes for Adults (18-65 years) Page 10 of 25 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The choices and needs of individual residents are recognized and staff take appropriate action to support and help residents to lead as independent a life as possible. Evidence: The care records of two of the five residents were inspected on this occasion. The records included care plans and risk assessments that described their care and support needs and how staff needed to provide assistance and support to enable them to lead as independent and full-filling a life as possible. Care records were well organized and contained all the information required to support residents properly. Discussion with the registered manager revealed that the way care plans are developed was in the process of review to make them even more person centered than they currently are. Detailed daily progress notes in respect of residents continue to be made and were dated, timed and signed. Residents told us that staff supported them to lead as independent a life as they can and treat them with decency and respect. Discussion with staff reflected that they are enabled to support residents both Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: within the home and in the wider community. Staff were seen to interact well with residents and clearly enjoyed good relationships with them. Residents continue to access community services - particularly the support and activities available from two local community mental health organizations and information about how to contact advocacy services for people with mental health needs was displayed in the home. Residents are encouraged to manage their own money and finances. Some are directly supported with this by the authority involved in their placement at the home. We were informed by the registered manager that at the time of this inspection the personal allowances of only three residents were being managed at the home. The arrangements for these people appeared to be secure and appropriate and also to have been examined by this residents care manager when their placement is reviewed. The registered manager informed us that no extra charges are made of residents in relation to their care and accommodation at the home. It is noted that the placement of each resident continues to be subject to regular review by the relevant placing authority. Care Homes for Adults (18-65 years) Page 12 of 25 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were being supported and encouraged to participate in the life of the local community, pursue leisure activities and live as independent a life as possible. Evidence: Residents told us that they were supported by staff to make decisions and exercise choice in their daily lives. They were able to go out on their own and with staff and the staffing arrangements ensured that staff could support residents appropriately in the community. This enabled residents to participate in leisure activities and access the local community in general. Residents continue to be supported to have their own visitors at the home. The routines of daily life at the home were flexible and housekeeping tasks are equally shared by residents and staff - the emphasis being on the rehabilitaion benefit for residents of being involved in these aspects of life at the home. The kitchen and dining area were clean, suitably furnished and appropriately Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: equipped. Because there is a maximum of six residents at the home mealtimes are able to be very flexible. Menus were varied, balanced and provided a wide change of choice. Residents spoken to said they were encouraged to participate in the preparation of meals and staff encouraged each resident to cook at least one meal per week. Again this was seen as an important part of the rehabilitaion of residents. Fresh fruit was seen to be freely available and staff encourage residents to eat a healthy diet. Food stocks were good and residents and staff do the food shop locally. Suitable arrangements were in place to respect cultural food preferences residents may have. The registered manager told us that no supplemental charges are made in respect of food provision to residents. Care Homes for Adults (18-65 years) Page 14 of 25 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Proper arrangements were in place to ensure the personal health care support provided to residents is consistent and appropriate. This is important to ensure residents are confident they will be cared for and supported appropriately. Evidence: Residents said that staff treated them politely, were supportive and friendly and that their privacy and dignity was respected. Daily life was was said to be homely and the routines were flexible. Housekeeping tasks are equally shared by residents and staff the emphasis being on the rehabilitaion benefit for residents of being involved in these aspects of life at the home. Residents have full access to the lounge and dining/kitchen areas. Staffing arrangements enable residents to be helped to engage in activities outside the home. Staff continue to support residents with their personal hygiene needs and evidence of this is written in their care records. All residents were registered with a local GP and continue to be assisted to access specialist mental health services, chiropody, optical and other relevant health and social services. Each of the residents has a care manager who has been appointed by the placing authority to support them and periodically review their placement at the home. We also looked at how residents medicines were handled by the home. We looked at Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: the levels of medicines in the home, medicines records and spoke to the registered manager and staff about how residents are helped with their medicines. The way medicines are recorded has improved, was well organised and being managed properly. There is a proper process in place that records what medicines come in to the home, when and how they are administered and what happens to medicines no longer needed. Medicines administration records are printed and supplied by the chemist and had been completed appropriately by staff helping residents with their medicines. All these demonstrate that residents medicines are handled safely and appropriately. One resident was looking after their own medicines to some extent and had been risk assessed. This had been recorded in their care records. All staff have been provided with training in supporting residents with their medication needs since the last inspection. A system to regularly check (audit) medicines within the home was in place. Medication policies and procedures were being used and include a homely remedies policy. Storage of medicines was secure and appropriate. Care Homes for Adults (18-65 years) Page 16 of 25 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is an accessible and clear procedure in place to deal with complaints. Staff have been provided with recent safeguarding training and there are procedures in place that describe how to protect residents and keep them safe. Evidence: Residents were aware of how to make a complaint if they needed to do so. All residents are also regularly reviewed by their care manager so residents can raise issues this way as well. We were informed no complaints had been received by the home since the last inspection in October 2008. Discussion with residents and staff indicate that any issues that arise in the daily life of the home are dealt with promptly and do not need to become formal complaints. Staff said they are aware of the importance of residents feeling safe and the importance of safeguarding them from being abused. The home has a safeguarding policy and also has a copy of the Bolton inter-agency safeguarding policy. The home has accessed Boltons local authority safeguarding training for all staff. The recruitment process operated by the home ensures proper checks are made when employing staff. This is to help ensure that potentially vulnerable residents are being cared for and supported by suitable people. In relation to the Mental Capacity Act the registered manager informed us that no people living at the home were suject to a deprivation of liberty authorisation and that no one living at the home was having their liberty deprived without authorisation. Care Homes for Adults (18-65 years) Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides residents with a suitable and homely environment that is maintained to a good standard. Evidence: The home provides a clean, warm, homely and comfortable environment for residents. The home was very clean and there were no bad odours. The home was comfortably and suitably furnished throughout and the standard of decoration was good. Each resident has their own bedroom. Two bedrooms were inspected on this occasion and these were found to be clean, warm, suitably ventilated, comfortably/appropriately furnished and personalised. Residents spoken to expressed their satisfaction in respect of their rooms and say staff respect their privacy. WC and shower rooms were clean, suitably equipped and provided privacy. The lounge was comfortable and accessible to residents. Residents can access the internet via the computer in this room. Residents who wish to smoke are permitted to do so in the patio area to the rear of the home. Care Homes for Adults (18-65 years) Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Suitable and appropriate numbers of staff were provided to meet the care and support needs of residents. Staff had been appropriately recruited and trained. This is important so that residents are confident that the staff supporting them are competent and suitable to do so. Evidence: Inspection of staffing records and discussion with residents, staff and the registered manager demonstrated that residents were being effectively supported and being kept safe at the home. Staff spoken to demonstrated good understanding and knowledge about the care and support needs of their residents. All staff have obtained a nationally recognised qualification in care and a number were in the process of obtaining a higher qualification.There has also been an improvement in the way other staff training is provided. Such training is provided at the home and increasingly through training provided by the local authority training partnership. This includes induction training for newly appointed staff. Documentary evidence was seen that indicated staff had been provided with recent training in moving and handling techniques, fire safety, managing residents medicines, mental health issues and other relevant topics. There was in the main a proper process in place in respect of recruiting staff. This is important to ensure residents are being cared for and supported by suitable people. Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: The recruitment process included making police checks and another check regarding the suitability of the applicant working with vulnerable people. However it is required that an up to date photograph is kept of all people working at the home. This is to ensure the homes recruitment process protects residents as much as possible. Care Homes for Adults (18-65 years) Page 20 of 25 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was being managed in a way that seeks to ensure residents are confident they are cared for and supported properly and safely in a home that is well run. Evidence: One of the owners of the home has become the regsitered manager since the last inspection in October 2008 and has obtained a nationally recognised qualification in management and care. He has also undertaken a range of training and development relevant to his role since becoming manager. Regular checks (audits) were carried out by the registered manager to ensure an adequate quality of service is provided to residents. For example checks were regularly being made to establish the quality of food provided to residents, their care records, the environment of the home and how well their medicines were being managed. Regular meetings were also held between residents and staff when aspects of life at the home is discussed and any actions needed to address them agreed. The registered manager was also periodically seeking the views of residents care managers and other health/social workers who visit the home. Their responses were considered and if neccessary acted upon by the registered manager. Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: The registered manager was also taking steps to protect the health, safety and welfare of residents, staff and visitors to the home. Staff had been trained in moving and handling techniques and have been provided with training in fire safety, first aid, food hygiene, control of infection and other relevant topics. Regular checks had been conducted on gas and electrical systems within the home. Care Homes for Adults (18-65 years) Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 34 19 That as part of the evidence 31/10/2009 of proof of staff identity a recent photograph of each member of staff is kept at the home. To ensure the homes recruitment process protects residents as much as possible. 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 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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