Care Home: Mclaren House

What the care home does well This home provides a clean, homely and well maintained environment, where people`s own rooms are personal and individual. There are good, detailed plans to show staff how each person needs to be supported. People are involved in deciding how they want to be supported and they are encouraged to be as independent as possible. There are good arrangements for making sure that people are kept safe. There is a stable team of well trained staff who support people to live their lives in the way they prefer. People are encouraged to develop their skills and to have new experiences. What has improved since the last inspection? There are new, more detailed care plans and service user guides. There are more frequent activities for the people in the home. There are improved menus which include healthier choices. Staff have received more training and more staff have achieved NVQ level 3. The adult abuse protection policy and complaints procedure have been updated so that people are better protected. Some areas of the house have been refurbished so that the high standards have been maintained. The home has received a gold award for food hygiene. What the care home could do better: The manager needs to make sure that she continues to implement and develop the quality assurance system so that the home continues to improve. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Mclaren House 93 Bratt Street West Bromwich West Midlands B70 8SH     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: Christine Lancashire     Date: 2 8 0 4 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 28 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 28 Information about the care home Name of care home: Address: Mclaren House 93 Bratt Street West Bromwich West Midlands B70 8SH 01215005430 F/P01215005430 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) : Mrs Paulette Shirley care home 9 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 9 The maximum number of service users who can be accommodated is: 9 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: Mental disorder, excluding learning disability or dementia (MD) 9 Date of last inspection Brief description of the care home McLaren House is registered to provide residential care for 9 people aged between 18 and 65 who have mental health needs. The aim of the home is to provide a rehabilitation service to enable its users to return to living independently in the community. There are however no set limits and this may be over a long period of time. The home is a three storey mid-terraced property situated close to West Bromwich town centre with easy access to all local amenities and transport networks. There is parking space for two cars at the front of the property and gardens at the rear. Accommodation is provided over three floors. On the ground floor there is an office, Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home staff toilet, one single bedroom, lounge, dining room, conservatory (smoking room), kitchen, laundry and toilet with a shower. On the first floor there are four single bedrooms and a bathroom with toilet. The second floor has two double bedrooms both with en-suite toilet and shower facilities. The fees for this service are available on application to the home. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We carried out this inspection in order to check that the home had met the requirements of the last report. We also measured the performance of the home against the key National Minimum Standards. We arrived at this home on a weekday morning without telling anyone that we would be visiting that day. We toured the building and some of the people living there invited us to see their rooms. We talked to people who live in the home, to staff, the manager and the owner. We looked at information provided to us by the manager before the inspection and we examined a sample of records about the people in the home, the staff, health and safety and quality monitoring. We checked the arrangements and records relating to the administration of medication. We used our findings to write this report. Care Homes for Adults (18-65 years) Page 6 of 28 Care Homes for Adults (18-65 years) Page 7 of 28 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 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and aspirations are fully assessed prior to coming to this home. Evidence: We saw that the Statement of Purpose and service user guide to the home have been updated so that they reflect the current conditions at the home. They provide useful information about the home for people considering moving in and their relatives. There have been no admissions since the last report. The manager told us that, should there be any referrals, she would go out to visit the person concerned and carry out an assessment. She would take into account relevant assessments and comments from other professionals and would consider the needs of the other people in the home. If there was a possibility that the person may be admitted, they would be invited to visit. We looked at a sample of two files, including that of the last person to be admitted. We saw that they contained the necessary assessments before the person was admitted and copies of letters offering a place and saying that the home would be able to meet their needs. The information from the assessments was used to form the basis Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: of the care plans which help staff to know what support to provide to each person. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and personal goals are reflected in their care plans. They are encouraged to participate in decisions about their lives and are supported to take risks as part of an independent lifestyle. Evidence: We looked at three sampled files and found that care plans have been developed using the information gained through the assessments. These provide staff with clear information about how to support individuals. The plans contain evidence that people have been consulted when changes have been made. They also show that peoples capacity to make decisions has been taken into account and efforts have been made to make sure that people have been involved in making decisions where possible. The manager is in the process of updating the plans and these have nearly been completed. The manager told us that plans are reviewed on a regular basis and the Staff provide people with choices about their lives and decisions are recorded in files. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: There are written agreements about various aspects of peoples lives such as the management of their money and medication and the admission of certain visitors. People have signed to indicate whether or not they want support from staff in these areas. We saw risk assessments on files and these show how people are supported to take reasonable risks so that their ability to have new experiences is not restricted unnecessarily. There are records of the measures taken in various circumstances, such as when there are trips outside the home, to minimise the risks to each person. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to take part in appropriate activities and to maintain links in the local community. They have appropriate relationships and their rights are respected. They are supported to have a healthy diet and enjoy their mealtimes. Evidence: We sampled the files and found that people are supported to live as full a life as possible. People attend day centres where they have the opportunity to develop skills and undertake a range of activities. One person has achieved an NVQ and does voluntary work. Other people enjoy arts and crafts in the home, day trips to places on interest such as the Black Country Museum and meals in pubs. There are annual holidays. People who live in the home are involved in making decisions about how they want to spend their time. Their choice to relax is respected. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: People are encouraged to maintain friendships and relationships with family members and other people in the community. The files contain details of people who are important to each person and the manager explained how people are supported to have visitors. Staff support people to be as independent as possible, whilst remaining safe. People cook for themselves on arranged days each week and they also shop for their own food. There are also meals which are prepared by staff. We looked at the menus and they showed a variety of meals. People usually have a choice of two main meals, but alternatives are prepared if they prefer not to eat what is on the menu. The manager told us that people are encouraged to maintain a healthy weight through healthy eating. However, their choices are respected. The kitchen was clean on the day of the inspection and the home has received a gold award for good food hygiene from Sandwell environmental services. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal support in the way they prefer and require so that their physical and emotional needs are met. They are supported to retain and administer their own medication where appropriate and protected by the homes practices in dealing with medicines. Evidence: We saw records in the daily notes which show that staff provide personal care when needed and prompt people who do not need physical assistance in this area. Staff know peoples preferences and how they like to be supported. People are supported to choose their own clothes and style of presentation and their cultural and religious preferences are respected. We sampled three files and found that they contained details of peoples physical and mental health diagnoses and the implications for their daily lives. We saw records of involvement with various health professionals. There are clear instructions for staff about the action to take and who to contact should a person display specific symptoms. The plans also demonstrate that the staff encourage people to maintain a healthy lifestyle. For example, there are agreements with some people in the home so that staff can look after cigarettes for them and help them to cut down Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: the number they smoke. The manager told us that she has amended and improved the medication procedures so that people are better protected because staff make a careful check to make sure that the medication which has been supplied to the home is exactly as prescribed. There are suitable arrangements for the storage of medication and most people are supported to administer their own items under staff supervision where a risk assessment has shown that this is a safe arrangement. We saw records which show that staff are trained to administer medication and the records are appropriately completed. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home has systems to ensure that the views of the people who live there are listened to and acted upon, and to make sure that people are well protected. Evidence: There is complaints procedure and details of how to complain are included in the Statement of Purpose and service user guide. All people in the home and their representatives are provided with copies of these. Details are also displayed in the communal area of the home. People in the home are also reminded at regular intervals about how to make a complaint. The records show that there have been no recent formal complaints. Minor complaints are recorded in peoples notes and the action taken is made clear. The manager explained the history of one safeguarding referral which they made due to considering someone to be vulnerable to abuse from a third party. Appropriate action has been taken and there are good records. There are procedures for protecting people from abuse and whistleblowing and we saw that staff have been trained in this area. We saw a folder which contains the relevant information for staff so that they know what action to take should they suspect that someone is being abused. No complaints have been made to CSCI recently and there have been no safeguarding referrals in respect of care at the home. Care Homes for Adults (18-65 years) Page 18 of 28 Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people at this home live in a homely, clean, safe and comfortable environment which is well maintained and where there are good arrangements for infection control. Evidence: We toured the building and found that there was a homely atmosphere. All areas were very clean and there were no unpleasant odours. There is a full time cleaner to make sure that standards are maintained. People who live in the home are encouraged to keep their rooms tidy. The home is well maintained throughout. There is a maintenance worker who carries out minor repairs and decoration and contractors are used for larger and more specialist tasks. The manager told us that many areas have recently been refurbished. Some people showed us their bedrooms. These were individual in style and contained many personal items, including artwork and photographs. There are five single rooms with washing facilities and two double rooms with en-suites. Only one double room is used at present. The people using it told us that they like to share. There is a garden at the rear of the house. This has a paved area, grass and plants. There are several bird feeders which have been made by one of the people who lives in Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: the home. The laundry has suitable equipment. Staff receive training in infection control and there are suitable policies and procedures in this area. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are suported by adequate numbers of appropriately trained and competent staff so that their needs are met. They are protected by the homes recruitment practices. Evidence: We looked at two sampled care staff files and saw that staff are recruited through a standard process which includes taking up references and checks through the Criminal Records Bureau and the Protection of Vulnerable Adults list. New staff receive induction training in basic areas such as first aid and infection control. Checklists show what subjects have been covered. The training records for the home show that 65 per cent of staff have NVQ level 2 or above, 4 have level 3 and one has level 4. Staff also receive training in a range of other areas relevant to their roles. The rotas show that there are sufficient numbers of staff on duty at all times. There were enough staff on duty on the day of the inspection so that people could be accompanied to the shops and the dentist, whilst still leaving staff in the home to carry out other tasks. The manager told us that the home does not use agency staff so people are always supported by people who know them. We saw minutes which show that staff are supported by regular supervision and team meetings. The manager told us that she plans to increase the frequency of these. Care Homes for Adults (18-65 years) Page 22 of 28 Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in this home benefit from from a well run home where their views underpin self monitoring, review and development. Their health, safety and welfare is promoted and protected. Evidence: The manager has over 15 years experience in managing homes and is well qualified, having the Registered Managers Award and NVQ level 4. We discussed her approach to managing the home and she told us that she likes to spend time with the people who live in the home and has a hands on approach. She has spent time updating various policies and procedures and rewriting care plans so that they are more detailed and relevant to the people in the home and plans to delegate some tasks such as chairing meetings so that she can continue to undertake the necessary paperwork, whilst keeping in touch with the people in the home. The home has just started to use an improved system for monitoring the quality of care provided and making sure that the high standards are maintained. The owner Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: makes frequent of the visits to the home and visited on the day of the inspection. The reports of these visits are very brief and concise, but discussion with the owner showed that she has a good level of knowledge about the people in the home and the systems in operation. People in the home are asked on a regular basis, about their preferences and whether or not they are pleased with their care. We saw three monthly questionnaires which had been completed by people in the home. The manager had analyzed these and put a feedback sheet up on the noticeboard, summarising the areas where people wanted change and saying what changes would be made. This shows that peoples views are valued and acted on. The manager provided us with information about the dates of safety tests and servicing of equipment in the home. We checked a sample of these, including fire safety drills and found that there are good arrangements for making sure that people who use the building are kept safe. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 37 The manager should continue to implement and develop the new quality assurance system to make sure that the home continues to improve. Care Homes for Adults (18-65 years) Page 27 of 28 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. 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