Latest Inspection
This is the latest available inspection report for this service, carried out on 10th June 2010. CQC found this care home to be providing an Good service.
The inspector made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
For extracts, read the latest CQC inspection for Pen y Bryn.
What the care home does well New people have their needs assessed and are encouraged to try out the service before moving in. People have a personalised care plan that includes goals they are working towards. They are consulted about their life style and the activities they take part in.Medicines are being managed safely. There is always a first aider on duty and people`s health needs are being met with professional support. People are consulted about their meals and given a choice each day. They are being well supported to use communications aids to support them to express their needs and understand information and plans. The home is well maintained, safe, clean and attractive. Ongoing improvements are being made. Routine safety checking systems are in place. Complaints are taken seriously and staff are trained to identify and report any concerns or abuse. There are enough staff on duty to meet people`s needs and they work well as a team. Staff are suitably trained and are supported by a senior structure. What the care home could do better: People may be able to benefit from having their money and medication kept in their bedrooms and their level of involvement increased. Protocol guidance about medicines used occasionally could be made clearer in some cases. Continue to encourage one man to accept personal belongings in his flat. Consider the use of specialist furniture to help improve his environment. The hallway outside the laundry needs to be kept clear to provide safe access for people living and working in the home. More of the staff team should be qualified. A permanent manager needs to be appointed and registered with us to provide stability to the service. Random inspection report
Care homes for adults (18-65 years)
Name: Address: Pen y Bryn 48 Hafod Road Hereford HR1 1SQ two star good service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jean Littler Date: 1 0 0 6 2 0 1 0 Information about the care home
Name of care home: Address: Pen y Bryn 48 Hafod Road Hereford HR1 1SQ 01432375926 Telephone number: Fax number: Email address: Provider web address: www.voyagecare.com Name of registered provider(s): Name of registered manager (if applicable) Milbury Care Services Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 8 The maximum number of service users who can be accommodated is: 8 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 8 Date of last inspection Brief description of the care home Milbury Care Services Ltd is a national company that runs many registered care homes and supported living schemes for people with complex needs. Pen Y Bryn at 48 Hafod Road was first registered in November 2005 to provide accommodation with personal care for eight adults. People using the service must need care primarily due to learning disabilities and may also have physical disabilities and/or a mental health disorder associated with their learning disability. Most people who live there have an autistic
Care Homes for Adults (18-65 years) Page 2 of 10 Brief description of the care home spectrum disorder and use behaviours that can challenge a care service. They therefore have complex needs and need a high level of support from staff. Pen Y Bryn is located in one of Herefords older residential areas about a mile from the city centre, on a main bus route. The house is a large, detached Victorian property that has been converted into a care home. There are parking spaces at the front and a large, enclosed garden at the back. The home has six bedrooms with en-suite facilities (including a shower or bath) and two self-contained flats, which have their own sitting room, kitchen and bathroom. There is a lounge, dining room and sensory room for everyone to use and a kitchen, laundry room, storage areas and office. Information about the service is provided in a statement of purpose and a service users guide. The guide is available from the home. Fee levels vary according to the assessed needs of individuals using the service, as agreed with their funding authority. Additional charges include for such as personal toiletries, clothing, the cost of holidays over two hundred pounds, newspapers, magazines, hairdressing and transport (which is a weekly payment depending on if people receive mobility allowance). Care Homes for Adults (18-65 years) Page 3 of 10 What we found:
We (the Care Quality Commission) carried out this inspection unannounced, which means no one at the home knew we would be arriving. One of our inspectors spent an afternoon at the home and looked at a cross section of things. While we were at the home we met some of the people who live there and spoke to some of the staff on duty. We walked around the building and then looked at some of the most important records, such as those about medication and staff recruitment. We were able to see staff supporting people and we got a picture of day to day life in the Home. We found out how activities and food are organised. Some weeks earlier the acting manager sent us the annual quality assurance assessment (AQAA for short). This is a document which services are required to send to us to tell us what they do well, what they think they need to improve and what their plans are to achieve these changes. The AQAA was completed in detail. It showed that improvements have been made during the last year and that people using the service have been consulted, as far as possible, about what can be changed to enhance their quality of life further. Ongoing development plans are in place. We also received surveys from seven people living in the home, who were assisted to give their views by a family member or a member of staff. The feedback was very positive. One family added, Our son had several visits to the home before moving in. The staff always treat him well. Another family said, Excellent care and communication to our daughter and us. Plenty of opportunities to go out and for activities in her care plan such as going shopping. The meals are very good, there is plenty of variety and home cooked meals on offer. She also goes out to dine. The consultant psychiatrist said, Medication management arrangements for these clients are satisfactory. They contact me or the GP appropriately. I find the home in a reasonable state and people suitably engaged. Perhaps staffing shortages are sometimes an issue. Our findings showed that people living in the home are treated as individuals. They are having their health and care needs met in a personalised and flexible manner. Several examples were given of personal developments people have made over the last year. Support with special needs is provided by health professionals based in the Herefordshire Community Team, or by the company behaviour therapist who supports those people not funded by Herefordshire County Council. The staff have been trained to understand specific conditions such as Epilepsy and Autism. No physical restraint is being used, but staff are trained to respond to complex behaviours they may find challenging. The acting manager told us in the AQAA that care plans are reviewed each month and that Keyworkers are consulting people and developing more person centred plans. Examples of this being three people getting passports and going to Euro Disney, two people climbing Snowdonia and fund raising at the same time, and one person having a
Care Homes for Adults (18-65 years) Page 4 of 10 meal out with his mother for the first time. People are also being consulted abd encouraged to make choices. For example, menus and activities are discussed at the regular House meetings. One person was being supported to choose the colour for her flat lounge to be painted. People all have personal aims for the year ahead. The assessment for the person, who moved in most recently, was seen. This was quite brief, but it had flagged up key points that needed to be considered before the placement was offered. The latest review meeting report showed that the placement was successfully meeting the persons needs and he had settled in well. Several examples were seen of different methods being used to support people to communicate and understand their daily lives, such as a pictorial staff rota and symbol timetables. People all have personalised activity plans that they were engaged in. One man returned in a happy frame of mind after attending a college course. The atmosphere during the evening meal was relaxed and some people had chosen to then attend a disco that evening. The manager was aware of some of the recent changes in legislation such as the Mental Capacity Act. Following her training she had acted appropriately and requested authorisation from the Local Authority (under the Deprivation of Liberty Safeguards) for the restrictions placed on one man entering the main house from his flat. This had lead to the Assessor making four recommendations, including support and guidance from the community team. These should lead to his needs being met in a less restrictive way. Medication systems were found to be in good order and people are receiving the medicines prescribed for them. These are being kept under review by the doctor. The one sampled indicated that protocol guidance about medicines used on an As Needed basis could be made clearer. No one is involved in managing their own medication and it is all stored centrally. Specialist health professionals are being appropriately involved to give advice or treatment. People all have a personalised Health Action Plan. They are supported to attend Annual Health checks at their GP surgery. One mans review report showed he had accessed various health checks in the last year such as a dental and eye test. Regular chiropody is also being arranged. One persons financial records were sampled. Receipts are being kept and balance checks are carried out at every shift change. The system is audited routinely as part of the monthly monitoring visits carried out by a senior manager. The money is kept centrally and people are not currently being supported to manage their own affairs. A complaints poster is displayed that includes symbols to help aid peoples understanding of their right to complain. Postcards are prewritten and accessible to people to enable them to ask for external support if they have a problem. The home has received one complaint in the last year. This related to staff members conduct while taking people on a community outing. This had been recorded in the log book and the details showed it was investigated and taken seriously. We have not received any complaints about the service. There have not been any safeguarding issues in the last year. A compliments book is also kept and positive feedback from a social worker had been recorded following a recent review meeting. The house was clean, homely and well maintained. Double glazed doors have been fitted at the rear of the building in the last year. There is a well equipped sensory room that is
Care Homes for Adults (18-65 years) Page 5 of 10 kept unlocked and is used regularly. There is an attractive garden where one man enjoys cutting the lawn and growing vegetables. The staff are working to help one man accept personal items into his flat. This work should continue and specialist furniture considered to aid the process. The home has been awarded a 4 Star rating by Environmental Health. Suitable infection control arrangements are in place and the laundry is fitted with professional equipment. There is a lack of storage in the laundry so laundry baskets are lined up in the hallway outside and dry clothes are sorted into these for each person. This practice creates a significant trip hazard for staff and for the person whose flat entrance into the main house is on this hallway. The acting manager agreed to find other ways of working so the hallway is kept clear, therefore a requirement was not made. The staff seemed very caring and were spending quality time with people, as well as meeting their practical needs. There are two waking staff at night and one to one staffing is provided during the day. On Sundays the staffing levels are reduced to six, as people have a more relaxed day at home. Staff feedback indicated they feel these levels are suitable. There are three maternity leave vacancies that need filling to maintain numbers and the managers hours are still vacant which has meant the team and bank staff are having to cover these. One staff recruitment file was sampled. This confirmed that a robust procedure is followed and new staff are not started until all background checks are received. This workers file also showed that a suitable induction and core training courses had been provided. All staff complete the Learning Disability Qualification. Only nine of the twentyseven staff hold a National Vocational Qualification in Health and Social Care. We were told that the owners are aware that more staff need to be supported to gain a NVQ award and are taken action to address this. The last registered manager left in June 2009. A new manager only stayed in post until November 2009. The deputy has been acting manager since this time with support from the team and company managers. She has applied for the position and the interview is pending. She had completed the AQAA well and has reported incidents to us appropriately. She was not aware of all the current changes in legislation that affect her role, such as the introduction of the Hygiene Code and the Essential Standards of Quality and Safety that come into force in October 2010. The company should be ensuring managers are kept better informed. The company has a quality assurance system that includes feedback surveys and an annual full audit carried out by a senior officer in the company. The findings from the review in 2009 had been analysed and action points identified. At the last Key Inspection in August 2007 we judged that people using the service were experiencing Good outcomes. We have considered all the information we have to help update our view and we found that overall people are still receiving Good outcomes. What the care home does well:
New people have their needs assessed and are encouraged to try out the service before moving in. People have a personalised care plan that includes goals they are working towards. They are consulted about their life style and the activities they take part in.
Care Homes for Adults (18-65 years) Page 6 of 10 Medicines are being managed safely. There is always a first aider on duty and peoples health needs are being met with professional support. People are consulted about their meals and given a choice each day. They are being well supported to use communications aids to support them to express their needs and understand information and plans. The home is well maintained, safe, clean and attractive. Ongoing improvements are being made. Routine safety checking systems are in place. Complaints are taken seriously and staff are trained to identify and report any concerns or abuse. There are enough staff on duty to meet peoples needs and they work well as a team. Staff are suitably trained and are supported by a senior structure. 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 2. Care Homes for Adults (18-65 years) Page 7 of 10 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 8 of 10 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, 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 20 Ensure protocol guidance about medicines used on an As and When basis are very clear and help ensure peoples health needs are met in the best way for them. Prioritise support for staff to obtain NVQ awards in Care, and strive to get at least half the team qualified. Set up new ways of managing the laundry so the hallway outside is kept clear of obstacles. 2 3 35 42 Care Homes for Adults (18-65 years) Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 10 of 10 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
