Care Home: Petersfield Care Home

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What the care home does well People told us they were happy at the home. They said ```I`m happy here, I`m not going anywhere else, I love it here``. Another said ``It`s a nice place to live``.People are supported to do the things they enjoy and staff support people to develop their interests.Staff support people well with their personal care to help them to feel comfortable and good about themselves.People who live at the home have bedrooms that contain their personal things.The home is well decorated and furnished so it is homely and comfortable for people to live in.Staff have been employed by the home for a long time. This means that people know the staff who will be helping them in meeting their needs.Staff have a qualification in care so they should have the skills and knowledge they need to meet the needs of the people living there. People are supported to do things for themselves. What has improved since the last inspection? The service user guide now includes pictures to help make it easier for people to understand.Care plans have been updated to include pictures so they are easier for people to understand.People`s weight is now monitored regularly to help make sure people are healthy.Surveys have been used to ask people what they think about the home.Staff have had more training to help them to meet people`s needs. What the care home could do better: Care plans need improvement to make sure that staff have enough information to meet people`s needs.Records of food need to be further improved to make sure that staff can monitor people are having a healthy diet.Records must be completed for all health appointments so that the home can monitor and meet people`s health needs.Guidelines should be available for medication to make sure staff have enough information about when it needs to be given to people.Make sure that lighting in people`s bedroom is in working order so that they can have the light on if they wish to.The person managing the home needs to apply to us for registration. So that people can be sure they have the right skills and experience.The fire risk assessment needs to be reviewed to make sure the information is up to date and that fire precautions in the home are satisfactory.Systems for quality assurance need to be further developed and improved so that people can be sure their views are listened to and acted on. Key inspection report Care homes for adults (18-65 years) Name: Address: Petersfield Care Home 60 St Peters Road Handsworth Birmingham West Midlands B20 3RP The quality rating for this care home is: one star adequate 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: Kerry Coulter Date: 2 0 0 1 2 0 1 0 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 37 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 © (2010) 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 37 Information about the care home Name of care home: Address: Petersfield Care Home 60 St Peters Road Handsworth Birmingham West Midlands B20 3RP 01215151654 01215151654 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) : Ms Vinette Campbell care home 5 Number of places (if applicable): Under 65 Over 65 5 0 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 5 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) 5 Date of last inspection 1 6 0 2 2 0 0 9 Care Homes for Adults (18-65 years) Page 4 of 37 A bit about the care home Petersfield Care Home is in Handsworth close to Perry Barr shopping centre. The home offers care for up to five people with a learning disability. The home is close to local shops, pubs, places of worship and bus routes. The owner lives at the home and the staff are family members. There is one bedroom with its own bathroom on the ground floor. There are two single and one shared bedroom on the first floor. Care Homes for Adults (18-65 years) Page 5 of 37 People need to have good mobility to use the stairs as the home does not have a lift. The home has a large lounge and dining room and a large kitchen/dining area. The home has an enclosed rear garden. A copy of the last inspection report and service user guide are available in the home so that people can read them if they choose. The service user guide did not say how much it costs to live at the home. Care Homes for Adults (18-65 years) Page 6 of 37 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: one star adequate 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 Care Homes for Adults (18-65 years) Page 7 of 37 How we did our inspection: This is what the inspector did when they were at the care home This inspection was carried out by one inspector over one day. The home did not know we were going to visit. The manager sent us information about the home before our visit, this is called an AQAA. We met with people who live at the home and they told us what they thought of the home. We also spoke with staff. Care Homes for Adults (18-65 years) Page 8 of 37 We looked at the care plans, health records and daily notes for two people. This is called case tracking. We also looked at staff and health and safety records. We looked at some areas of the home to include some peoples bedrooms. We sent surveys to people who live at the home. Two people returned completed surveys to us. What the care home does well People told us they were happy at the home. They said Im happy here, Im not going anywhere else, I love it here. Another said Its a nice place to live. Care Homes for Adults (18-65 years) Page 9 of 37 People are supported to do the things they enjoy and staff support people to develop their interests. Staff support people well with their personal care to help them to feel comfortable and good about themselves. People who live at the home have bedrooms that contain their personal things. Care Homes for Adults (18-65 years) Page 10 of 37 The home is well decorated and furnished so it is homely and comfortable for people to live in. Staff have been employed by the home for a long time. This means that people know the staff who will be helping them in meeting their needs. Staff have a qualification in care so they should have the skills and knowledge they need to meet the needs of the people living there. People are supported to do things for themselves. Care Homes for Adults (18-65 years) Page 11 of 37 What has got better from the last inspection The service user guide now includes pictures to help make it easier for people to understand. Care plans have been updated to include pictures so they are easier for people to understand. Peoples weight is now monitored regularly to help make sure people are healthy. Care Homes for Adults (18-65 years) Page 12 of 37 Surveys have been used to ask people what they think about the home. Staff have had more training to help them to meet peoples needs. What the care home could do better Care plans need improvement to make sure that staff have enough information to meet peoples needs. Care Homes for Adults (18-65 years) Page 13 of 37 Records of food need to be further improved to make sure that staff can monitor people are having a healthy diet. Records must be completed for all health appointments so that the home can monitor and meet peoples health needs. Guidelines should be available for medication to make sure staff have enough information about when it needs to be given to people. Make sure that lighting in peoples bedroom is in working order so that they can have the light on if they wish to. Care Homes for Adults (18-65 years) Page 14 of 37 The person managing the home needs to apply to us for registration. So that people can be sure they have the right skills and experience. The fire risk assessment needs to be reviewed to make sure the information is up to date and that fire precautions in the home are satisfactory. Systems for quality assurance need to be further developed and improved so that people can be sure their views are listened to and acted on. Care Homes for Adults (18-65 years) Page 15 of 37 If you want to read the full report of our inspection please ask the person in charge of the care home. If you want to speak to the inspector please contact Kerry Coulter CQC West Midlands Citygate, Gallowgate Newcastle upon Tyne NE1 4PA Tel 03000 616161 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 16 of 37 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 17 of 37 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have most of the information they need and their needs would be assessed before moving in so they can be sure that the home is right for them. Evidence: People told us they had received enough information about the home. The home has a service user guide in place that tells people about the home. It has been updated since our last inspection to include pictures making it easier to understand. The guide needs to be amended to include our new contact address and details about how much it costs to live at the home. This will help to ensure people have all the information they need. People who live at the home have done so for a number of years. As at the previous inspection there have been no new admissions to the home and so the outcomes for any new person coming to live in the home could not be assessed. However, we were told by the deputy manager that they always carefully consider the other people living at the home when they receive referrals. The home has an assessment and admissions policy in place and this records that people would be fully assessed and offered trial visits to make sure the home could meet their needs. Page 18 of 37 Care Homes for Adults (18-65 years) 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have most of the information they need so they can support people to meet their needs, make choices and keep them safe from harm so ensuring their well being. Evidence: We looked at the care files for two people who live at the home. Each person had an assessment of their needs and a care plan. The format of the plans has been reviewed since our last inspection so that they include pictures. This helps make it easier for people to understand their own plans. The care plans in place did not always detail how people need to be supported. For example one persons plan regarding dressing stated they need assistance. The plan did not say what type of assistance was needed or detail what the person could do for themselves. Peoples care plans were brief regarding some health needs. For example where people had epilepsy or constipation care plans were not specific about the support needed for people to stay well. Discussion with the deputy manager indicates that there is a good deal of knowledge about peoples care needs within the care team, but this knowledge should be transferred into peoples care plans. Care Homes for Adults (18-65 years) Page 19 of 37 Evidence: Throughout our visit people were encouraged to make their own choices, for example what to eat and drink, what to watch on television or where to spend their time. People told us they can choose what to do to include food, activities and where they go on holiday. Surveys from people told us they make decisions about what they do each day. Records included risk assessments that stated how staff are to support the individual to take risks whilst being as safe as possible. These included using the stairs, managing their money, going out, participating in domestic activities and manual handling. Risk assessments were regularly reviewed and updated. Care Homes for Adults (18-65 years) Page 20 of 37 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. Arrangements help people to experience a meaningful lifestyle that ensures their selfesteem and well being is promoted. Evidence: We saw staff talking with people who live in the home throughout the inspection politely and in a friendly manner. The home was seen to promote peoples daily routines in a flexible manner. For example, people were moving around the home freely, choosing where to sit, what they wished to do and who to interact with. As at previous inspections daily life at Petersfield reflects a homely atmosphere where people who live there have become part of a large family group. One person told us Im happy here, Im not going anywhere else, get good clothes, good food, I love it here. Another said Its a nice place to live. We saw people watching television and chatting to the manager and deputy manager. Two people were out at their daycentre when we visited and the other people at the home later went out to do some food shopping with the manager. People were actively Care Homes for Adults (18-65 years) Page 21 of 37 Evidence: involved in the homes daily activities such as making drinks and sweeping up which provide individuals important life skills. Surveys from people told us they can do what they want to during the day, evenings and at weekends. People spoken with on the day of our visit confirmed that visitors are made very welcome by the home and visiting was not restricted in any way. The deputy manager told us that the home does not have a set menu as people are asked on a daily basis what they would like to eat. We saw that there was satisfactory stocks of food in the home to include fresh fruit and vegetables. People told us Im having something nice for tea, chicken and potatoes. Can choose food, we have fruit, Foods nice, they look after you here and Have food I like, choose what we have. Records of food provided to people were not available in the home. Copies were sent to us soon after we visited. Staff record the meals that people have but the detail needs to be improved. For example, where people had vegetables the type of vegetables were not specified. Improved detail would make it easier to monitor if people are having a healthy diet. Care Homes for Adults (18-65 years) Page 22 of 37 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements may not always ensure that the health needs of people are met, which could impact on their well being. Evidence: On the day of our visit we observed that people needed minimal support with personal care. People were seen to be dressed appropriately for the weather and choices of clothing appeared to reflect personal tastes, ages and gender. One person told us I get good clothes here. Assessments had been completed for peoples needs regarding pressure care, nutrition and risk of falls. As stated earlier in this report some development is needed regarding health care planning. The introduction of health action plans would be beneficial in improving health planning for people. This is something we have previously recommended is introduced. At the last inspection it was identified that the home needed to monitor peoples weight. It is important that individuals weights are recorded and monitored to ensure that any significant losses and or gains are recognised in a timely manner, as this may be due to an underlying medical conditions. The home has acted on our recommendation and peoples weight is now being monitored on a monthly basis. Care Homes for Adults (18-65 years) Page 23 of 37 Evidence: Records showed that people had attended health checks such as breast screening, dental and optician check ups. One person at the home has high blood pressure and needs to have this monitored by the doctor regularly. The deputy manager told us this was done every three months but that records are not kept of these appointments. Records must be maintained of all health appointments and their outcome so that the home can effectively monitor and meet peoples health needs. Staff at the home have received training in medication administration. Discussion with a college tutor visiting the home indicates that refresher training in medication is currently being arranged. This should help to update staff knowledge and promote safe medication practice. Medication is stored in a locked cabinet. At the front of each persons medication administration record (MAR) there was a photograph of them so that if new staff worked in the home they would know who to give medication to. Where possible people have the opportunity to administer their own medication. One person administers their inhaler. We saw that an assessment had been completed regarding this to make sure they were safe to do so. One person at the home is prescribed medication on an as required basis only. Guidelines need to be completed for this so that staff know when this medication needs to be given to help the person stay well. Care Homes for Adults (18-65 years) Page 24 of 37 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. Arrangements help to ensure that the views of the people living there are listened to and acted on and they are safeguarded from abuse. Evidence: The homes annual quality assurance assessment stated that there has been no complaints received in the last 12 months and we have not received any complaints about this service. The home has a complaints procedure available to people. The procedure had been updated since we last visited the home to include some pictures to help make it easier for people to understand. As with the service user guide the procedure needs to be updated to include our new address so that people can contact us if they need to. Surveys from people who live at the home told us that they know how to make a complaint and who to speak to if they are unhappy. We spoke with three people during our visit and all said they would either speak to the manager or the deputy if they had any complaints. One person was asked if they had any complaints about the home, they told us No way!. Discussions with the deputy manager show the home is very aware that all of the staff team are related to each other and this may impact on people wanting to make a complaint. The deputy manager told us this was part of the reason they had brought in a care consultant. We were told they come to the home every month and is someone more Care Homes for Adults (18-65 years) Page 25 of 37 Evidence: independent that people can talk to if they wish. Records and discussions with the manager and deputy indicate that they and the other care staff have undertaken training in safeguarding adults from abuse. Whilst we were at the home a tutor from a local college was also visiting. We were told they were arranging refresher training for staff in safeguarding. There are safeguarding policies and procedures in place to offer protection to people living at Petersfield but the home does not have a copy of the Birmingham Multi Agency Safeguarding guidelines. The home should have a copy of these guidelines to make sure they know what to do if they need to make a safeguarding referral to the local authority. Discussion with the deputy manager shows that training in the Mental Capacity Act and Deprivation of Liberty Safeguards has not yet been undertaken. We were shown that the home has obtained information booklets from the Department of Health for staff to read. We were told by the deputy that training has been arranged via the college and is due to take place in February. As at previous inspection all individuals living at the home manage their own finances with some assistance. It was positive to see that risk assessments are in place which provide staff with instructions to follow ensuring individuals are safeguarded whilst managing their own finances. Care Homes for Adults (18-65 years) Page 26 of 37 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely, comfortable and clean environment that meets their individual needs. Evidence: Petersfield is a large Victorian house which provides spacious accommodation. The owner lives at the home. All furniture, fixtures and decoration were of a good standard so that people live in a well maintained environment that meets their needs and enhances their lives. All areas of the home were seen to be clean and hygienic with no offensive odours present. One person has their own ensuite bathroom, other people at the home share the communal bathroom. We looked at two peoples bedrooms with their permission and all communal rooms. We found that the home was warm and clean and that the rooms were large with many homely touches. The dining area is situated in the large kitchen area with dining table and chairs to seat six people. Off the dining area towards the back of the house is an adjoining small toilet and laundry area which people living in the home are able to access if they wish to assist with laundering tasks. The lounge area is also a large space which has a table and chairs towards the conservatory area of the home and the other half of this room has a comfy leather settee Care Homes for Adults (18-65 years) Page 27 of 37 Evidence: and chairs so that people are able to relax and watch television as they please. One of the people who live at the home showed us their bedroom which they share with another person. This was clean and bright with personalised objects of this individuals own choice displayed on the walls, tables and bed. Due to the person sharing their bedroom there is a privacy curtain in place so that peoples rights can be maintained within their personal spaces. The individual told us that they liked their room very much and enjoyed sharing it. We saw that the bulb was missing from the main light fitting in the bedroom. The manager told us that the bulb had been removed as one person kept leaving the light on at night and it had been annoying the other person. The only working light available in the bedroom was one bedside lamp. This meant that the other person did not have close access to light facilities. Care Homes for Adults (18-65 years) Page 28 of 37 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. The staffing arrangements generally help to ensure that the needs of the people living there are met. Evidence: People who live at Petersfield are supported by three care staff, the owner who is the also the registered manager, the deputy manager and another family member. A part time cleaner also works at the home. On the day of our visit both the manager and deputy manager were on duty. We were told that staffing levels are usually one to two staff during the day but that sometimes all three staff may be on duty. As stated earlier in this report the manager also lives at the home and so they are available if needed throughout the night. The staff rota was not available in the home. This was sent to us soon after our visit to the home and showed that there are usually one to two staff on duty. There was no evidence to suggest that staffing levels are not meeting peoples needs. Surveys from people told us that staff treat them well and listen to them. We saw that the interactions between people who lived at the home and the staff on duty reflected that they have formed friendly and respectful relationships with them. We were told that people had lived there for between eight and twelve years and that the staff have worked at the home since it opened. This means that people are always supported by staff they know well. Care Homes for Adults (18-65 years) Page 29 of 37 Evidence: We were told that no new staff have started working in the home since the last inspection. We briefly looked at the recruitment files of the existing staff and found that Criminal Record Bureau (CRB) checks were available. Some of these had recently been renewed as recommended at the previous inspection. The deputy manager told us that she had applied to renew her CRB and was awaiting the new disclosure. We looked at the training undertaken by staff. The homes annual quality assurance assessment told us that all of the care staff in the home have completed a National Vocational Qualification in care. As stated earlier in this report arrangements are in progress for staff to have refresher training in medication administration and safeguarding people from abuse. Certificates were available to show that staff had received training in infection control, emergency life support, food hygiene, fire and manual handling. Certificates did not show that all staff had recent refresher training in fire. The deputy manager told us that all staff had recently completed this training and were awaiting their certificates. Certificates also did not show that all staff had completed refresher manual handling training. The deputy manager said all staff had done this and said that copies of the certificates would be sent to us when located. Care Homes for Adults (18-65 years) Page 30 of 37 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management arrangements need to improve to ensure that the health and safety of the people living there is promoted and protected. Evidence: As at the homes last inspection, the registered manager has relinquished the majority of her role to her daughter who is the deputy manager. As the deputy manager is in effect managing the home they need to make an application to us for registration. Discussions and records show that the deputy manager of the home has completed an National Vocational Qualification (NVQ) in Care and has also achieved the Registered Managers Award. Since our last inspection the manager has completed an NVQ at level three. Both the manager and the deputy manager demonstrated a commitment for wanting to improve outcomes for people who live at the home. The Annual Quality Assurance Assessment (AQAA), which tells us how the home thinks they are meeting the regulations and standards, was returned to us when we asked for it. Some areas of the AQAA lacked detail and did not clearly tells us about outcomes for Care Homes for Adults (18-65 years) Page 31 of 37 Evidence: people at the home. To help identify areas for improvement the home employs the services of a care consultant who helps with staff training and administration. Since the last inspection the home has introduced surveys to help gain peoples views about the service. People who live at the home were seen to have completed a survey. The deputy manager told us that it was intended to develop the survey into a pictorial format to make it easier for people to understand. A report of the survey results should be completed and made available to people. Survey formats were available for visitors to the home and other care professionals. The deputy manager said that surveys had been sent to a day centre that people attended and to an involved health professional but that they had declined to fill in the survey. Some records were not available when we visited. The deputy manager told us that staff rotas and peoples daily records were all in one folder. She said she had taken the folder home the previous day and had forgotten to bring them back. The homes policy and procedures for the safe keeping of records should be reviewed. This will help to make sure that records required for the effective running and management of the home are available. Certificates were available to show that the gas and electrical installations in the home had been tested by qualified engineers who stated that these were safe. Fire records showed that staff test the fire equipment regularly to make sure it is working and that regular fire drills are held so that people know what to do if the fire alarms sound. An assessment had been completed regarding the risk of fire occurring in the home, this needs to be reviewed to make sure the information is up to date. Staff undertake some monitoring of hot water outlets in the home to make sure they do not put people at risk of scalding. Records showed that water temperatures were safe. We saw that one outlet is tested each month and this means that the water at the bath is not monitored regularly. This outlet may pose a higher risk to people due to the possibility of full body immersion. It is therefore recommended that the home increases the frequency of monitoring of the hot water at the bath. Care Homes for Adults (18-65 years) Page 32 of 37 Are there any outstanding requirements from the last inspection? Yes  No  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 33 of 37 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 Description Timescale for action 1 19 12 Records must be maintained 26/02/2010 of all health appointments and their outcome. So that the home can effectively monitor and meet peoples health needs. 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 Description 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 1 The service user guide needs to be amended to include our new contact address and details about how much it costs to live at the home. This will help to ensure people have all the information they need. Care plans should be further developed to make sure that they clearly record all the support that each person needs so that people can be sure their needs will be met. 2 6 Care Homes for Adults (18-65 years) Page 34 of 37 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 3 17 Records of food need to be further improved to make sure they are sufficiently detailed to enable staff to monitor that people are having a healthy diet. Health action plans should be developed so that individuals health is monitored effectively and any action required is provided within a timely manner. Where people are prescribed medication on an as required basis guidelines should be available on when it should be given. This will help to ensure people get the medication they need to stay well. The complaints procedure should be updated with our new address so that people can contact us if they need to. The home should have a copy of the Birmingham Multi Agency Safeguarding Guidelines to make sure they know what to do if they need to make a safeguarding referral to the local authority. Make sure that lighting in peoples bedroom is in working order and access to lighting controls is easily accessible to people. The person managing the home should proceed as soon as with their application for registration. So that people can be sure the home is managed by a qualified, experienced and competent person. Systems for quality assurance need to be further developed and improved so that people can be sure their views are listened to and acted on. The homes policy and procedures for the safe keeping of records should be reviewed. This will help to make sure that records required for the effective running and management of the home are well looked after. The frequency of monitoring of the hot water at the bath should be increased to make sure people are not at risk of being scalded. 4 19 5 20 6 7 22 23 8 24 9 37 10 39 11 41 12 42 Care Homes for Adults (18-65 years) Page 35 of 37 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 13 42 The fire risk assessment needs to be reviewed to make sure the information is up to date and that fire precautions in the home are satisfactory. Care Homes for Adults (18-65 years) Page 36 of 37 Helpline: Telephone: 03000 616161 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 © (2010) Care Quality Commission (CQC). 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