Care Home: Selborne House

Similar services:

• Polesworth Group Friary Road
• Polesworth Group Pooley Heights
• Polesworth Group 32 Station Road
• Polesworth Group 70 Long Street
• Breme
• Polesworth Group 64 Long Street
• Polesworth Group 68 Long Street
• 10 Whitfield Avenue

What the care home does well The people living there are supported to go out often and to the places they want to go to. Each person who lives there has a care plan that they help to write. This tells staff how they need to help the person. One person said, ` The staff look after me well.` Staff support the people living there to be as independent as possible in their own home, encouraging and supporting them to do the cleaning, cooking and their washing. The people living there said they can keep in touch with their family and friends, staff support them to do this where needed. People have a varied and healthy diet. One person said, `The meals are good.` People are given the medication they need to help them to keep well. The home is clean and well decorated so it is a nice place to live. Each person has their own bedroom. The people who live in Beverley unit have their own apartment. People said they can choose how their room is decorated and what things they have in there. Staff ask the people who live there what they want to do, where they want to go, what they want to eat and drink and how they want to spend their time. What has improved since the last inspection? The statement of purpose has been updated so it includes all the information that people need to make a choice as to whether or not they want to live there. We are told about things that affect the well being of the people living there to help to make sure that people are being safeguarded from abuse. People`s property lists are updated often so that it is clear if people`s things should go missing what belongs to each person and when they last had them. Some rooms had been redecorated to make the home more comfortable to live in. What the care home could do better: Audits of care plans should be more robust to make sure that staff know how to support people to meet all their needs. Risk assessments should clearly state how a person is to be supported so that the risks to their safety and that of others is reduced as much as possible. All concerns should be recorded so that it is clear that the views of the people living there are listened to and improvements are made where needed.Staff should have the training they need so they know how to support the people living there. Reports of visits by a representative of the owner should be in the home so that staff know what to do to improve the service where needed. Key inspection report Care homes for adults (18-65 years) Name: Address: Selborne House 34 Selborne Road Handsworth Wood Birmingham West Midlands B20 2DW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sarah Bennett     Date: 2 0 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 33 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 33 Information about the care home Name of care home: Address: Selborne House 34 Selborne Road Handsworth Wood Birmingham West Midlands B20 2DW 01215153990 01215154340 selborne.house@selbornecare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Selborne Care Ltd care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 15 The registered person may provide the following category of service only: Care Home with Nursing (Code N); 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) 15 Date of last inspection Brief description of the care home Selbourne house was designed specifically to provide a choice of accommodation to the people living there, offering rooms with en suite facilities with some bedrooms also offering kitchenette and dining room facilities. The care home is split into two areas called Ascot and Beverley. Each unit has two lounges, a dining area, separate office and medication room. Seven people live in Ascot and eight people live in Beverley. There are several communal areas that can be used as rooms for the people living there and/or staff areas for the purposes of private meetings and for staff training and interviews. Care Homes for Adults (18-65 years) Page 4 of 33 Over 65 0 15 Brief description of the care home The accommodation has a large patio area and a substantial garden. The home is located in the residential area of Handsworth Wood, and is close to main transport links. Shopping and leisure facilities are available in Handsworth Wood and Birmingham would be accessible. The fees charged were not stated in the statement of purpose of the home. Inspection reports are available in the home. The manager said that copies could be provided on request. Care Homes for Adults (18-65 years) Page 5 of 33 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: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This inspection was carried out by one inspector over two days. The home did not know we were going to visit. This was the homes key inspection for the inspection year 2009 to 2010. The focus of inspections we, the commission, undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home and the Annual Quality Assurance Assessment Care Homes for Adults (18-65 years) Page 6 of 33 (AQAA) completed by the manager. This provides information about the home and how they think it meets the needs of the people living there. We case tracked the care received by four people living there. This involved establishing individuals experience of living in the care home by meeting and talking with them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. We looked at parts of the home and a sample of care, staff and health and safety records. The people living there, the manager, staff and the operations manager were spoken with. We gave surveys to four people living there, five staff and five relatives. We received three surveys from the people living there and two staff and their views are included in this report. Care Homes for Adults (18-65 years) Page 7 of 33 What the care home does well: What has improved since the last inspection? What they could do better: Audits of care plans should be more robust to make sure that staff know how to support people to meet all their needs. Risk assessments should clearly state how a person is to be supported so that the risks to their safety and that of others is reduced as much as possible. All concerns should be recorded so that it is clear that the views of the people living there are listened to and improvements are made where needed. Care Homes for Adults (18-65 years) Page 8 of 33 Staff should have the training they need so they know how to support the people living there. Reports of visits by a representative of the owner should be in the home so that staff know what to do to improve the service where needed. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 33 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 10 of 33 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 the information they need about the home and know if their needs can be met there. This helps them to make a choice about whether or not they want to live there. Evidence: The statement of purpose and service users guide were produced using pictures and photographs making them easier to understand. They included the information that people would need so they can make a choice as to whether or not they want to live in the home. This information was available in the reception area of the home. Records sampled of the people who live there included a service users guide and it stated that this had been explained to the person. People told us that they had enough information about the home before they moved in. Records sampled showed that an assessment was completed of each persons needs when they moved into the home. One person had moved in during the last year. We looked at their records and it did not include an assessment of the persons needs before they moved in. The manager stated that this was completed but their Care Homes for Adults (18-65 years) Page 11 of 33 Evidence: assessment was currently with their placing authority who needed the information to apply to be the persons appointee. The manager said and the AQAA stated that pre admission assessments are always completed to ensure the home can meet the needs of the individual. Records sampled included a statement of the terms and conditions of living at the home. This was produced using Widget symbols making it easier to understand. It stated what the home provided and what the persons rights and responsibilities of living there are. Care Homes for Adults (18-65 years) Page 12 of 33 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 generally know how to support people to meet their needs and make choices about their lives whilst ensuring their safety. Evidence: We looked at the records of four of the people living there. These included an individual, detailed care plan that stated how staff are to support the person to meet their needs and achieve their goals. Care plans were also in Widget (symbols) format making them easier to understand. One person is unable to speak English. The manager had obtained quotes as to how much it would cost to get the persons care plans translated into the language they understand. This was expensive so the manager is now looking at computer software that would make it easier to translate these. Staff said that they are always given up to date information about how to meet peoples needs. This means they know how to support the people living there. Care Homes for Adults (18-65 years) Page 13 of 33 Evidence: Some people are doing life plans using a computer software program. This enables the person to be more involved as they can look at pictures on the computer and click what things they like or dislike and what things they want. One person was observed working with a member of staff on their plan. Staff took time to ensure that the person was making the choices about what they wanted and helped them to type in the things they wanted to be included. One person said they had been asked if they wanted to do this plan but had chosen not to. One persons records did not include a care plan to show staff how to meet all their needs. Two people whose records we looked at had autism. They each had a care plan that stated how staff were to support them but these were very similar and stated generally how autism can affect a person. They needed to be more individual as to how autism affected them. We told the manager about this on the first day and by the second day all this was addressed and individual plans were in place so staff knew how to support people to meet all their needs. The manager does regular audits of care plan, these issues should be highlighted as part of these. Care plans had been regularly reviewed and updated where the persons needs had changed so that they included the current needs of the person. Staff had signed to say they had read them so they knew how to support individuals. Individuals were involved in their plans and had been asked to sign to say they agreed to them. Records included how people are supported to make choices and decisions about their lives. Some people are able to use a key to their bedroom and said that they had this. People were observed to make choices during the day about what they did, where they went and what they ate. One person told us and it was observed that they can go out when they want to and go where they want to go. One person had said to other professionals that staff had physically stopped them from going out when they wanted to. The persons records showed that this had been discussed with their psychiatrist who had stated that the person must not be stopped from going out. The person told us and it was observed that since then this no longer happens and they can come and go when they want to. Staff said they had done this to protect the person who can sometimes be vulnerable when they leave the home on their own. Staff now recognised that the person had a right to take this risk. The person said and their records showed that they do sometimes go out with staff and enjoy this. Minutes of meetings with the people living there were looked. These showed that in each unit there are monthly meetings. The minutes are produced using Widget making Care Homes for Adults (18-65 years) Page 14 of 33 Evidence: them easier to understand. People talked about activities, day trips, holidays, the decoration and furniture in the home and what they liked to eat. Records sampled included individual risk assessments. These detailed how staff are to support individuals to take risks in their day to day lives whilst being as safe as possible. Some risk assessments did not state how the risk was to be reduced. For example, one persons records showed that they sometimes grabbed and pulled staff and the other people living there but not how staff were to support them so people were as safe as possible. This was updated to include this by the second day of our visit. Two people had told other professionals that night staff checked on them during the night so disturbing their sleep. Risk assessments had been written to ensure that the person understood and agreed to night staff taking a risk not to check on them. Both people had agreed that if they were low in mood or by behaving in certain ways had put themselves at risk of being unsafe the night staff could check that they were safe. Risk assessments had been regularly reviewed and updated. Where people were able to they had signed their risk assessments to say that they agreed to them. Care Homes for Adults (18-65 years) Page 15 of 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living there are supported to experience a meaningful lifestyle. People are offered a healthy diet that meets their individual needs so ensuring their well being. Evidence: Some people attend day centres and were out at these during the days we visited. Some people were looking at college courses to attend in September and had attended an Open Day at the college to look at what they wanted to do. Some people are able to go out on their own and had decided that they did not want to go to day centres or college. They chose when they wanted to go out and what they wanted to do. Records sampled, staff said and it was observed that people are offered the opportunity to go out each day. Records stated where people had been asked if they wanted to go out but had refused to go. People go shopping, to the cinema, to Care Homes for Adults (18-65 years) Page 16 of 33 Evidence: restaurants, pubs, parks and to discos. Some people had recently joined a local leisure centre where they wanted to use the gym and go swimming. Minutes of meetings showed that people had talked about where they wanted to go on holiday. Some people said they wanted to go abroad but did not have a passport so staff have been supporting them to get these. Other people said they wanted to go to Blackpool and this had been arranged. Staff were supporting other people to arrange holidays to the South coast. The manager said that as well as organising week holidays for people they were also looking at planning short breaks away so that people had regular opportunities to go away and experience different things. Some people were going on a day trip to a local theme park at the weekend with staff. One person said this had been arranged for them as they would soon be leaving the home. They said they had enjoyed opportunities to go to theme parks, which they had not done before they moved to the home. Some people were looking at the brochure about the theme park with staff to decide what they wanted to do on the day. People talked about previous trips to theme parks with staff and of a trip to Blackpool which they had clearly enjoyed. People were supported to keep in contact with their family and friends. People said their friends could visit them at the home and they could go and meet with their friends and family if they wanted to. Records showed that people who wanted to had regular contact with their family through visits and telephone calls. People living there are from different cultural and religious backgrounds. Records sampled showed that people were supported to continue with their religion if they wanted to. One person is supported to visit the Gurdwara regularly to follow their religion. Their care plan detailed how staff are to support them with this and what staff need to do when there to ensure they respect the persons religion. The AQAA stated and records sampled showed that the people living there are supported to maintain intimate personal relationships with people of their choice. Records showed that people are given advice from staff and health professionals about contraception and relationships. Records sampled showed and it was observed that people are encouraged to do jobs in the home and to help with their laundry and cooking their meals. This helps people to increase their independence. Some people said they cook most of their meals and choose when they eat. Sometimes they said they eat with the other people living there so to make it a social occasion. Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: People who cook their own meals make their shopping list and give it to staff to order with the main shopping. Sometimes they go to local shops to buy food. One person was writing their shopping list and was discussing with the manager about where they could get some ingredients to meet their dietary needs. People said they always got the food they asked for. One person said, The meals are good. Food records sampled showed that people are offered a varied diet that meets their individual dietary and cultural needs. Their diet also included regular portions of fruit and vegetables to ensure they have a healthy diet. Fresh fruit and vegetables were available in both units. One persons records showed that they were being supported to lose weight and attend a local slimming club. Some peoples body mass index calculations showed they were overweight and care plans had been put in place to ensure they are supported to reduce this. Care Homes for Adults (18-65 years) Page 18 of 33 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. The personal and health care needs of the people living there are met so ensuring their well being. Evidence: The people living there were dressed in individual styles that reflected their age, cultural background, their gender and the weather. People said that if they needed support staff would go with them to buy their clothes. People looked clean and attention had been given to their personal care so helping to raise their self esteem. Staff were supporting one person to paint their nails and asking them to choose what colour they wanted. People told us, People help me in Selborne House with my appearance. They look after me well. Records sampled showed that all people had been assessed as to the support they needed to move around. This helps to ensure that they are supported safely to reduce any injury to the person or to staff. Most people are able to move around independently but their assessments are regularly reviewed so that if their needs Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: change they can be supported appropriately. Care plans stated how people are to be supported to meet their personal care and health needs. People do not have a separate plan as to how their health needs are to be met but staff know what support they need from their care plan. Records of all health appointments and the outcome of these is kept so that staff can follow the advice given to ensure the persons health needs are met. Records sampled included an assesment of their nutritional needs. It was not clear how staff had concluded that the person was average or not weight and build for their height. This was discussed with the manager. By the second day the body mass index had been calculated of each person. Where people had been assessed as being underweight, overweight or obsese a care plan and risk assessment had been written so that staff knew how to support the individual to ensure their health needs are met. Information about weight loss plans had been downloaded from the Internet. Where there were concerns about individuals health because of their weight and other needs they had appointments had been made with their GP for further advice. Staff record each month individuals weight so to monitor this. Losing or gaining a significant amount of weight can be an indicator of an underlying health need so it is important to monitor this. Records sampled showed that where people were unwell staff had sought advice from other professionals to support the person. One person was unwell on the first day we visited. Staff were observed reassuring them as the person was anxious about how they felt. Staff supported them to visit their GP for further advice. Records showed that where people had infections staff had supported them to go to their GP and get treatment. Records showed that the treatment was given and people recovered from the infection. Records sampled showed that people had regular check ups with the dentist and optician to ensure that any health needs could be identified and they are well. One person said they had a visual impairment. Staff ensured that all information they needed was produced in large print and on yellow paper making it clearer for them to read. Medication is stored in locked cabinets in the unit where the person lives. Records sampled included how staff are to support the person with their medication. Records showed that the person had been asked for their consent if they were able to, to take their medication. This was written in Widget format making it easier to understand and signed by the person. Care Homes for Adults (18-65 years) Page 20 of 33 Evidence: Some people are prescribed as required (PRN) medication. Protocols were in place that stated when, why and how much of the medication should be given to ensure it was not misused, which could affect the persons health. Some people needed their medication to be put in jam or yogurt to make it easier for them to take. Agreement had been sought from the persons GP so that it could be given in this way without affecting the medication so it would still be effective. Medication records sampled showed that it had been given as prescribed. Staff had signed when medication had been received and how much. When a bottle or box of medication had been opened staff had written the date it was started. This makes it easier to audit how much of the medication has been given so it is clear people are getting what they need. All staff that give medication receive training that includes what each medication is for and how it may affect people. Staff said they have yearly refresher training, which they said was good to keep them up to date. Care Homes for Adults (18-65 years) Page 21 of 33 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 generally ensure that the views of the people living there are listened to and they are safeguarded from harm. Evidence: People living there said they knew who to speak to if they were unhappy and how to make a complaint. People said that staff always listen to them and act on what they say. The complaints procedure included the information that people would need so they knew what to do if they were unhappy with the service provided. It was available in the service users guide in the reception area of the home. Records sampled included a copy of the complaints procedure and stated that it had been explained to the person. The complaints log included three complaints and showed that these had been dealt with appropriately and action had been taken to improve the service. We received two concerns from other professionals about the home, one of which was the same as two of the complaints recorded in the log. During our visit we saw that action had been taken to address the issues raised. When sampling records we noticed one concern that had been recorded from a relative. This was discussed with the manager who agreed that it would be recorded in the log so it was clear what action had been taken. Staff have training in how to safeguard the people living there from abuse. Staff spoken to were clear about what they would do if they witnessed a person living there Care Homes for Adults (18-65 years) Page 22 of 33 Evidence: being abused or if this was reported to them. The week before we visited, a member of staff had reported an incident where they had witnessed abuse. Another member of staff has been suspended pending investigation. This was reported to the appropriate authorities to ensure that people are safeguarded. Staff also have training in how to deal with behaviour that may be challenging. Care plans about how staff are to support a person who may be aggressive or agitated were very clear that restraint was only to be used as a last resort after several other strategies had been tried first. A health professional told us that one person had been restrained to stop them from leaving the home. Staff said this had happened to prevent the person from being vulnerable when out in the community. This issue has now been resolved and staff know from the persons care plans and risk assessments how to support them appropriately. Records of peoples finances were sampled. Some people look after their own money if they are assessed as being able to do this. Some peoples relatives look after their money and bring some to the home so that people have the cash to spend. The placing authority is the appointee for some people and staff request money from them as the person needs it. Finance records showed that staff ensure that money is spent on personal items not on things that should be provided by the home as part of the fees they pay. Records cross referenced with the amount held in the home for the person. Receipts were kept of all purchases. Records included a list of peoples belongings. These had been regularly updated when people had bought new things. This means that if anything should go missing it is clear what belongs to each person who lives there and when they last had it. Staff have not had training in the Deprivation of Liberty Safeguards but the manager said this is booked for all staff later this year. Staff should have this training so they are aware of how this legislation affects the people who live there. Care Homes for Adults (18-65 years) Page 23 of 33 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 comfortable, safe, clean and homely environment that meets their individual needs. Evidence: The home is split into two units, Beverley and Ascot. Both units were well decorated and furnished. Staff and the people living there told us that people choose the colours for decoration and the furniture. Minutes of meetings with the people living there showed that people are asked what decoration and furniture they wanted. Staff said that people had chosen new sofas for both lounges and these had been ordered. This will make the lounges more comfortable for people to sit in. On the first day we noted that there were some marks on the walls in the lounge of Beverley unit. This was brought to the managers attention who said the room had been decorated recently. However, that night staff cleaned the walls so by the second day the room looked more comfortable. People that live in Beverley unit have an apartment. This includes a bedroom, kitchen and en suite shower room and toilet. In Ascot unit people have a bedroom with en suite facilities. The bedrooms or apartments of the people case tracked were looked at. These were personalised and people said they had everything they needed. The Care Homes for Adults (18-65 years) Page 24 of 33 Evidence: decoration and furnishings reflected the tastes, interests, gender, age and cultural background of the person. One persons carpet was stained, staff said this had been identified and alternative flooring was being looked at to make this room more comfortable for the person. The home was clean and free from offensive odors throughout making it pleasant for people to live in. The people living there are supported by staff to clean the home and their individual space. This helps to develop their independence skills. A house keeper is employed to clean the communal areas of the home so that care staff do not have to spend too much time doing other tasks. Care Homes for Adults (18-65 years) Page 25 of 33 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 arrangements for staffing, their support and development generally ensure that the needs of the people living there are met and they are safeguarded from harm. Evidence: Training records showed that 58 per cent of staff have completed National Vocational Qualification (NVQ) level 2 or 3 in Care. This exceeds the standard that at least 50 per cent of staff have this qualification so they should have the skills and knowledge to meet peoples needs. Other staff were completing this qualification and two of the Team Leaders were also doing the Registered Managers Award so to develop their skills further. Vacancies or absence of staff is covered by permanent staff working extra hours so that they know the people living there well. The manager said that in Beverley unit during the day there is a Team Leader and three support workers and in Ascot unit there is usually the same but when most people are at day centres there are two support workers. At night there is a Team Leader and two support workers in Beverley unit and a Team Leader and one support worker in Ascot unit. Rotas showed that these staffing levels were met. The people living there and staff told us that there are always enough staff on duty to meet individual needs. A professional told us that people did not always seem to get the 1 to 1 staffing support they needed. This needs Care Homes for Adults (18-65 years) Page 26 of 33 Evidence: to be monitored by the persons placing authority to ensure they are getting the support that is being paid for. People who live there told us, Staff always treat me well. Staff look after me well. The manager said that they only had access to staff records two weeks before. Since then they had completed an audit and found that three files were missing. They were unable to contact the previous manager so have asked staff to provide this information again including another Criminal Records Bureau (CRB) check. A risk assessment has also been put in place to ensure that vulnerable people are protected by the staff that work there. We looked at the records of four of the staff that work there. We found the required recruitment records were in place including a satisfactory CRB check to ensure that people are safeguarded. Staff said they had an induction when they first started working there that included training, reading care plans of the people who live there, policies and procedures and shadowing other staff. This lasted for about three to four weeks depending on the individuals previous experience. One member of staff had recently started and was doing their induction. They were not included as part of the rota but were spending time getting to know the people living there and how they needed to support them. Staff said that they got the training they need to meet the needs of the people living there. The training matrix was for 2009 only as the manager did not yet have access to previous staff training records. The matrix showed that staff had completed most of the training they needed but should be updated so it is clear when some staff are due refresher training. Staff learn about mental health in safeguarding and violence and aggression training but said this was not a separate training session. Given the needs of some of the people living there it would benefit staff if they had more specific training in this. Care Homes for Adults (18-65 years) Page 27 of 33 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 management arrangements ensure that the people living there live in a home that is safe, well run and listens to their views. Evidence: The manager has been in post since May this year and has applied to be registered with us. She has over eleven years experience in the care profession and was previously the deputy manager. The manager has achieved NVQ level 3 in Care and the Registered Managers Award. People living there said, The manager has done good with everybody and treats people equally. The manager is a very good person. Staff said that the home is well run and they see the manager as a role model who models good practice. The manager said that the Operations Director visits the home to complete the monthly visits to audit the home as required in the Regulations. However, the reports of these are held at the Head Office. People living there and staff told us that these visits are done and the Operations Director visits at least once a week. They should be available in the home so that any action needed to improve the home can be taken. Care Homes for Adults (18-65 years) Page 28 of 33 Evidence: Audits were seen that the manager completes regularly of care plans, medication, training and staffing to ensure that these meet the Regulations. As stated earlier in this report care plan audits completed did not identify that some people did not have a care plan for all their identified needs. These should ensure that the people living there are being supported to meet their needs. Fire records showed that staff regularly test the fire equipment to make sure it is working. An engineer regularly services the fire equipment to ensure it is well maintained. Regular fire drills are held to ensure that staff and the people living there know what to do if there is a fire. A fire risk assessment was in place to ensure that action is taken to minimise the risks of there being a fire. Staff regularly check the water temperatures to ensure they are not too hot, which could put people at risk of being scalded. Records showed that these were at the correct temperature to reduce this risk. Records showed that electrical and gas equipment is regularly checked and serviced to ensure it is safe to use. Care Homes for Adults (18-65 years) Page 29 of 33 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 30 of 33 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 2 6 7 Care plan audits should be robust so that staff know how to support each person to meet their needs. Staff should ensure that they enable people to make choices and decisions about their lives so their rights are respected. Risk assessments should be clear as to how the person is to be supported to reduce the identified risks so ensuring their safety and that of others. All concerns raised should be recorded in the complaints log. This will make it clear that action has been taken to listen to what people say and show where improvements have been made. All staff should have training in the Deprivation of Liberty Safeguards so they are aware how this legislation affects the people who live there. Staff should have specific training in how to meet the needs of people who have mental ill health so they can support them appropriately. 3 9 4 22 5 23 6 35 Care Homes for Adults (18-65 years) Page 31 of 33 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 7 35 The training matrix should be updated so it is clear that all staff have the training they need to meet the needs of the people living there. Care plan audits should ensure that the people living there are being supported to meet their needs. Reports of monthly visits by a representative of the Provider should be available in the home so that any action needed to improve the home can be taken. 8 9 39 39 Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 33 of 33 - 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!