Care Home: Shervale Home

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What the care home does well People have access to a variety of social activities to reflect their interests to ensure they live a stimulating and fulfilled lifestyle. One staff member said, "We do take people out to places they like to go." The home`s recruitment procedure ensures staff are suitable to work with vulnerable people. One person who live there said, "The staff are nice." People have access to relevant healthcare services so their physical and mental healthcare needs are met. People are supported to maintain contact with people important to them so they can have meaningful relationships. The home was clean and tidy so people`s comfort can be assured. What has improved since the last inspection? The home`s recruitment process now ensures two written references are obtained so the suitability of new staff can be assured. What the care home could do better: To ensure people have access to information in away that it makes it easier to understand, so they know what to expect from the service. All complaints received should be recorded and show what actions have been taken to resolve the problem so people can be confident their concerns will be taken seriously. An assessment of people`s needs should be undertaken before they move into the home, to ensure their needs will be met on admission. To ensure information collated from quality assurance questionnaires are feedback to people and the necessary action taken to improve the quality of the service provided so people can be assured their needs will be met. Menus should be reviewed to ensure people are offered a variety of well balanced, nutritional meals to reflect their likes, dislikes and dietary needs. To ensure staff have access to clear detailed care plans and risk assessments so people can be confident staff will know how to meet their needs. To ensure controlled drugs are appropriately stored and recorded so the security of these medicines are assured. A written fire risk assessment must be in place so staff know how to ensure people`s safety in the event of a fire. Key inspection report Care homes for adults (18-65 years) Name: Address: Shervale Home Shervale 1 Shervale Close Penn Wolverhampton West Midlands WV4 5TU     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: Dawn Evans     Date: 2 7 0 7 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 34 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 34 Information about the care home Name of care home: Address: Shervale Home Shervale 1 Shervale Close Penn Wolverhampton West Midlands WV4 5TU 01902342811 01902342811 shervale2000@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr John Greensill,Mrs Thelma Greensill care home 5 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: 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 Brief description of the care home The date of the last inspection was 14 September 2007. Shervale House is a residential home that provides a service for both men and women who have a learning disability. The home also currently provides a service for one person who has a physical disability. The home is located in quiet residential area and is within walking distance of local Care Homes for Adults (18-65 years) Page 4 of 34 Over 65 0 5 Brief description of the care home shops, pubs and restaurants. The bus route is nearby, making travel to Wolverhampton City Centre easy. The home offers one bedroom on the ground floor and four on the first floor. Each bedroom is equipped with an en suite. A bathroom is also located on the first floor and separate toilet on the ground floor. People have access to a lounge, separate dining room, activities room, laundry and a kitchen situated on the ground floor. A well maintained garden is accessible at the rear of the property. Limited car parking is available at the front of the home. Ramp access to the property enables people with restricted mobility to gain entry in and out of the building. Staffing is provided on a 24 hour basis to ensure people receive the necessary support when needed. People have access to relevant healthcare services to ensure their healthcare needs are met. People also have access to previous inspection reports, this enables them to find out about the quality of the service provided and peoples experience of living there. The fees charged for the service provided at Shervale House was not made available to us. The reader is advised to contact the service direct for this information. Care Homes for Adults (18-65 years) Page 5 of 34 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 peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection was carried out over one day; the home did not know we were going to visit. 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, standards of practice and focuses on aspects of service provision that need further development. Prior to the visit taking place we looked at all the information that we have received, or asked for, since the last key inspection. This included notifications received from the home. These are reports about things that have happened in the home that they have Care Homes for Adults (18-65 years) Page 6 of 34 to let us know about by law, and an Annual Quality Assurance Assessment [AQAA]. This is a document that provides information about the home and how they think it meets the needs of people living there. Three people living in the home were case tracked. This involves establishing individuals experiences of living in the care home by meeting them, observing the care they receive, 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 around some areas of the home. A sample of care, staff and health and safety records were looked at. Where people who use the service were able to comment on the care they receive their views have been included in this report. Due to the communication needs of some people living here, it was not possible to ask them for their views on the home, so time was spent observing care practices and staff interaction. We spoke to two people who use the service and three staff members. We sent five of Have your Say surveys to people who use the service. We received three of returned surveys and these views have been included in this report. Care Homes for Adults (18-65 years) Page 7 of 34 What the care home does well: What has improved since the last inspection? What they could do better: To ensure people have access to information in away that it makes it easier to understand, so they know what to expect from the service. All complaints received should be recorded and show what actions have been taken to resolve the problem so people can be confident their concerns will be taken seriously. An assessment of peoples needs should be undertaken before they move into the home, to ensure their needs will be met on admission. To ensure information collated from quality assurance questionnaires are feedback to people and the necessary action taken to improve the quality of the service provided so people can be assured their needs will be met. Menus should be reviewed to ensure people are offered a variety of well balanced, nutritional meals to reflect their likes, dislikes and dietary needs. To ensure staff have access to clear detailed care plans and risk assessments so people can be confident staff will know how to meet their needs. To ensure controlled drugs are appropriately stored and recorded so the security of these medicines are assured. A written fire risk assessment must be in place so staff know how to ensure peoples safety in the event of a fire. Care Homes for Adults (18-65 years) Page 8 of 34 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 34 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 34 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements in place do not ensure people can be confident their needs will be met on admission to the home. Evidence: The home has a Statement of Purpose and a Service User Guide, this provides information about the service and facilities available. The Statement of Purpose or Service User Guide provided relevant information about the service and facilities available but was not in a format people can understand and this was also confirmed by the manager. The manager said these documents were not available in any other format. One person had recently been admitted to the home, the manager said the Statement of Purpose and Service User Guide was given to the placing Social Work and not the person wishing to use the service. We spoke to the person who had recently moved into the home and they could not Care Homes for Adults (18-65 years) Page 11 of 34 Evidence: remember receiving any information about the home before they were admitted. They told us they were happy with the service provided to them. However, the lack of information about the service and what to expect does not ensure people will be able to find out about the homes suitability to meet their needs before they move in. The manager said they do not undertake a needs assessment. This is an assessment to find out the persons needs and the level of support required to enable them to live fulfilled lifestyle. The manager said they were reliant on information received from Social Services. We looked at one assessment undertaken by Social Services and discussions with the manager confirmed, this persons care plan did not provide sufficient information about the persons needs. People cannot be confident that the home will know how to meet their needs when they move in. Further discussions with the manager confirmed people are able to visit the home before making a decision to use the service. One person spoken to who live there also confirmed this. Care Homes for Adults (18-65 years) Page 12 of 34 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. People cannot be confident that all staff will know how to meet their needs to ensure their wellbeing. Evidence: We case tracked three people and looked at their care plans. A care plan should provide information about the persons care needs and tell staff how to meet them to ensure the persons wellbeing. Discussions with staff and the manager confirmed information contained within the care plans do not always reflect peoples needs or their involvement to ensure they receive the necessary support in a way their prefer. One person spoken to was not aware of their care plan. However, we saw some information within their bedroom about their social interests and people important to them. There was no evidence of their involvement in their care planning. Another person spoken to was unable to tell us if they were involved in their care planning to reflect their individual choice and preferences. Care Homes for Adults (18-65 years) Page 13 of 34 Evidence: The manager told us meetings are undertaken with people who live there. Minutes given to us showed only one meeting had been undertaken this year. Discussions related to access to social activities and meals provided. We also saw confidential information about a complaint was discussed in this meeting. It is recommended that peoples privacy should be respected and sensitive matters should not be discussed within these group meetings. The manager was not able to show us how information discussed in these meetings were actioned to improve or ensure the service reflected peoples needs. The manager told us that due to peoples mental capacity they were not able to manage their financial affairs. Social Services were appointees. The home held a small amount of cash in safekeeping. There was a record to show expenditures for each person and receipts were maintained. We looked at two account sheets and funds, which were correct. People can be assured their finances will be well managed. Risk assessments were not in place to provide staff with relevant information on how to ensure peoples independence and safety. For example, one person who live there, said they assist with cooking. Care records showed and staff confirmed this person had a health condition. The manager acknowledged there was no risk assessment in place to ensure this persons safety whilst in the kitchen. One risk assessment showed the person was at risk of weight loss. There was insufficient information in place, to ensure staff know how to reduce or eliminate the risk of weight loss. For example, it did not tell staff if this person required a special diet. The manager told us this person required their meals to be mashed [soft diet] but this was not shown in the risk assessment. One staff members spoken to was aware this person needed their food to be cut up small. We also observed this person being given a soft diet. We observed staff feeding this person. However, the assistance required for eating and drinking was not shown in the risk assessment. There was no information to tell staff if the person had access to a dietician. One staff member spoken to was aware this person needed assistance with eating and drinking. However, due to the fact the home has recently recruited new staff; the lack of access to clear detailed information about peoples needs may compromise the care provided to them. Care records showed the person needed the use of a hoist for all transfers. We did not see a moving and handling assessment in place for the safe us of this equipment. The Care Homes for Adults (18-65 years) Page 14 of 34 Evidence: manager said they did not have one. We spoke to one staff member who was aware of the equipment needed to assist this person with their mobility. However, the lack of written risk assessment does not ensure all staff will know how to meet this persons needs. We looked at staff training records which, showed staff had received moving and handling training. One staff member said this training included how to use the hoist safely. Care Homes for Adults (18-65 years) Page 15 of 34 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to pursue their social interests to live a stimulating lifestyle. However, meals provided within the home may not meet their dietary needs. Evidence: The AQAA told us the service does well at giving people the opportunity to develop and take part in activities they are interested in. One person told us they attended college, learning daily life skills and said they enjoy attending. One person told us they use to go horse riding and showed us their awards. They said due to ill health they were no longer able to do this. This person told us they attended day care services Monday to Friday and enjoyed it. They said, I did first aid today at the centre. Care Homes for Adults (18-65 years) Page 16 of 34 Evidence: The registered provider said We take people out every alternative week on a day trip. One person who lived there said, We are going to the Safari Park next week. Care records showed one person enjoyed going clothes shopping and having lunch at the local pub. One staff member said, We do take people out to places they like to go. Discussions with the person who live there also confirmed this. People can therefore, be assured they will be supported to pursue their social interests. Care records also showed people were able to maintain contact with their family and friends. One person said they were able to maintain contact with their family and were able to visit them when they wanted to. We observed people were able to have visitors. One person said they were able to be alone with their boyfriend and staff respected their right to privacy. This means people are are able to have meaningful relationships. On the day of our visit three people had attended day care services. One staff said, Its peoples choice to attend and they enjoyed it. We observed one person getting excited when the transport came to take them to the centre. We saw one person watching the television throughout the day and staff assisting to the needs of another person who required constant support due to their healthcare needs. The home had a two week menu. Menus given to us showed meals were not varied or well balanced. One care records showed the person liked fruit and vegetables. However, menus did not offer people a variety of fruit and vegetables on a daily basis. For example, week one of the menu, for Saturday lunch offered turkey and coleslaw and gateau. The evening meal was beef burgers or sausages with scrambled eggs and fruit. Friday lunch, was cheese on toast and for the evening meal, fish fingers or fish pie, chips and peas. We looked at the food in storage and saw only eggs, yogurt and margarine in the fridge. There were ample supplies of fruit. Fresh vegetables consisted of a small amount of potatoes. The registered provider said he had just used all the fresh vegetables for the evening meal. This was cheese and potato pie with baked beans. The registered provider said, We dont use fresh vegetables we use frozen. There was a small supply of food in the freezer. The provider acknowledged this and said, We are a bit low on food we are due to go out shopping. Due to insufficient Care Homes for Adults (18-65 years) Page 17 of 34 Evidence: menu planning and the lack of food provisions in storage people cannot be confident their dietary needs will be met. Two people who lived there told us the food was fantastic. One person told us they did not have a choice of meals. We observed cheese and potato pie was served to everyone. However, two people told us, I like cheese and potato pie, its nice. The manager said no one required a special diet due to cultural or religious needs, as previously mentioned in this report one person required a soft diet. Care Homes for Adults (18-65 years) Page 18 of 34 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. The lack of written information does not ensure all staff will know how to meet peoples personal and healthcare needs. Evidence: We looked at three care plans, these did not provide staff with detailed information on how to support people with their personal care needs. For example, one care plan showed the person suffered with constipation. One care staff and the manager told us this information was incorrect. The manager said this person had not experienced any bowel problems for at least 18 months. The care plan had been reviewed in May 2009. The manager said these details had just been copied from previous care plan and acknowledged it did not reflect the persons current needs. This person cannot be assured staff will know how to meet their needs. The care plan also showed a person was allergic to a specific medicine. Further details within care records told us the person did not have any allergies. One care staff spoken to was not aware of the persons allergic reaction to this medicine. This care staff also told us they were responsible for giving people their prescribed medicines. Information about this persons allergies was shown on the medicine cabinet. The Care Homes for Adults (18-65 years) Page 19 of 34 Evidence: conflict of information contained in the care records could compromise this persons health. Another care plan showed the person was diagnosed with a health condition, which affected them on a daily basis. One staff had been in post for six months; they were aware of this diagnosis but not the impact this had on the person. The staff member did not know whether a record was in place to monitor the persons health condition. Due to staffs lack of knowledge this person cannot be confident their care needs will be met. Another care record showed the person displayed behaviours that challenged the service. The care record did not provide staff with sufficient information on how to manage these behaviours appropriately. The care records showed good behaviours were rewarded with a hug. As the home employs both male and female staff, we discussed with staff and the manager whether this was appropriate. The manager said she had not considered this. This person cannot be confident that staff will have the skills and knowledge to meet their needs properly. We observed people were smart and well dressed and appropriate to their gender and age. One person said they enjoyed going clothes shopping and was able to choice their clothes. This should ensure people are able to dress in a way that reflects their style and individuality. The AQAA shows people have access to relevant healthcare services. One care staff spoken to confirmed this. The care records we looked at showed healthcare visits were recorded. This should ensure people healthcare needs are met. We looked at how the home manages peoples prescribed medicines. The manager said due to peoples mental capacity they were not able to administer their medicines. The manager said one person was prescribed a control medicine. This is a medicine required to be stored in an appropriate medicine cabinet and recorded and signed by two staff when administered. This medicine was not appropriately stored or recorded, which may compromise the security of these medicines and place people at risk of harm. Some people were prescribed when required medicines. These are medicines given to people only when needed. We did not see a written protocol in place for the safe use Care Homes for Adults (18-65 years) Page 20 of 34 Evidence: of these medicines. The manager confirmed this was not in place. We also saw homely remedies were in use. These are non prescribed medicines. We saw written authorisation from the General Practitioner for the use of these medicines. There was no written information in place to tell staff when and how often to use these medicines and what to do if symptoms persist. The manager also confirmed there was no written protocol for the safe use of these medicines. We saw an unsecured prescribed medicine for the registered provider in the bathroom, which was accessible to people. The registered provider acknowledged these were his prescribed medicines and that they should be securely stored to ensure peoples safety. Care Homes for Adults (18-65 years) Page 21 of 34 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The lack of access to a complaint procedure people can understand does not ensure they will know how to share their concerns or be assured their rights will be respected. Evidence: Discussions with the manager confirmed people do not have access to a complaint procedure they can understand. The manager said some people would not be able to understand the complaint procedure even if produced in a easier format. The AQAA told us peoples complaints are listen to and acted upon. Three surveys received from people us use the service showed they would know who to speak to if they were unhappy. One person who lived there said, If Im not happy I would tell the staff they would sort things out. The AQAA showed the home had not received any complaints since the last inspection visit. However, discussions with the manager confirmed this was not entirely correct. The home had received a complaint about the service provided to one person who lived there. The Learning Disability Team and the Police were involved. The manager confirmed that we, the Commission were not notified of this incident or complaint. The home have a legal obligation to notify us of any incident that may have an adverse impact on peoples lifes. The manager said this complaint was investigated by the Learning Disability Team and Care Homes for Adults (18-65 years) Page 22 of 34 Evidence: there was no evidence of poor care practices. This complaint was not clearly recorded to show the nature of the complaint or what action had been taken to safeguard the person. The manager was not aware of the importance to clearly record all concerns and complaints and to show what action has been taken; so people can be confident their concerns are taken seriously and addressed. We have not received any concerns or complaints about the service since the last inspection visit. We asked to see the homes safeguarding policy and this was not made available to us. A safeguarding policy should tell staff about various forms of abuse and how to protect people from this. The manager said 6 out of 8 staff members had received safeguarding training. One staff member spoken to confirmed they had received this training. This training should ensure staff have the skills to recognise abuse and safeguard people from harm. One staff member spoken to said, if they received an allegation of abuse they would report it to the manager and if they felt the appropriate action had not been taken, they would report it to the police, social worker and where necessary ensure the person is seen by the doctor. Although staff may not have access to a written safeguarding policy they did have the knowledge of how to safeguard people from potential harm. Care Homes for Adults (18-65 years) Page 23 of 34 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is suitable to meet peoples needs and a good hygiene standards ensure their comfort. Evidence: Shervale House in located in quiet residential area, the home is near to local shops and a bus route, making travel to Wolverhampton City Centre easy. The modern two storey property offers five bedrooms, having one bedroom on the ground floor and the remaining on the first floor. All bedrooms are equipped with en suite facility. There is no passenger lift is in place, ramp access to the property enables people with restricted mobility to access the home. A hoist is in place to assist one person with their mobility. The property also offers a lounge, separate dining room, activities room, laundry and a toilet situated on the ground floor. The size and layout of the property was suitable to meet peoples needs. We saw bedrooms were personalised to reflect their interests. Care Homes for Adults (18-65 years) Page 24 of 34 Evidence: People have access to a well maintained garden at the rear of the property. Limited car parking is available at the front of the building. All areas of the home was clean and tidy to ensure peoples comfort. Care Homes for Adults (18-65 years) Page 25 of 34 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident their care needs will be met by suitably recruited skilled staff. Evidence: The manager said 4 out of 8 staff members had completed the National Vocational Qualification level 2 in Care. This training should ensure staff have the skills to provide a good service to people. The AQAA told us staff are given training to improve their competency. Training records showed staff had received the following training: Moving and Handling, Management of Medicines, Basic Food Hygiene, Health and Safety, Mental Health Act, First Aid, Fire Safety amongst others. One staff member spoken to confirmed receiving this training. This training should ensure staff have the skills to deliver a good standard of care. The home does not provide domestic or catering staff; these tasks are carried out by the care staff. The manager said she was confident sufficient staffing was available to meet peoples needs and felt that care staff undertaking domestic duties did not compromise the quality of care given to people. She said, Some people are out in the day and there is usually only three people in the home during the day. Care Homes for Adults (18-65 years) Page 26 of 34 Evidence: The staff working rota showed two staff members were provided throughout the day, having one wakeful staff during the night and one staff member sleeping in. On the day of our visit we saw two care staff and both registered providers one of which is also the registered manager on duty. People can be confident staff will be available to assist them when needed. One person who use the service said, The staff are nice. We observed staff talking to people in friendly manner and were attentive to their needs. The AQAA told us staff have the necessary safety checks before working in the home. We looked at the homes recruitment and selection procedure and looked at three staff personnel files. All contained evidence of appropriate safety checks to ensure staffs suitability to work with vulnerable people. These safety checks included a Criminal Record Bureau (CRB) clearance, Protection of Vulnerable Adults (PoVA 1st) check and the receipt of two written references. One staff member spoken to confirmed having these safety checks before starting work at the home. Care Homes for Adults (18-65 years) Page 27 of 34 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 home is not always run in a way to ensure staff have the information required to meet peoples needs. Evidence: The AQAA shows the manager is experienced within her role and is a registered general nurse. Discussions with the manager and training records looked at showed she undertakes regularly training to enhance her skills. As shown within the contents of this report there are a number of short falls, which may compromise the quality of service provided to people. Staff do not have access to clear and detailed care plans or risk assessments to ensure they know how to meet peoples needs. The management of peoples medicines was not robust to ensure their wellbeing. Inadequate menu planning and the lack of food provisions in storage does not ensure peoples dietary needs will be met. Care Homes for Adults (18-65 years) Page 28 of 34 Evidence: The manager said quality assurance questionnaires are given to people. These questionnaires should enable people to express their views and opinion on the service they receive. We asked the manager what they do with the information gathered from these surveys. She said, We dont do anything with the information. If there are any issues, I just deal with it. The manager said, We would talk about it at the meeting. Records showed these questionnaires had be given to people in January 2009. We asked to see evidence of this within the minutes of meetings undertaken with people who live there. This information was not made available to us. This means people may not have a say in how the home is run to ensure the service they receive meets their individual needs. The AQAA was sent to us within the required timescale. However, the information contained within the AQAA did not show shortfalls as identified within this report. It is recommended that the AQAA is used to show not only strengths within the services but also weakness and action that will be taken to address these to ensure peoples best interests. We looked at health and safety systems and procedures, we saw that portable electrical appliances were routinely checked on a yearly basis to ensure they are safe. The homes public liability insurance was valid. We asked to look at the homes fire risk assessment. The manager was not sure what this was. A fire risk assessment should provide staff with detail on fire prevention and also tell them what do to safeguard people in the event of a fire. This should also include a evacuation plan. Care Homes for Adults (18-65 years) Page 29 of 34 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 34 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 2 14 Appropriate action must be taken to ensure the necessary assessment of peoples needs are carried out. This should ensure peoples needs are met on admission to the home. 05/10/2009 2 6 12 The appropriate measures must be taken to ensure staff have access to detailed information about peoples needs. This should ensure staff know how to care for people and ensure their needs are met. 05/10/2009 3 9 13 Action must be taken to ensure staff have access to a written risk assessment. This should ensure staff know how to support peoples independence and safety. 05/10/2009 Care Homes for Adults (18-65 years) Page 31 of 34 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 4 17 16 Action must be taken to ensure people are provided with a varied and well balanced diet. This should ensure their health is promoted and their individual dietary needs and preferences are met. 05/10/2009 5 20 13 Action must be taken to ensure controlled medicines are appropriately recorded. This should ensure the appropriate management of controlled medicines. 05/10/2009 6 20 13 Measures must be taken to ensure the appropriate storage of controlled drugs. This should ensure people are not placed at risk of harm. 30/10/2009 7 22 37 The registered person must ensure the Care Quality Commission are notified of any incident that may have an adverse affect on people who live in the home. This should ensure the service complies with their legal obligation. 30/09/2009 8 42 23 The necessary measures must be taken to ensure staff have access to a written fire risk assessment. 09/10/2009 Care Homes for Adults (18-65 years) Page 32 of 34 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 This should ensure staff know how to safeguard people in the event of a fire. 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 To ensure people have access to a Statement of Purpose and Service User Guide in a format they can understand so they know what to expect from the service. To ensure people are involved in their care planning so they receive the care in a way they prefer. To ensure peoples right to privacy; confidential matters should not be discussed within group meetings. To ensure all complaints are recorded and show what action has been taken to resolve the concern, so people know their concerns are listened to and taken seriously. To ensure people have access to a complaint procedure in a format they can understand so they know how to share their concerns. To ensure staff have access to the safeguarding policy so all staff know what to do to safeguard people from potential abuse. To ensure peoples views and opinion on the service they receive are listen to acted on enabling them to live a lifestyle of their choice. 2 3 4 6 7 22 5 22 6 23 7 39 Care Homes for Adults (18-65 years) Page 33 of 34 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. 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