Care Home: Stapleton Drive

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What the care home does well The Service User Guide and Statement of Purpose have been changed since the last inspection and are now available in a format which is easy for people to read and understand. Information is recorded in picture format to help those people with reading difficulties. Behaviour management guidelines and behaviour charts were detailed and gave staff specific guidance regarding the action if people become anxious or aggressive. Staff have a lot of knowledge about people`s likes, dislikes, needs and abilities and were aware of the support needed for individuals. People are encouraged to keep in contact with their families and friends so that important relationships are maintained. People are being encouraged to lead a healthy lifestyle including gym membership for some people and healthy meal choices when planning menus and shopping. People have access to health care professionals as needed to ensure that their health needs are being met. The complaint procedure is available for everyone and has been developed using pictures to help those people who have difficulty reading understand the information. What has improved since the last inspection? Person centred review meetings have been held for some people and information recorded following these meetings is detailed. These review meetings will help to ensure that support is provided to people in a way in which they prefer and that they lead fulfilling and meaningful lives. The manager has introduced regular staff meetings in which staff can share their views, learn from each other, receive updates and discuss issues. What the care home could do better: Support plan documentation should be fully completed for each person and should include instructions for staff on how to support people on a daily basis. All risk assessments should be reviewed on at least an annual basis. This is to ensure that people`s needs have not changed which may affect the level of risk from completing an activity thus putting people at risk of harm. Key workers should ensure that they complete all relevant documentation in care files to demonstrate that they have met people`s needs. Care files contained a lot of duplicate information which made the files bulky and information may be difficult to find. Health care files should record the support and services needed by individuals in order that they can stay healthy and well. Some of the information on one file seen was blank, other information was not fully completed. The manager confirmed that other files were not up to date. Work should be undertaken to the decor in one of the houses as it appeared shabby and some areas did not have a homely feel. Further improvements are required to quality assurance systems to enable the views of parents and carers to be obtained. Key inspection report Care homes for adults (18-65 years) Name: Address: Stapleton Drive 25 - 29 Stapleton Drive Chelmsley Wood Birmingham West Midlands B37 5LQ     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: Deborah Shelton     Date: 1 4 1 2 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 32 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 32 Information about the care home Name of care home: Address: Stapleton Drive 25 - 29 Stapleton Drive Chelmsley Wood Birmingham West Midlands B37 5LQ 01217702469 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Solihull Care Trust Name of registered manager (if applicable) Miss Amy Elizabeth Cole Type of registration: Number of places registered: care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to accommodated is 12. 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) 12 Date of last inspection Brief description of the care home Stapleton Drive consists of three separate houses that provide care and accommodation to up to four people with a learning disability in each house. The home is situated in the Chelmsley Wood area of Solihull and there are shops, pubs, places of worship and public transport links nearby. People have their own bedroom and share kitchens, lounges and dining areas as well as bathroom facilities. One bedroom has an en suite shower and toilet. There are car parking spaces at the front of the houses and Care Homes for Adults (18-65 years) Page 4 of 32 Over 65 0 12 1 3 1 1 2 0 0 8 Brief description of the care home gardens to the rear. We did not have access to information about the fees charged to live in the home at this visit. Care Homes for Adults (18-65 years) Page 5 of 32 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: This visit took place over one day and was conducted by one inspector. The people who live and work at the home did not know that we were coming. There were eleven people living at Stapleton Drive on the day of our visit. Before we went to the Home we looked at notifications that the home had sent us which informed us of any events that had impacted on the health and well being of the people who live there. We also reviewed the annual quality assurance assessment which was completed and returned in time for this inspection, providing the managers views of the homes performance during the last year. This document gives us information about how they are meeting national minimum standards, details about the staffing of the home, the policies and procedures in place to make sure that people stay safe and well and how the home plans to make improvements to the service. We case tracked three people who live in the home. Case tracking involves meeting or observing people, reviewing records of their care and talking to the staff who support them in order to focus on Care Homes for Adults (18-65 years) Page 6 of 32 outcomes. Case tracking helps us understand the experiences of people who live in the home. The inspection included seeing some of the people living at the home. Due to the communication needs of some people it was not possible to get a clear impression of their views of the service. We looked at the way medicines and health and safety were being managed, observed the environment that people live in and reviewed staff training and recruitment records. The manager was present at this visit and helped answer our questions about the running of the home. Care Homes for Adults (18-65 years) Page 7 of 32 What the care home does well: What has improved since the last inspection? What they could do better: Support plan documentation should be fully completed for each person and should include instructions for staff on how to support people on a daily basis. All risk assessments should be reviewed on at least an annual basis. This is to ensure that peoples needs have not changed which may affect the level of risk from completing an activity thus putting people at risk of harm. Key workers should ensure that they complete all relevant documentation in care files to demonstrate that they have met peoples needs. Care files contained a lot of duplicate information which made the files bulky and information may be difficult to find. Health care files should record the support and services needed by individuals in order that they can stay healthy and well. Some of the information on one file seen was Care Homes for Adults (18-65 years) Page 8 of 32 blank, other information was not fully completed. The manager confirmed that other files were not up to date. Work should be undertaken to the decor in one of the houses as it appeared shabby and some areas did not have a homely feel. Further improvements are required to quality assurance systems to enable the views of parents and carers to be obtained. 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 32 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 32 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 are given information about the home before they move in and their individual needs are assessed so that they can be confident their needs can be met. Evidence: There have been no new people admitted since we visited the Home in November 2008. The systems and documentation in use for assessing peoples needs have not changed since the last inspection where they were found to be comprehensive. If people were to move in they would be coming for a visit or an overnight stay before they decide that Stapleton Drive is the right place for them and to ensure that everyone will get on well. The statement of purpose and service users guide have been amended, an individualised document is available for each house. The document shows pictures of the relevant house and is produced in large print, easy read format with pictures to help those people who have difficulty reading. The document has been developed with help from a speech and language therapist and includes pictures of staff and rooms in the Home. It tells people useful information about life at Stapleton Drive, as well as Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: how to complain and who to go to if they have any concerns or worries. The manager agreed to discuss the service users guide and its contents at person centred review meetings where people will be reminded of the facilities and service available to them as recorded in the service users guide. Care Homes for Adults (18-65 years) Page 12 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care planning information does not always ensure that staff have all the relevant information they need to ensure that peoples needs are met safely and in the manner they prefer. Evidence: We looked at care plans and risk assessments for three people, one person living at 25, one at 27 and one at 29 Stapleton Drive. These records describe the support that people need in their day to day lives and describe how risks to their health and well being should be managed. The manager explained that she has started work to improve the information written in care files as some do not contain enough information about peoples needs and how they should be met. The care files of all people living at 29 Stapleton Drive have been re-written and each person has had two person centred review meetings. The manager confirmed that now the new system is working well at 29 Stapleton Drive she will introduce the new person centred planning approach and documentation to Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: each of the other houses. The information recorded on the new documentation using person centred reviews included photographs of the meetings showing who attended and what was discussed. It recorded information such as what is important to XX, what people like and admire about XX, and how best to support XX. The detailed information was a lot easier to read and follow. The manager says that she writes down what do you need to know and what do you need to do. This makes it easier for staff to understand what they need to do to meet peoples needs. In the file seen, sample support plan documentation had not been completed but was going to be used as a guide to show staff the sort of information needed about each person such as information about what is a good day for me, what is a bad day, daily routines and a learning log. Each of the three files contained detailed management guidelines which had all been reviewed and updated in November 2009 and risk assessments. Risk assessments related to various activities such as preparation of meals and drinks, falls and going out on community activities. These risk assessments were detailed and record, for example, the benefits for the person, potential risks, what can be done to minimise risk and if it happens how will you respond at the time. One risk assessment seen had not been reviewed since January 2008. The needs and abilities of this person may have changed in this time and the risk assessment should be reviewed to identify any risk present and record the action necessary by staff to reduce the risk. A key worker responsibilities sheet records the actions that key workers are to undertake to support people, for example, regarding finances, weight, birthdays, appointments and holiday. Detailed instructions were recorded for staff to tell them what to do regarding each area. A key worker check list is to be signed when each task detailed under keyworker responsibilities has been done. One check list seen had not been signed since July 2009. There is therefore no written evidence that the key worker has been providing appropriate support. Two of the care files seen did not clearly reflect peoples personal goals. The care file which had been changed to the new format with the person centred plan reflected the persons needs, aspirations and dreams. Information regarding likes and dislikes, activities that people like to join in were recorded on a pen picture. Behaviour charts were available as necessary and information for staff on how and when to use physical intervention was recorded. The Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: manager said that she has had discussions with staff regarding the use of physical restraint and all physical restraint protocols are being reviewed to ensure that staff are aware of any other actions that they can take before using restraint. Each care file contained a lot of information, some of which was duplicated on various forms. However, in general, the information needed to meet peoples needs was recorded. We were told that people make choices about their daily routines, house meetings are held each week and people make decisions about meals, activities and any trips out of the Home. Care Homes for Adults (18-65 years) Page 15 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to take part in a range of community and leisure activities. People are consulted and involved in menu planning in order that they are provided with the meals they enjoy. Evidence: We looked at the social and leisure diaries which are on display for people in each house. Each person has a small noticeboard, this is used to remind people of the activities that they will be doing each week. Pictures of the activities that people will be doing are put on the noticeboard. Some people prefer to have a calender which records the pre-planned activities that they will be doing for the month and these were seen. People choose what activities they want to do at the weekly house meeting. Staff advocate for some people who are unable to communicate their wishes. Records show that people are doing the activities that they enjoy, pre-planned Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: activities such as a pottery class, weekly disco and a hydrotherapy session are enjoyed by some people. One person was getting ready to go the disco while we were there and was looking forward to a good night out, another person had returned from a pottery session and said that he enjoyed going to pottery. Ad hoc activities such as a trip to the cinema or gym can also take place. Weekly meetings are held amongst staff to link up regarding peoples common interests, such as going to the cinema or disco, so that, if everyone involved is in agreement, people from each house can all go together. Records show that requests made by people such as horse riding and gym sessions had taken place. A file is kept in each house to record what activities people have done. Each file contained a lot of detailed information which was repeated on some forms. Staff are recording on a weekly log the activities that people do. One seen did not record any activities taking place in the evening or at weekends. Some other activity records had not been fully completed. The manager said that activities take place seven days per week and in the evening but records had not been updated to show this. A learning log is used by staff to record whether the person has enjoyed the activity, whether it was beneficial for them and other likes and dislikes. This helps to ensure that activities undertaken by people are meaningful and enjoyable. The Homes annual quality assurance document records that they plan yearly holidays and short breaks in accordance with peoples needs and wishes and they facilitate and support activities requested by people. Records also show what household activities people have been involved in, for example housework, gardening, preparing breakfast. The support given by staff is also recorded. This shows that people are involved in the running of their home. Menu cards showing pictures of meals are used to help people plan their weekly meals. Staff said that people take it in turn to plan the meal for each day during the weekly house meetings. If on the day someone had changed their mind and wanted an alternative this would be prepared using stocks of food in the house. People with limited communication are shown packaging, tins or foodstuffs to help them decide what they want to eat if they do not want the main meal served. Staff said that people are able to change their mind on a daily basis and have an alternative. Staff also said that they are trying to encourage people to have a healthy diet including the use of wholemeal pasta and rice and introducing healthier alternatives. Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: Some people living at the Home were not able to share their opinions due to complex communication needs, however staff demonstrated an in depth knowledge of these peoples likes, dislikes, needs and abilities including how they communicate through their body language and actions. Care Homes for Adults (18-65 years) Page 18 of 32 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. Staff support people so that their personal care and health care needs are met. Improvements are required to recording systems regarding health care to ensure peoples needs are not missed. Evidence: The three care files seen recorded some comprehensive information about peoples health needs and medical diagnosis. A separate folder called my health needs is apparently available for everyone. These should describe the support and services needed to stay healthy and well. The manager said that not all of these are up to date. Only one of these files was seen. This showed that the person had contributed to and agreed to all issues raised. Information was recorded in picture format to help the person understand what has been recorded. Standardised headings regarding, for example, people who help me, medication, communication, general health were available on file but not all of the information had been completed. Other information regarding lifestyle, me and my families health had not all been completed. The manager said that she intends to change all of these files as some of the information is duplicated in each file. Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: Weight charts show that peoples weight is monitored on a monthly basis and records seen showed that peoples weight had increased slightly. Personal care plans described preferred daily routines such as bathing or showering, assistance needed with daily tasks such as shopping, choosing what to wear etc. The Homes AQAA records that each person has an allocated key worker and that staff react quickly to any change in a persons well being and liaise with the appropriate professional as necessary. Records seen confirm that people have access to professionals such as chiropody, GP, practice nurse, psychology, optician and dentist. Hospital letters, optical prescriptions, psychology referrals and other letters were all available on file Medication systems and practices were reviewed. It was noted that they are the same in each house. The manager confirmed that recently there have been some medication errors. Meetings have been held with the staff involved and discussions held at supervision meetings to try and ensure that further errors do not occur. The Care Trust has visited the Home and completed a medication audit and will be attending team meetings to discuss medication. All medications seen were stored appropriately and records were correct. Copies of the current prescription are available for each person and are used to check against medication received into the Home. Records show how people prefer to take their medication. Currently nobody takes any controlled medication, however if they needed to there are no storage facilities to store controlled meds. The manager said that this is being looked into currently with a view to providing appropriate storage facilities. PRN (as needed medication) protocols are in place explaining the circumstances under which these medications should be given. The PRN protocol appropriately refers staff to the correct behaviour management guidance in place on the care file so that appropriate interventions can be tried before resorting to the use of medication. Care Homes for Adults (18-65 years) Page 20 of 32 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. There are effective procedures in place to listen to and act upon peoples concerns and complaints if they have any. The home is taking adequate measures to promote the protection of vulnerable adults. Evidence: Each house has a log book for recording any complaints or concerns received. We have not received any complaints since the last inspection. The Home has received some complaints and records show that appropriate action has been taken to resolve issues raised. The complaint procedure has been amended and is now in picture format to help people understand it. It is available in each house and in the service users guide. There has been a safeguarding incident since the last inspection. The incident has been referred for investigation under the safeguarding procedures and appropriate action has been taken by the manager to address this issue. Staff have undertaken training regarding physical restraint. This is included in the management of aggression training course that they undertake. The manager said that they will also be undertaking a course which only relates to restraint. The manager feels that staff have all of the knowledge needed to be able to restrain people safely. Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: Peoples money is being held on their behalf at the Home. Procedures are in place for security for people who request a withdrawal of money in excess of £50. Records of withdrawals from bank are kept on file. Peoples money is well managed on their behalf and books are kept for each person to record any expenditure. Care Homes for Adults (18-65 years) Page 22 of 32 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 clean and comfortable home with facilities that meet their needs Evidence: The home is situated in the Chelmsley Wood area of Solihull and is close to shops, restaurants, places of worship and public transport routes. This is important to the people who live in the home as they make regular use of these facilities. The home consists of three houses, which have a separate garden at the rear. There is car parking space available at the front of the home. Each of the three houses were seen and decor in two of the houses was in a good state of repair. Lounges were homely and comfortable and people appeared to be at ease in their surroundings. Christmas trees and decorations had been put up and people were occupying themselves watching television or doing other activities. No unpleasant odours were noted and all areas seen were clean and hygienic. Each house has a kitchen, dining room and lounge. Single bedrooms, bathrooms and a staff sleep in room. The decor in one house is a little shabby and dated. One bedroom seen needs redecorating to ensure that it has a homely feel and is in a good state of repair. All of the bedrooms seen had been personalised, were clean and tidy and people were proud Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: to show how nice their rooms were. Care Homes for Adults (18-65 years) Page 24 of 32 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. Robust recruitment and staff training systems are in place to ensure that people are supported by suitable staff. Evidence: People were seen to have a good relationship with staff on duty. Staff were attentive to peoples needs and had a good understanding of peoples abilities and the support required each day. Separate duty rotas are completed for each house. House leaders are responsible for arranging staffing. Duty rotas seen showed that sufficient numbers of staff are on duty each day to meet the needs of the people who live there. Three or four staff work during the daytime and a member of staff is on sleep in duty in each house. This person would be expected to wake and provide assistance if needed. There is also a member of waking night staff in one house who could be called upon as needed. Currently there is a house leader per house and an assistant house leader at 29 Stapleton Drive. The manager confirmed that no new staff have been employed since the last inspection. Three staff are in the process of being employed and their records are held at the Care Trust personnel Department. People living at Stapleton Drive are not involved in the recruitment of staff and are not introduced to staff before they Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: start working at the Home. Staff are employed by Solihull Care Trust and could therefore work wherever they are placed. The manager confirmed that if a member of staff did not get on with the people at Stapleton Drive they would be transferred to another job within the Care Trust. Although new staff have been recruited, there are still staff vacancies. Currently shifts are covered by regular bank staff. An on call rota is provided by house leaders, assistant house leaders, managers and senior manager. This helps to ensure that support staff have access to help and support twenty four hours per day. The manager reported that she intends to undertake staff supervision every 4 - 6 weeks. Records seen for one person who that supervision has taken place on at least a monthly basis. The manager has just completed person centred supervision training and said that everyone will be completing this supervision training in the near future. Regular managers meetings are now taking place every Wednesday. House leader meetings are taking place once per month, these are being held to discuss issues and so that house leaders can help each other. Staff away days have also taken place and the manager has taken pictures of flip charts, comments recorded and actions taken so that these can be used as discussion points in future if needed. A staff training matrix has been developed for each house. This shows what training has been done by staff and what training is needed. The manager said that staff are now able to complete computer based training regarding fire, waste and infection control. The AQAA completed by the manager records that a rolling programme of staff training is provided. Twenty seven staff are employed at Stapleton Drive including house leaders and assistant house leaders. One member of staff has just passed her National Vocational Qualification (NVQ) assessors award and will therefore be able to assess peoples competence when they are doing NVQ training. This should help to ensure that staff are able to undertake this training upon employment. According to the information recorded in the AQAA, seventeen staff have an NVQ at level 2 or above. Providing staff with the opportunity to undertake suitable training helps to ensure that staff have the skills and ability to meet the needs of those under their care. Care Homes for Adults (18-65 years) Page 26 of 32 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 home is well managed, however quality assurance systems have not been fully developed to ensure that peoples views are considered in the day to day running of the service. Evidence: There have been no changes to the management arrangements at the Home since the last inspection. The manager has over eleven years experience working with people with a learning disability and has completed training that is appropriate to her role including a National Vocational Qualification at level 2, 3 and 4 and the Developing Tomorrows Leaders course. The manager is currently undertaking the Registered Managers Award. A house leader is employed in each house to support the manager in the running of the home. An assistant house leader is also employed in one house. Since the last inspection of the Home management systems and practices have improved and the manager is aware of the action to take to make further improvements. Quality assurance systems were discussed. It was noted that satisfaction surveys have Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: not been sent out to parents and carers. The manager said that she would like to meet all families and try to build a good working relationship with them before satisfaction surveys are sent out to them. The manager and staff meet families during person centred reviews which will soon be introduced for everyone living at Stapleton Drive. During these meetings discussions are held regarding whats working, whats not working and any issues or ways of improving the quality of care could be discussed. Various audits are undertaken to ensure staff are following working practices. It was noted that all incident forms are checked to ensure that staff are taking the appropriate action following an incident. The manager tries to visit each house every day to speak to people and to staff and to see what is going on. The Assistant house leader completes a monthly audit. The manager said that she will randomly audit this audit to ensure that it is being completed correctly. Records show that various health and safety issues, medication, maintenance and records are reviewed. The Assistant house leader feeds back the audit results at a managers meeting. Solihull Care Trust use experts by experience to visit the Home. An expert visited on person in July 09 and was assisted by staff as the person had no communication, the Home receive a copy of a report following this visit. This is a good way of finding out if people are happy with the service provided. A sample of Health and safety records were checked to make sure that peoples health and safety is promoted and people are protected. Fire records seen include a risk assessment, a report by West Midlands Fire Service dated April 07, a fire procedure. Records show that weekly fire system checks and fire drills take place. The Solihull Care Trust Contract Department check fire equipment every 3 months. Records did not show that emergency lighting had been checked since September 09. A member of staff looked at the lighting during the inspection and confirmed that it was working. Other records seen were up to date and in good order and included a Landlords Gas safety certificate July 09, electrical safety check February 09. Portable electrical appliances were being tested on the day of the visit. Records seen and information provided in the Homes AQAA demonstrate that systems are in place to maintain health and safety systems and practices. Care Homes for Adults (18-65 years) Page 28 of 32 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 6 15 Each person must have a plan of care which explains how their needs with regard to health and welfare are to be met. This will make sure that people receive the care they need to stay healthy and well. 30/04/2009 Care Homes for Adults (18-65 years) Page 29 of 32 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 6 Care files should clearly reflect peoples personal goals and aspirations. The quality of information recorded in care plans should be improved so that staff have all the information they need to meet peoples needs properly in a safe manner. Risk assessments should be reviewed and updated on at least an annual basis to ensure that the risk level has not changed and that staff take appropriate action to reduce any risk identified. Activity records should record details of any activities undertaken during the evenings and at weekends. Health care files should include detailed information for staff on peoples health needs and instructions on how staff are to meet these needs. Work should be undertaken to improve the decor in the House discussed on the day of inspection. This should include communal areas and bedrooms. Improvements should be made to quality assurance systems to ensure that the views of people living in the Page 30 of 32 3 9 4 5 11 19 6 30 7 39 Care Homes for Adults (18-65 years) 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 Home and their parents or carers are sought. 8 42 Records should demonstrate that emergency lighting is checked on a monthly basis to ensure it is in good working order. This is in accordance with the Homes procedures. Care Homes for Adults (18-65 years) Page 31 of 32 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). 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