Care Home: The Coach House

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What the care home does well The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 People who live at The Coach House are supported by a team of staff who they like and who treat them with respect. Staff say that the home has a family atmosphere. Staff were observed to involve people in carrying out every day tasks and enable people to make choices, for example what they would like to drink and whether they would like to take part in the planned activities. People all have their own rooms which are spacious and have been decorated in peoples chosen colour schemes. People are enabled to keep in touch with family and friends and staff know how important family contact and support is to the people living at the home. Staff enjoy working at the home and were described as `brilliant` by one person who lives there at the time of our visit in January. A visitor to the home at that time said that people are supported by `an excellent staff team`. The home works closely with health care professionals to meet people`s needs and as a result people are now receiving safe and individualised support to enable them to live full and active lives. What has improved since the last inspection? Since the time of our last visit in January 2009 there have been considerable improvements made at The Coach House resulting in the home being able to demonstrate that it can meet the care and support needs of people living there. Management arrangements have changed and the new manager, who is in the process of applying for registration with us, has taken over the running of the home. She has reviewed all care plans and made sure that they now accurately reflect people`s care and support needs and she has sought input from health and social care professionals to develop protocols and guidelines to support staff in delivering safe and consistent care. Arrangements are now in place to support the storage and use of oxygen within the home thus reducing the likelihood of risks of harm to people. Guidelines are also in place to support the safe administration of medication taken as and when required.The Coach HouseDS0000071103.V375990.R01.S.docVersion 5.2Staffing levels are currently sufficient to enable people to enjoy opportunities and activities on a regular basis both planned and impromptu. Records show that staff have received all required training to demonstrate that they have the skills and competencies to meet people`s needs safely and in ways that people prefer. Other records seen at the time of the inspection were well organised, well maintained and up to date. There was evidence that assessments have been reviewed to show that they are still relevant to support safe activities of daily living. Staff who spoke with us thought that staff morale and care plans have all improved since the time of the last inspection of the home. What the care home could do better: At the time of our visit the manager had rewritten the homes Statement of Purpose and had all information required to develop a new Service User Guide for the home. Since our visit she has contacted us to say that the Service User Guide is now complete and ready to give to everyone living at The Coach House. For the future she is looking to develop this document, the Statement of Purpose and the Complaints Procedure in an easy read format. This will make the information more accessible to the people who may require it. The home should consider making the laundry facilities more accessible to ensure that everyone living at the home is able to access them should they wish to and also the garden could be more accessible for people who use a wheelchair as it may prevent one person, at least, from fully enjoying the space. Key inspection report CARE HOME ADULTS 18-65 The Coach House Church Road Baschurch Shrewsbury Shropshire SY4 2ED Lead Inspector Sue Woods Key Unannounced Inspection 16th June 2009 09:50 The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. 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 home adults 18-65 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. The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 2 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 The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Coach House Address Church Road Baschurch Shrewsbury Shropshire SY4 2ED 01939 260 150 01939 260 150 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Select Health Care Limited Care Home 8 Category(ies) of Learning disability (8) registration, with number of places The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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: 2. Learning Disabilities (LD) 8 The maximum number of service users to be accommodated is 8 Date of last inspection 21st January 2009 Brief Description of the Service: The Coach House is a care home registered with the Care Quality Commission (CQC) to provide personal care and accommodation for a maximum of eight adults with a learning disability. The Registered Provider of the home is Select Healthcare (2006) Limited. There is currently no registered manager at The Coach house although the home has appointed a new manager and that person is in the process of registering with us. The home is situated in the village of Baschurch, Shropshire and is within walking distance of the post office, general convenience store and local pubs. The accommodation provided is very spacious and furnished to a high standard All bedrooms have spacious en suite bathrooms and additional bathing facilities are also available. Seven of the eight bedrooms are on ground level. One bedroom is accessed via a steep flight of stairs. The home is situated in wellmaintained extensive gardens. The home uses hoists, standing frames and other aids to help people with mobility problems. Information is shared with people who live at the home during regular meetings and informally on a daily basis. Advocacy support is promoted and a quality assurance system is in place in the form of questionnaires for people The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 5 who live at the home and relatives. The cost of living at The Coach House is not included in the Service User Guide so the reader may wish to contact the home directly for details of fees charged. The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use this service experience Good quality outcomes. The inspection of The Coach House took place on 16th June 2009 with a view to check compliance with a number of requirements made at the time of our last key inspection on 21st January 2009 when we found that the home was offering poor quality outcomes to people who live at the home. This inspection visit lasted five hours and the manager knew a couple of days before our visit that we were coming. We reviewed all twenty two of the key standards for care homes for younger adults and information to produce this report was gathered from the findings on the day and also by review of information received by CQC prior to the inspection date. A quality rating based on each outcome area for service users has been identified. These ratings are described as excellent/good/adequate or poor based on findings of the inspection activity. As part of the inspection we, the commission, met and spent time with three of the four people who live at The Coach House. We also spoke with the three staff on duty and the home manager. We looked at two care files and two staff files that contained recruitment and training information. We also looked at other records referred to within the report. Prior to the visit taking place we looked at all the information that we have received, or asked for, since the last key inspection that took place on 21st January 2009. This included notifications received from the home and correspondence from both the manager and a senior manager from the organisation who told us how the home had met the requirements that we made at the time of out last visit. What the service does well: The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 7 People who live at The Coach House are supported by a team of staff who they like and who treat them with respect. Staff say that the home has a family atmosphere. Staff were observed to involve people in carrying out every day tasks and enable people to make choices, for example what they would like to drink and whether they would like to take part in the planned activities. People all have their own rooms which are spacious and have been decorated in peoples chosen colour schemes. People are enabled to keep in touch with family and friends and staff know how important family contact and support is to the people living at the home. Staff enjoy working at the home and were described as ‘brilliant’ by one person who lives there at the time of our visit in January. A visitor to the home at that time said that people are supported by ‘an excellent staff team’. The home works closely with health care professionals to meet people’s needs and as a result people are now receiving safe and individualised support to enable them to live full and active lives. What has improved since the last inspection? Since the time of our last visit in January 2009 there have been considerable improvements made at The Coach House resulting in the home being able to demonstrate that it can meet the care and support needs of people living there. Management arrangements have changed and the new manager, who is in the process of applying for registration with us, has taken over the running of the home. She has reviewed all care plans and made sure that they now accurately reflect people’s care and support needs and she has sought input from health and social care professionals to develop protocols and guidelines to support staff in delivering safe and consistent care. Arrangements are now in place to support the storage and use of oxygen within the home thus reducing the likelihood of risks of harm to people. Guidelines are also in place to support the safe administration of medication taken as and when required. The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 8 Staffing levels are currently sufficient to enable people to enjoy opportunities and activities on a regular basis both planned and impromptu. Records show that staff have received all required training to demonstrate that they have the skills and competencies to meet people’s needs safely and in ways that people prefer. Other records seen at the time of the inspection were well organised, well maintained and up to date. There was evidence that assessments have been reviewed to show that they are still relevant to support safe activities of daily living. Staff who spoke with us thought that staff morale and care plans have all improved since the time of the last inspection of the home. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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. The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 People using the 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 who live at, or visit, The Coach House are now supported by appropriate assessments of their care and support needs to ensure as far as is possible that the home can support them safely. Changes to the way that information about the home is presented will make information more accessible to people who may be interested in living at The Coach house and thus help them to make the decision if the home is right for them. EVIDENCE: The homes Statement of Purpose is available to any one who is interested in the service provided at The Coach House and with a few minor amendments will contain all required information to help people decide if the home is right for them. The information required to make up the Service User Guide is available separately and the manager plans to bring all of the information together to provide one document that is written in an easy to read format. This will make The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 11 it more user friendly and more readily accessible to new and prospective service users. We were informed on 18th June 2009 by the manager that the Service User Guide is now complete and contains all required information. She will now give everyone a copy and is sending one to us for reference. There have been no new admissions to the home since the time of the last inspection but the manager has obtained the assessments of needs for the last two people to receive a service to support the current care plans. This means that the home can be sure that all relevant information is available to them to enable them to identify peoples care and support needs. The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 12 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 People using the 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 new and improved care plans ensure people’s needs are identified and met and ensure that people receive care and support in a way that they prefer and that is safe. People are supported to enjoy full and active lives and risks are assessed to ensure people can do so as safely as possible. EVIDENCE: Everyone living at The Coach House now has a care and support plan. We looked at the care files of two people living at The Coach House and found that information is available to inform staff how to safely meet each persons care and support needs. Likes and dislikes are recorded and protocols are in place to support all identified areas where complex support is required to enable staff to carry out these tasks consistently, safely and competently. Staff told us The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 13 that these protocols gave them reassurances that they were doing tasks correctly and were used as reference when staff were unsure as to how to carry out a procedure. This means that people can now have their care and support needs met safely and in a way that keeps them healthy and promotes their well being. Plans seen had been reviewed by health and social care professionals over recent months and the manager reported that they were happy with the content. One health care professional had supported the manager to develop protocols and this means that staff are working to agreed procedures that reflect current best practice. As a result the quality of the care and support provided has improved. Throughout our visit we heard staff involving people in decisions about how they wanted to spend their day, what they wanted to drink and even where they wanted to sit. People have also been consulted on the décor of the home and how the garden is developed. Meetings now take place for people living at the home to enable them to share any suggestions or comments on how to improve the service and what the home does well. The home supports people to be as independent as they are able and use risk assessments to identify possible risks in activities planned. Likewise risk assessments enable staff to carry out personal care tasks as safely as possible and where risks are identified actions are taken to reduce these risks. Assessments are now being regularly reviewed to ensure that people continue to be supported safely. The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: Standards 12, 13, 15, 16 and 17 People using the 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 who live at The Coach House are currently enjoying a variety of structured educational and leisure opportunities that reflect individual choice and enable people to lead full and active lives. People benefit from supported family contact and involvement meaning that they are able to stay close to the people that matter to them. EVIDENCE: There are currently three people living at The Coach House and one person is visiting for respite. Staffing levels are enabling people to pursue activities of their choice enabling them to enjoy a good quality of life. The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 15 The home has introduced an activities board that reflected what people were doing on the day of the inspection. One person had gone to an art class, one person did some personal shopping while another person was visiting friends. While at home, staff made sure that people were involved in what was going on. For example when staff were sitting at the table people who were in the sitting area were invited to sit with them and be part of the conversations. Daily routines were seen recorded in people’s care files. People are supported to retain family contact as this is important to them. One person is supported to visit his family at their home and people have moved to The Coach House in order to be near to their family. One person told us at the time of our last visit that he had a girlfriend and he speaks to her regularly. One person attends college twice a week course to develop his cooking skills. The manager has continued to develop the menu to reflect people’s likes and dislikes and the menu was seen to contain pictures of foods on offer enabling people to be more involved in making decisions about what they would like to eat. The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal and health care needs of the people who live at The Coach House are now considered to be well met enabling them to enjoy a good quality of life. People are safeguarded by the home’s system for handling, storing and administering medication and input from health care professionals ensures that medication is given appropriately and safely. EVIDENCE: People who live at The Coach House have some very complex personal care and support needs to ensure their good health and wellbeing. The home has shown that they are able to meet these needs and the recently developed protocols and procedures show that staff are told how to do this safely. Staff have also received training from various sources to give them the skills to carry out these tasks safely. The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 17 The manager and the staff team have worked closely with health and social care professionals including district and specialist nurses to ensure that the home is able to safely and competently meet peoples needs and this has given staff confidence which will improve the overall quality of the service provided. Likewise protocols are now in place to support the storage and administration of oxygen within the home and all medications taken as and when required are supported by clear guidelines for their administration that have been signed by the local GP. This ensures consistency and enables staff to maintain people’s good health safely. The quality of one person’s life has been improved after the manager prompted a review of his health and support needs to enable him to access the community for longer. One staff member told us that the training that she has received in relation to administering named medications was very good and enabled her to feel confident to carry out the procedures. Staff said the protocols were useful to guide them to take appropriate action when additional medication is required. The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standard 22 and 23 People using the 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 protected by procedures in place for managing concerns and complaints and can be confident that their concerns will be listened to. EVIDENCE: The Coach House has a complaints procedure that is shared openly with relatives and advocates of people living at the home. Select Healthcare has policies and procedures in place for managing complaints and for protecting people from abuse. There have been no complaints received by CQC or the home about the service provided at The Coach House. The manager is aware of adult protection policies and guidance and said she would be confident to use them if necessary to protect people living at the home. There have been no referrals within these procedures. At the time of our visit in January one person living at The Coach House said that if he had any concerns or worries he would speak with the staff. Other people who cannot communicate verbally are supported by an advocate who has been visiting them for a number of years. Some people have family members who would advocate for them meaning that their views and concerns will be raised. The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 19 At the time of our last visit in January we looked briefly at arrangements for supporting people to manage their money. One person said he has his own money when he is out and the home looks after it when he is at home. The manager later confirmed this arrangement. We saw records showing that staff check the amount of money within the home is correct and that it reflects the records kept proving it. We saw evidence during this inspection that a senior manager had reviewed people’s finances on 3rd June 2009 and all were in order suggesting that the home is able to safeguard people’s money. The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30 People using the 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 who live at The Coach House are provided with a clean, well-maintained and safe place to live. Recent improvements have made the house more homely and suggested changes will make the house more accessible. EVIDENCE: The Coach House opened in August 2007 and comprises of largely single story accommodation. There are currently three people living at the home and one person visits for regular planned respite. The manager has over recent months opened up the home to make best use of the space and has enabled people to enjoy different activities away form the main living space. This has been welcomed. The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 21 All areas were seen to be clean and ‘homely’. We looked at three bedrooms and all were personalised to reflect people’s individual tastes. The maintenance worker is regularly on site carrying out repairs and has also adapted areas of the home for future use. He previously told us that he had access to a budget for maintenance tasks and is able to make minor purchases. This has meant that he can make repairs sooner than in the past. The home has now installed fire exit signs that will provide clear guidance as to how to leave the building in the event of an emergency or a fire. This will make the home safer for people who live there. The home now has a new washing machine and tumble dryer. These items have enabled people to be more independent and take part in daily living tasks although access to them was a little restricted. Likewise the garden could be more accessible for people who use a wheelchair as it may prevent one person, at least, from fully enjoying the space. Infection control is promoted within care and support plans and staff were seen to use gloves when delivering personal care and all have received training in relation to good hand washing practices to ensure peoples protection from infection. The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 24 and 35 People using the 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 people who live at The Coach House receive good care and support from a well supported and a well trained staff team enabling their needs to be effectively met within the home. Appropriate pre employment checks on staff who work at The Coach House ensure that the home only appoints people who are suitable to work with vulnerable people. EVIDENCE: Everyone we spoke with at the time of this inspection and during previous visits said that they enjoyed working at The Coach House and felt well supported by manager. Records show that staff are now receiving regular supervision. The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 23 At the time of our last visit to The Coach House a visitor had commented on an ‘excellent staff team who really care about residents’. A GP and social worker both said that ‘staff are good’. Following that visit health care professionals told us that staff have the skills and abilities to meet peoples care and support needs effectively (despite the lack of evidence to support the fact). Since that time the manager has made sure that staff receive training to meet people’s needs and can now evidence that staff have been appropriately trained. The manager has a training matrix to enable her to see at a glance what staff are trained and when refresher training is due. This will mean that staff have ongoing competencies to carry out effective care and support. Staff files showed that staff have now received all mandatory training and have an effective induction. Discussions at the time of our visit confirmed that this is the case for all staff on duty. When asked what the home does well, staff said, ‘caring’ for people and one staff member said that training has given her confidence to do her job. One staff member commented on the family atmosphere within the home that makes people feel comfortable and safe. Staff felt that care plans and staff morale were areas where improvement have been made. Given that there are currently three people living at the home, and one person visiting for regular respite the manager and the staff on duty feel that staffing levels are adequate. We found that there were enough staff on duty on the day of the inspection for everyone to be supported to carry out activities of their choice within the home and in the local community and this is an improvement enabling people to live a better quality of life. The staff files of the last three care staff to join the team were reviewed and found to contain the essential information required for the home to demonstrate that people are recruited safely to ensure the protection of vulnerable people. All checks are carried out before people support people living at the home. Records were well maintained and readily available for inspection. The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42 People using the 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 who live at The Coach House benefit from the home being supported and monitored by a competent and knowledgeable manager. The health, safety and welfare of people living at The Coach House is promoted and protected enabling people to be safe in their home EVIDENCE: There have been significant changes to the running of The Coach House since the time of our last inspection in January 2009. The registered manager no longer has any contact with the home and the organisation has notified us that Ms Lucy Brumpton is now managing the home. The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 25 Over the last six months she has demonstrated a strong management style and a sound knowledge of the needs of the people who live at The Coach House. She has also reviewed all records, including those which caused concern at previous visits and updated them so they contain essential information to support and enable staff to deliver care and support to people how they prefer and in a safe way. The manager is now in the process of being registered with us. The organisation has also offered effective support to enable the manager to make changes that have improved the quality of people’s lives and thus improved the quality rating for the service. At the time of our last visit we found that staff carry out regular safety checks to make sure that the home environment is safe and that everything is working as it should. Records completed by the maintenance worker were up to date and showed that, for example, in the event of a fire, people would be kept safe. The home’s health and safety officer said that health and safety arrangements are in place and up to date. For example he checks that chemicals used within the home are stored securely and used safety. Select health Care have arranged for an external health and safety officer to visit the home and carry out an audit. This will further ensure that people are able to feel safe at the home. Records seen at the time of this inspection visit reflected that a senior manager form the organisation reviews that health and safety checks are up to date when she carries out her monthly health and safety visits. The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Version 5.2 Page 27 The Coach House DS0000071103.V375990.R01.S.doc NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA24 Good Practice Recommendations The home should consider making the laundry facilities more accessible to ensure that everyone living at the home is able to access it independently should they wish to It is recommended that the home consider making the garden more accessible for people who use a wheelchair as it may prevent people from fully enjoying the space. 2 YA24 The Coach House DS0000071103.V375990.R01.S.doc Version 5.2 Page 28 Care Quality Commission West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway, Birmingham B1 2DT National Enquiry Line: 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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