Care Home: The Mendips

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What the care home does well We spoke to people at the home about the way the home operates and standards are met at the home. We sought feedback from one person about the way the staff meet their needs. However, this person was unable to recall that they had a care plan. When we asked two people about the staff meeting their needs, they confirmed that staff knew how to care for them. We also asked about making decisions and they told us that they were able to make decisions about all aspects of their lives. Visiting friends, going for walks, reading and watching television were the examples given by the two individuals consulted about the way they kept occupied during the day. A more in-depth consultation continued with one person about the way they are respected as individuals. It was stated that bedrooms are single and keys to rooms are provided, there are no set times to rise or retire and staff respect their rights to privacy and dignity. We then asked about expectations of individuals to contribute towards the running of the home, we were told that there are no expectations that people undertake household chores. It was confirmed that visitors to the home are welcome and bedrooms were used for more private conversations. Discussions with two individuals took place about making complaints and protection. Both individuals would first approach the staff with complaints and would pass it to the service provider where the complaint was not resolved. These individuals said that staff did not shout and they felt safe at the home. We spoke to two staff on duty about the way standards of care are maintained at the home. Both staff said that there are more opportunities for 1:1 time with people at the home, there is a good team of staff and additional staff are rostered so that people can be accompanied on visits. Care planning was discussed with one member of staff and it was stated that they attend care plan review meetings, complete daily reports and associated forms. We were also told that handovers take place when shift changes occur which ensures staff are aware ofthe individuals changing needs. Induction and training was then discussed with these staff. In terms of induction the most recently employed staff said that familiarisation of the building; discussion of the role and the needs of the people were in-house with the service provider. External training is provided to all staff and medication training was recently provided. Food Hygiene and Safeguarding Adults training will be attended in the near future. Staff also said that vocational qualifications was accessible and one had completed NVQ3 and the other was looking forward to undertaking the training. We spoke to the staff about the service providers` leadership style. We were told that the service provider uses a gentle approach towards people at the home and team working is the way standards are met. What the care home could do better: Three requirements from previous inspections were not fully met and two arising from this visit. A more personalised way of meeting needs must be further developed so that care plans can be essential to meeting needs and people can shape the way their care is delivered. Risk assessments must be more in-depth so that staff can be guided on the actions that need to be taken whenver behaviours that challenge are exhibited. Fire risk assessments must be more detailed and must show the frequency that fire safety checks will be conducted and the training and practices that will take place so that staff know the procedure for fire. Requirements arising from this insepction are focus on medication and recruitments. In terms of medication, the service provider must ensure that where medication occurs, written confirmation is obtained. For example a prescription or by letter. Where staff declare convicitions in the application form, the service provider must undertake a risk assessment to assess that the person is suitable to work with vulnerable adults. Random inspection report Care homes for adults (18-65 years) Name: Address: The Mendips 2-3 Shamrock Road Upper Eastville Bristol BS5 6RL one star adequate service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme 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 review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Sandra Jones Date: 2 3 0 6 2 0 1 0 Information about the care home Name of care home: Address: The Mendips 2-3 Shamrock Road Upper Eastville Bristol BS5 6RL 01179518548 01179518548 s_ghamy@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Bibi Ghamy & Mr M R Ghamy,Mr Mamode Raschid Ghamy Name of registered manager (if applicable) Mrs Bibi Ghamy & Mr M R Ghamy Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Conditions of registration: May accommodate up to 9 persons with mental disorder aged 30 years and over Date of last inspection Brief description of the care home The Mendips is operated by Mr and Mrs Ghamy, it is a registered care home for nine adults with mental health care needs, aged 30 years and over. The home is situated close to the Fishponds Road and is within walking distance of shops, library, places of worship and other amenities and bus routes. The property has the appearance of a domestic dwelling and blends well with its local environment. The fees range from GBP 334.00 - GBP 533.54 per week. Items not included in the fee include dry cleaning Care Homes for Adults (18-65 years) Page 2 of 10 care home 9 Over 65 9 9 Brief description of the care home chiropody, clothing and hairdressing. Currently prospective residents are given this information verbally. Care Homes for Adults (18-65 years) Page 3 of 10 What we found: A random visit was undertaken on 23/06/2010 to look at the way the requirements made at previous inspections were met. We looked at the records, spoke to people at the home and staff to determine that the requirements were met. Records that relate to care plans, associated risk assessments, medication systems, recruitment processes and fire risk assessments were examined during this visit. Care plans are in place for each person accommodated at the home and list the needs and the action that staff must take to meet the need. While care plans describe the need, the action plans instructs staff on the way the need is to be met. The care plans provide little evidence that people were involved in their care plans and that they were able to shape the way their care is to be delivered. There was one new admission since the last key inspection. However, the social workers needs assessment was not up to date or for this service. A homes care plan had not been devised because the needs assessments had not been provided. Making it difficult to determine the way the staff are consistently meeting this individuals needs. A monitoring form is available at the home to record the progress made in the care plans. We are reassured by the service provider that care plans will be developed using a personalised approach, where people are involved in the care plan which are then monitored monthly. Medications are administered from the original packages and staff sign the records to show the medications were administered. The records of administration were signed by the staff and confirm that records are signed immediately after administration. However, it was noted that the direction for one persons medication was changed by the staff. While it is accepted that the changes were made by a health care professional, the service provider must ensure that there is written confirmation of the changes. Medication leaflets are now attached to the medication record leaflet which tells staff about the purpose of the medication and their side effects. Risk assessments are in place for any activity that may involve an element of risk including behaviours that challenge the service. Management plans are then devised and, from the risk identified, known triggers are incorporated. For people that may present aggressive and violent behaviours or abuse drugs, risk assessments are in place. Risk assessments are reviewed annually. However, they require further updating in terms of the actions that must be taken to lower the level of risk. The recruitment process followed for new staff was examined during this inspection and to determine that suitable staff are employed, we look at the personnel files of new staff. Application forms were updated and seek full employment history, the names of two referees (one of which must be the last employer) and disclosure of criminal background which must be signed by the candidate. Two written references are sought and must be validated by the referee; this ensures the authenticity of the reference. Criminal Records Bureau (CRB) are obtained to ensure that the person is suitable to work with vulnerable Care Homes for Adults (18-65 years) Page 4 of 10 adults. While the process followed is robust, the service provider did not undertake a risk assessment for staff that declared convictions and cautions. The service provider must undertake a risk assessments that includes a discussion with the staff involved about the lessons learnt that would prevent any reoccurrences. Fire risk assessments are in place which looks at the potential of fire. However, they lack depth. Although there is evidence that risk assessments were reviewed, they must assess the potential of an outbreak of fire in the home. Within the risk assessments the practices and checks to be conducted must be included. The fire log book was checked to ensure that fire safety procedures were followed and it is evident that fire safety alarm checks and staff training and practices take place What the care home does well: We spoke to people at the home about the way the home operates and standards are met at the home. We sought feedback from one person about the way the staff meet their needs. However, this person was unable to recall that they had a care plan. When we asked two people about the staff meeting their needs, they confirmed that staff knew how to care for them. We also asked about making decisions and they told us that they were able to make decisions about all aspects of their lives. Visiting friends, going for walks, reading and watching television were the examples given by the two individuals consulted about the way they kept occupied during the day. A more in-depth consultation continued with one person about the way they are respected as individuals. It was stated that bedrooms are single and keys to rooms are provided, there are no set times to rise or retire and staff respect their rights to privacy and dignity. We then asked about expectations of individuals to contribute towards the running of the home, we were told that there are no expectations that people undertake household chores. It was confirmed that visitors to the home are welcome and bedrooms were used for more private conversations. Discussions with two individuals took place about making complaints and protection. Both individuals would first approach the staff with complaints and would pass it to the service provider where the complaint was not resolved. These individuals said that staff did not shout and they felt safe at the home. We spoke to two staff on duty about the way standards of care are maintained at the home. Both staff said that there are more opportunities for 1:1 time with people at the home, there is a good team of staff and additional staff are rostered so that people can be accompanied on visits. Care planning was discussed with one member of staff and it was stated that they attend care plan review meetings, complete daily reports and associated forms. We were also told that handovers take place when shift changes occur which ensures staff are aware of Care Homes for Adults (18-65 years) Page 5 of 10 the individuals changing needs. Induction and training was then discussed with these staff. In terms of induction the most recently employed staff said that familiarisation of the building; discussion of the role and the needs of the people were in-house with the service provider. External training is provided to all staff and medication training was recently provided. Food Hygiene and Safeguarding Adults training will be attended in the near future. Staff also said that vocational qualifications was accessible and one had completed NVQ3 and the other was looking forward to undertaking the training. We spoke to the staff about the service providers leadership style. We were told that the service provider uses a gentle approach towards people at the home and team working is the way standards are met. 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 set out on page 2. Care Homes for Adults (18-65 years) Page 6 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 6 12 (3) For a more personalised 30/10/2009 approach to meeting needs, the individuals likes and communication needs must be incorporated into the care action plans. Not fully met 2 9 13 (4) (b) Risk assessments that 30/10/2009 include a) for people with mental health care need must include the triggers, signs and symptoms of a deteriorating mental health. b) For people with aggressive and violent behaviours risk assessments must include the triggers and safeguarding procedures that protect people from abuse. Not fully met 3 42 23(4) Fire risk assessments must be further developed to include the fire systems checks and practices that must be carried out to ensure people live and work in a safe environment. Not Fully met 30/08/2009 Care Homes for Adults (18-65 years) Page 7 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 8 of 10 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 1 6 13 The service provider must ensure that medication systems are safe. Where medication changes occur, the service provider must ensure that there is written confirmation of the changes. 08/07/2010 2 34 19 The service provider must ensure that the recruitment process is robust. Where staff declare convicitons, riks assessments must be undertaken to ensure that they are suitable to work with vulnerable adults 30/07/2010 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 Care Homes for Adults (18-65 years) Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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