Care Home: The New House

What the care home does well The Manager promotes independent living for people living in the home , by ensuring she consults with them on a daily basis. It was apparent from daily records that people enjoy freedom of choice and have support when required. One person told us "I have lived here for many years and all that time the manager and staff have not only looked after me but have been my friends``. The home ensures that people take part in a variety of activities that they have chosen with support from staff. People are encouraged and enabled to make decisions about their lives on an ongoing basis. People spoke avidly about their regular holidays which they clearly enjoyed and were happy with the day placements they attended and the activities they took part in. People spoken with were clearly satisfied with their lifestyles and participated in daily life at the home as well as pursuing their personal leisure pursuits. People spoken with were very happy with the food provided at the home. Records showed us peoples` health and personal care needs were met in a way that suited them. The medication system was well managed and ensured people received their prescribed medication appropriately. We were told by the people living in the home they were confident that their views were listened to and that if any issue arose they would have no difficulty raising it with the manager who would `do something about it.` What has improved since the last inspection? The care plans and risk assessments for the people living in the home had been improved. These now detailed how the personal care needs of the individual were to be met and how all risks were to be minimised. What the care home could do better: A quality assurance system must be introduced to ensure a consistent monitoring is in place with a view to continuously improving the service. The home should ensure that when menus are changed the information is recorded; this will ensure that the people living in the home receive a balanced diet and the home can monitor what people are eating. Key inspection report Care homes for adults (18-65 years) Name: Address: The New House 17 Stonerwood Avenue Hall Green Birmingham West Midlands B28 0AX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sue Scully     Date: 2 6 0 1 2 0 1 0 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 27 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: The New House 17 Stonerwood Avenue Hall Green Birmingham West Midlands B28 0AX 01217786391 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Mary McNamara care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 3 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: Mental disorder, excluding learning disability or dementia (MD) 3 Date of last inspection Brief description of the care home The New House is a detached two-storey house that was constructed in 1991 for the purpose of providing residential care to three adults for reasons of mental illness. Accommodation consists of three single bedrooms, one of which has en suite facilities. There is a separate bathroom on the first floor. Ground floor accommodation includes a lounge, kitchen/dining room, conservatory, off the kitchen providing access to a toilet and sleep-in room /lounge for visitors and staff. There is a small, well-maintained garden to the rear of the property with off road parking at the front. Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 3 0 3 0 3 2 0 0 9 Brief description of the care home People living there are actively involved in the day-to-day running. The fees for staying at the home that were detailed in the service user guide were not the current fees. People wanting this information should refer to the manager of the home. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The focus off inspections undertaken by the care quality commission (CQC) is upon outcomes for the people who use the service. This means they tell us if the home is meeting their needs and if the home is flexible to enable them to maintain their independence. We also assess the services capacity to meet regulatory requirements, minimum standards of practice and focus on areas that need further development. As part of the inspection we involve people using the service, by this we mean we talk to people about their experiences of the service provided. We involve staff, management and other social care professionals to seek their views about the service. Comments that have been made are included in the main body of the report. We also discuss peoples care and look at care files, health and safety records and staff records. In addition to this, information is looked at during inspections such as policies and procedures, and the general operation of the home in relation to meeting peoples Care Homes for Adults (18-65 years) Page 6 of 27 needs. The manager is also required to complete an Annual Quality Assurance Assessment (AQAA). The commission sends this document to the manager before the inspection. The (AQAA) tells us about any improvements that are being made in the future and also gives the manager the opportunity to tell us how the service is meeting peoples needs. The (AQAA) is a legal requirement that the manager must complete as part of the inspection process. The manager assisted us throughout the inspection which was completed over one day by one inspector. We involved one person using the service who gave us their view of the service provided. Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well: What has improved since the last inspection? 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. Care Homes for Adults (18-65 years) Page 8 of 27 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 27 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 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the information they need to decide if they would like to move in to the home. Assessment procedures are available should an admission take place. This means peoples needs will be assessed before admission. Evidence: The home provides people living in the home with a statement of purpose and service user guide before admission. Information contained in these documents enable people to make a choice whether to accept a placement or to decline. There have been no admissions to the home since the last inspection; however there is an admission procedure that includes details of visits to the home and a settling in period. People have lived there for many years. One person told us that they were very happy and said that the home provides all they need. People living in the home have individual contacts that tell them about the terms and condition of the service in addition to the placing authority contract so people know their rights. Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: Care Homes for Adults (18-65 years) Page 12 of 27 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. People who use the service can be assured that there is a consistent care planning process to meet their changing needs. There are safe procedures in place for assisting people with their medication. This means people are supported to take their medication as prescribed. Evidence: Two care files were reviewed both contained a detailed care and support plan and a comprehensive Health Action Plan. Plans are well set out and include all health issues, communication, community activity, daily living, personal care, relationships with others, leisure and recreational activities. People living at the home continue to access a wide range of services. It was evident through observations, examining records and discussions with one person living in the home that staff and management respect peoples rights and provide opportunities for decision-making. The manager considers a strength of the Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: home is that staff turn over is low and the established team know people very well. Health and social care assessments have been used to form the basis of person centred plans which means if another member of staff joined the current staff team they would know how to support the people living in the home. One person said I have lived here for 15 years and would not like to live anywhere else this is my home the manager and staff are very good to me. One person was at the home throughout the inspection through ill heath and told us Ill get dressed later and maybe have a shower, depends how I feel. This means the peoples living in the home make choices about what they do each day. People had been involved in drawing up their plans and they included lists of I like and I dont like. These included statements such as I can wash my back myself, I will ask for assistance if I need it. The care plan also included a person profile, where information was recorded about the person past. The care plans were reviewed each month and where peoples needs had changed this information was included. The care plan clearly showed how peoples wishes were maintained. Peoples risk management plans detailed of how the risks were to be minimised. The risk management plans detailed the risks involved when doing tasks around the house for example laundry, cleaning, making lunch or tea or going out independently. This has been included since the last inspection of the service. Information was also included in risk management plans for when people had disagreements, these showed how staff would manage this for example, separating the people and discussing the acceptability of being abusive to one another. All people living in the home were spoken to and they were very positive about the home and staff. One said I am very happy living here I go out and do what I want to do. Care Homes for Adults (18-65 years) Page 14 of 27 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 encouraged to participate in activities of their choice with their rights and choices respected. People receive a varied diet, which means any specific dietary needs are met. Evidence: People spoke of how staff respects their wishes and any choices they make, such as their preferred time to get up and go to bed, what they like to eat or do during the day. The routines of the home are very flexible to enable staff to support people to exercise choice as far as possible and according to their differing capabilities. People go out regularly and attend different day centres and clubs throughout the week. People living in the home go shopping, on holiday, or just for a walks. One person told us, I do what I want to do in the week but the weekends are for Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: relaxing. One person said I meet people when I am out have a good chat, get what I want to get and come home , its nice to come home. Peoples rights to privacy is detailed in their individual plans of care and include if they want a key to their bedrooms, when they want to be alone, if they have visitors or if they are going out. One person told us We all take it in turns cleaning the home, washing up, doing laundry, and helping to prepare meals. My family are part of this family, my sons are always welcome and are treated as if they also live here. Daily records showed us what people did on a daily basis whether it was going out or staying in. The home has a menu , but the manager told us that this changes almost on a daily basis , because people living at the home choose what they want to eat, so the menus does not work that well. It is recommended when the meals change this is recorded, so the manager and staff can see if the people living in the home are having a balanced diet. Where information shows that people are having more fats, or surgery items the staff can discuss with them to promote a healthy diet. Care Homes for Adults (18-65 years) Page 16 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are met in a way that suite them. The medication system is well managed and ensured people received their prescribed medication appropriately. Evidence: As previously stated care and support files are very detailed and input from health care professionals has formed the basis of person centred support plans. Care files reviewed reflected that health care needs are met and there was evidence that when reassessments have taken place they have led to improvements into the quality of a persons life. Preferences in relation to personal support were clearly documented in the files reviewed. Health appointment records are comprehensive and evidence that individuals have regular access to NHS healthcare facilities. Accidents and incident reports are appropriately recorded and countersigned by the manager. Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: People told us that their health needs were met and this was evidenced on the day of the inspection, when one person remained at home due to ill health. They told us that they had seen the doctor and had regular check ups. Medication records showed us that information is recorded about peoples allergies and the medication they are taking. When sampling MAR Charts (medication administration records) information was clear and detailed when the medication had come into the home and the balance carried forward and when they were dispensed. Care Homes for Adults (18-65 years) Page 18 of 27 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. Peoples views contribute to the running of the home which means the service provided meets their needs. People are safeguarded by the home polices and procedures. Evidence: The complaints procedure continues to be available to people living in the home, relatives and external organisations. The manager told us there have been no complaints since the last inspection of the service, and that she and staff talk to the people living in the home on a daily basis so where any concerns are raised they are dealt with immediately. One person spoke to said If I have any problems then I talk to the manager and she sorts it out. The manager told us staff have undertaken training in the safeguarding of vulnerable adults,and evidence was available in training records. There are a range of policies available which relate to safe working practices such as health and safety,manual handling and infection control,. The manager was very clear about the responsibilities of what to do in the event of an allegation being made or suspected abuse and the external agencies she would contact. Care Homes for Adults (18-65 years) Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides people with a safe, comfortable and well maintained environment in which to live. Evidence: The New House is like a large family home and is furnished and decorated as such. Furnishings and fittings were domestic in character and the home was very well decorated and well maintained. Bedrooms varied in size and all the people spoken with were very happy with their bedrooms. All the bedrooms reflected the individuals personal preferences and personalities. There were adequate bathing, showering and toilet facilities in the home. The home has two lounges with a domestic style kitchen/diner. People living in the home were seen to be very comfortable and relaxed. The garden at the rear of the home was well maintained and furniture was available for the people to use in the better weather. People spoken with were very happy at the home and told us they help make the home clean and tidy by ensuring they take it in turns to do laundry and keep the home clean. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured that suitable trained and supervised staff will support them. This means staff have the knowledge and skills to meet their needs. Recruitment procedures ensure peoples are safeguarded. Evidence: The staff rota shows that the number of staff allocated day and night were sufficient to provide the care to the three people living in the home. Staff files showed us that the homes recruitment system is good and staff turnover is minimal. This means people living in the home have continuity of care. Training records showed us that staff have undertaken training in first aid, manual handling safeguarding, food hygiene, infection control, fire prevention. The manager told us that staff had recently undertaken updated training in safeguarding, manual handling and first aid. Over 50 staff of staff have undertaken NVQ level 2 (national vocational qualification in care) There are clear lines of accountability within the staff team, with the manager and senior member of staff, because the home only has a small staff team joint working Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: and communication is very good. People told us, The staff know what they are doing are very helpful and polite. Supervision take place regularly, so staff have a clear direction, about the people living in the home, training needs and support. Care Homes for Adults (18-65 years) Page 22 of 27 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 and structures support the delivery of good care. Health and safety matters are addressed to reduce the risks to people in the home. Evidence: The home is run in the best interest of the people who live there. People living in the home have the opportunity to comment on the service they receive by communicating on a daily basis with the staff team and management. The manager has many years of experience and possesses the skills to oversee the day to day management of the home. The manager told us that it is the home of the people who live there and the overall aim is to provide a place that they can call home. People spoken to gave very positive views of the staff and the management and said they would not want to live anywhere else as it is their home. The staff are well supported by the manager with on going supervision. the manager told us communication plays a major part in meeting peoples needs. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: Health and safety records, such as fire records and testing, electrical wiring, gas, and accident records showed us that regular servicing of equipment and recording of information was up to date. This means people living in the home can be assured that all the necessary precaution are taken to enable them to live in a safe secure environment. The home did not have a formal quality assurance system. Meetings with the people living in the home did take place and clearly peoples views were listened to at all times. Quality Assurance was discussed with the manager and the need to have a system in place that continually monitors the service on offer with a view to continuous improvement that results in a yearly development plan for the home. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 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 15 The manager should consider methods to record information about peoples meals when the menu is changed. This will ensure the person food intake is monitored. The manager should ensure the views of the people living in the home are captured in a formal way, such as a quality assurance assessment. This will enable the service to progress further. 2 39 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!