The Care Quality Commission
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Archived: Real Life Options - Stacey Drive

Overall: Requires improvement read more about inspection ratings

8-12 Stacey Drive, Kings Heath, Birmingham, West Midlands, B13 0QS (0121) 441 2677

Provided and run by:
Real Life Options

Important: This service was previously managed by a different provider - see old profile

All Inspections

8 February 2016

During a routine inspection

This inspection took place on 8 and 12 February 2016 and was unannounced.

At the last comprehensive inspection in August 2015, this provider was placed into special measures by CQC. Breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do meet legal requirements. in relation to breaches of regulations. We undertook this full comprehensive inspection to check they had followed their plan and to confirm they now met legal requirements. This inspection found there were enough improvements to take the provider out of special measures. The provider now met their legal requirements but further improvement was required.

Stacey Drive is three, interconnected bungalows, where care and support is provided to up to 12 people who have learning disabilities and/or mental health needs and who need support to live in the community. There were ten people living in the home at the time of the inspection.

At the time of this inspection there was no registered manager in post. A registered manager is

a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. A manager had been appointed to run the home and was in the process of applying to become the registered manager. However they were not able to work at the home on a full time basis as they also had responsibility to manage another location which was located several miles away.

At the time of our inspection a suspension of admitting any new people to the home by the local authority was still in place. Our inspection identified that changes and improvements had occurred across the service. Hazardous substances that may pose a risk to people were now kept securely. Arrangements had improved to make sure staff would respond appropriately in the event of a fire occurring at the home and infection control procedures had been improved. The actions taken had reduced some of the risks to people’s safety but some minor improvement was needed to ensure medication was administered and recorded in a safe way.

Safeguarding procedures were available in the home and staff we spoke with knew to report any allegation or suspicion of abuse. Previously there was not enough staff to meet personal care needs of people in a timely manner or to accompany people to go out of the home should they have chosen to go out at the same time, this restricted people’s choices. Changes to how staff were deployed had meant that staff were better able to support people but further improvement was needed.

People were supported to maintain good health and to access appropriate support from health professionals where needed. People were supported to eat meals which they enjoyed and which met their needs in terms of nutrition and consistency.

Care plans were not all up to date so staff did not have up to date information to ensure they could meet people’s needs effectively. We observed some caring staff practice, and staff we spoke with demonstrated a positive regard for the people they were supporting. We saw staff treating people with respect and communicated well with people who did not use verbal communication.

New staff were provided with an induction that would ensure they knew how to care for people and would ensure they could work safely. Training and supervision arrangements for staff had improved and further training for staff was scheduled.

There was a complaints procedure which was on display and was available in an easy to read version with pictures. A system was in place to respond to concerns and complaints received.

Changes had taken place in the management staff team, in addition to the manager there was a team co-ordinator in post and both were being supported by a newly recruited area manager. Whilst we received positive feedback from staff about the manager they were only able to spend some of their time at Stacey drive as they were also responsible for managing another care home. Arrangements for checking the safety and quality of the service had improved since our last inspection but further improvement was needed to ensure people were provided with a good service.

4 & 5 August 2015

During an inspection looking at part of the service

This inspection took place on 4 and 5 August 2015. The inspection was unannounced.

Stacey Drive is three, interconnected bungalows, where care and support is provided to up to 12 people who have learning disabilities and/or mental health needs and who need support to live in the community. There were ten people living in the home at the time of the inspection.

We last inspected Stacey Drive in November 2014 when we found the provider had breached the Health and Social Care Act 2008 in two regulations. We found that the requirements of the Mental Capacity Act 2005 had not been met and the systems in place to assure people would receive a high quality and safe service breached the regulations. We issued two compliance actions and asked the provider to send us an action plan detailing the improvements they would make. An action plan was not received. In August 2015 we revisited the home and found that not all of the compliance actions had been met. In addition we identified other issues of concern related to safety issues.

At the time of this inspection there was no registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The interim manager who had been working in the home, and still worked for the provider in a different capacity, returned to the home during the inspection to provide some assistance and answer some questions.

People living at Stacey Drive could not be confident that the registered provider would be able to keep them safe. This included the arrangements to make sure staff responded appropriately in the event of a fire occurring at the home and securely stored chemicals and cleaning materials to protect people from harm. A bathroom on one bungalow had not been in full working order for several months which had impacted on the dignity of people using the service. Some areas of the home were not sufficiently clean putting people at risk from inadequate infection control measures.

There was not enough staff to accompany people to go out from the home or to undertake activities in the local or wider community, and this restricted people’s choices. Agency staff were being used to cover staffing vacancies and on some night shifts there had been no permanent staff, who knew people well, working in the home.

New staff had not all been provided with an induction that would ensure they knew how to care for people and would ensure they could work safely. Staff had not all been provided with all of the training they required or with regular supervision and were not consistently following the instructions in people’s care plans which placed some people at risk. .

People told us, or indicated by gestures, that they were happy at this home. They provided examples of when in the past they had been to places of interest or been supported to do things they enjoyed. We observed some caring and compassionate practice, and staff we spoke with demonstrated a positive regard for the people they were supporting. We saw staff treating people with respect and communicating well with people who did not use verbal communication.

The management of the home had recently undergone significant change. At the time of our inspection the interim manager had ceased working at the home and there was no manager, deputy manager or other senior staff working at the home. Whilst we received positive feedback from staff about the interim manager who had recently left, it was not evident that arrangements for checking the safety and quality of the service by the registered provider were effective.

We found the provider was in breach of Regulations. You can see what action we told the provider to take at the back of the full version of the report.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

28 November 2014

During a routine inspection

The inspection took place on 25 November 2014 and was unannounced.

Stacey Drive is three, interconnected bungalows, where care and support is provided to up to 12 people who have learning and/or mental health needs and who need support to live in the community. There were ten people living in the home at the time of the inspection.

At the last inspection, in November 2013, we found that there were enough qualified, skilled and experienced staff to meet the needs of the people in the home. However, there were not sufficient numbers of suitably qualified staff to carry on the regulated activities for which the home was registered. The home was registered for nursing at that time and there were not sufficient numbers of nurses employed. The home is no longer registered to provide nursing care and there is no-one in the home who requires nursing care.

At the time of this inspection there was no registered manager. The home was being run by a manager who was in the process of applying for registration. This manager also managed two other services, one in Birmingham and one in Coventry. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us, or indicated by gestures, that they were happy at this home. They provided examples of when they had been to places of interest or been supported to do things they enjoyed. We saw staff treating people with respect and communicating well with people who did not use verbal communication. However, we saw examples of staff not following the instructions in people’s care plans, for example during meals, and this placed people at risk.

At this inspection we found that some areas of the home were not sufficiently clean, with food spillages and stains in places. The carpet in one bungalow was worn and stained. The provider had no clear systems in place for ensuring that the home was clean and this meant that there was a risk of infection spreading and people were not fully protected.

We spoke with some newer staff who told us that they had shadowed more experienced staff and they had some knowledge about people who lived in the home. This did not mean they had the knowledge or skills needed to meet the complex situations that may have arisen in the home. Although more detailed training was planned, this had not yet been delivered. We found enough staff to cover people’s basic needs but found that staff were not always deployed to ensure that people’s needs were met. There were not enough staff to accompany people should several have chosen to go out of the home and this restricted people’s choices.

The provider had not taken action to ensure that people not put people at risk of receiving inappropriate care and support.

You can see what action we told the provider at the back of the full version of the report.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The Mental Capacity Act 2005 (MCA) sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected, including when balancing autonomy and protection in relation to consent or refusal of care. This includes decisions about depriving people of their liberty so that they get the care and treatment they need where there is no less restrictive way of achieving this. The MCA Deprivation of Liberty Safeguards (DoLS) requires providers to submit applications to a ‘Supervisory Body’ for authority to deprive someone of their liberty. We spoke to staff and looked at records to see of the home was complying with this legislation. We found that the manager and staff had not received training in relation to recent interpretations of this legislation and they demonstrated no understanding of the impact on people at the home. This meant that people’s human rights were not being fully protected.

You can see what action we told the provider to take at the back of the full version of the report.

1, 3 November 2013

During an inspection in response to concerns

We made two visits to this home, one on a weekday and one on a Sunday, in response to comments received which indicated that people may have been at risk due to changes in staffing arrangements.

We found that there was good evidence to show that the recent staffing changes were beneficial to people who lived in the home. However, we found that, although the home is not providing nursing care, it is registered as a care home with nursing and also for the treatment of disease, disorder or injury. These activities need suitably qualified staff and the rotas showed that they were not always available. We discussed this with the manager who assured us that an application would be made to remove these activities from the home’s registration.

We observed staff communicating well with people. People told us that they were happy in this home. One person said, “I love it here....I like my food and I love my room.”

There were good arrangements for assessing people’s needs and for planning the care and support which each person needed.

We found that there were suitable arrangements for the storage, administration and recording of medication.

There were good systems for monitoring the performance of the home and for making sure that staff carried out their roles in the right way. These had been used to identify some shortfalls in relation to the environment and the records. Action was being taken to improve these areas.

11 January 2013

During a routine inspection

At the time of our visit in January 2013, there were eleven people living in the home. We spoke to most of the people who lived at the home and they told us that they liked living there. We saw that staff interacted well with people, ensuring they were treated with respect. People were observed to be involved in managing the daily activities of the home and some people were observed going out with members of staff. This ensured that they maintained both their independence and had the opportunity for physical exercise.

One person told us: “I like it very much here”

Most people were happy to show us around the home and were keen to show us their rooms, most of which appeared to reflect their specific personalities.

Evidence of verbal encouragement was noted to good effect and staff demonstrated their detailed knowledge of people by responding appropriately to their gestures or other expressions During the course of the inspection, we noted that staff offered people choices in all aspects of their daily lives and responded appropriately to their needs

The provider may wish to note that the care directive for one person living at the home suggested a need for two staff to undertake any community activities. Staff told us that this may have needed to be reviewed as the needs of this individual no longer required the same staffing ratio as the care planning indicated.