Inspection on 17/06/09 for 111 Eastbourne Road

This is the latest available inspection report for this service, carried out on 17th June 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

111 Eastbourne Road 13/09/06

111 Eastbourne Road 22/02/06

111 Eastbourne Road 08/11/05

111 Eastbourne Road 01/02/05

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Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Key inspection report Care homes for adults (18-65 years) Name: Address: 111 Eastbourne Road 111 Eastbourne Road Lower Willingdon Eastbourne East Sussex BN20 9NE     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: Jo Mohammed     Date: 1 7 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 111 Eastbourne Road 111 Eastbourne Road Lower Willingdon Eastbourne East Sussex BN20 9NE 01323482174 01323482174 111eastbourne@regard.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): The Regard Partnership Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 9. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home 111 Eastbourne Road is a large detached two storey property situated off the main road between Eastbourne and Polegate. The home is a short walk from local amenities in Polegate. The nearest main town is Eastbourne. The home is registered to provide residential care to nine younger adults with learning disabilities. Residents accommodation is provided in nine single bedrooms with en-suite facilities. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 9 Brief description of the care home An additional communal bathroom is situated on the first floor. Communal areas comprise of a large lounge, separate dining room and a quiet room. A good sized garden is situated to the rear of the property. Parking is available at the front of the home. The Registered Providers of the service are The Regard Partnership Ltd. This organisation owns a large number of homes across England and Wales. The appointed Manager advised that current weekly fees at the home range between £1300-£1800. More information about the services provided at 111 Eastbourne Road can be found in the homes Statement of Purpose and Service User Guide. Copies of these documents can be obtained directly from the home. The latest Care Quality Commission [CQC] inspection reports are available upon request from the home. Care Homes for Adults (18-65 years) Page 5 of 28 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: This report reflects a key inspection based on the collation of information received since the last inspection including a review of the homes most recent Annual Quality Assurance Assessment [AQAA], the last inspection report dated 23rd May 2007 and the Annual Service Review report dated 23rd May 2008. An unannounced site visit was conducted on Wednesday 17th June 2009 between 9.15am and 4.15pm. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001,uses the term service user to describe those living in care home settings. For the purpose of this report, those living at 111,Eastbourne Road are referred to as residents. 111,Eastbourne Road is an established home that provides residential care to nine Care Homes for Adults (18-65 years) Page 6 of 28 people with Learning Disabilities. There is currently one vacancy. The home is part of a larger group of homes owned by The Regard Partnership Ltd. The site visit included looking around the premises, examination of some care, medication, staffing, menus and general records. The visit also included meeting the majority of residents, the appointed Manager and speaking to a member of staff. Surveys for residents were sent to the home prior to the inspection. Two surveys were returned blank and the others showed that staff had supported residents to complete them. From the responses received the information indicated satisfaction with the service and a comment made on one said They are always there if I needed to speak to them. Care Homes for Adults (18-65 years) Page 7 of 28 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. 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 8 of 28 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 9 of 28 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. Prospective residents and their representatives have the information they need to make an informed choice about where to live. The pre-admission and assessment process followed for a resident was comprehensive. Evidence: There was one admission to the home in August 2007 that occurred not long after the last inspection in May 2007. Pre admission documentation that was available was viewed this included a care needs assessment, personal information and support that this person required. A statement of need report from the Borough the resident originally lived in, a community care plan, a referral/moving in form with details of introductory visits and an account of how these went. An initial risk assessment was drawn up on the day the resident moved in. It was evident this resident visited the home prior to moving in for a few hours increasing to overnight and then a few days stay. Staff from this residents previous placement were also involved in these visits and from this an action plan was drawn up. There are eight residents living in the home and one vacancy. It was said that all residents get along with each other. The age range is between 21 and 29 years; there are five males and three female Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: residents. A house file containing the homes Statement of Purpose and Service User Guide was viewed. Both these documents were in pictorial format. The Service User Guide had been updated in May 2009. The Statement of Purpose identified the last review date as January 2008: information contained in this showed there were five single rooms rather then nine. The management structure needed updating to reflect the current situation as this stated there was a Registered Manager with a deputy and three seniors which is not currently the composition as there is an appointed Manager and four seniors. The appointed Manager agreed to update these documents in line with the Care Homes Regulations 2001, to ensure they were accurate and contained all the information they should. It was said that all residents have a copy of the Service User Guide and associated information in their bedrooms. Care Homes for Adults (18-65 years) Page 11 of 28 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. Residents assessed and changing needs and personal preferences are identified in their individual plans and they are supported to take risks as part of an independent lifestyle. Evidence: All residents have person centred plans [PCP] in place and the appointed Manager confirmed these were all up to date. Two residents care records were tracked including the person who was admitted into the home in August 07. The information contained within these files was clear, easy to follow with good detail and information about each residents lifestyle, activities, finances, preferences, support, care, health and communication needs. It was in a pictorial and narrative format that suited residents understanding of their own plan and showed evidence that where possible residents had been involved in this and signed their plans. The information was current showing when care plans had been implemented and when reviews had taken place. Linked to care plans were individual Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: risk assessments containing more detailed guidance about care processes. It was said these records are kept in the office and a discussion around promoting and enabling residents to access these in complimenting the person centred planning approach was discussed with the Manager to consider and review. Review meeting minutes viewed showed evidence that all interested parties are invited to residents reviews including Care Managers and these are produced in a pictorial form. The Manager advised that actions from each review are carried forward and discussed at subsequent reviews to ascertain progress. Monthly one to one meetings are held with residents and their keyworkers. Minutes of a meeting with a resident and keyworker viewed for May and June 2009, showed the resident was not responding or gaining the best out of this arrangement/meeting. The Manager advised that they were due to change the format to include different communication methods to improve this process. The Annual Quality Assurance Assessment [AQAA] states two residents are involved in the East Sussex Self Advocacy Group and the Manager reported that one resident attends this group monthly and another resident occasionally. Care Homes for Adults (18-65 years) Page 13 of 28 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. Residents have opportunities to access the community and take part in educational, leisure and occupational activities. Evidence: On arrival, all the residents were at home; some were finishing their breakfast and five were preparing to go to College. Two residents require one to one support from staff in the home when they attend College. One resident was staying at home because they were not feeling well. One resident said they were going to College later in the day and another resident was having a lay in bed before going to College in the afternoon. Residents were chatted too before going off to college, one person explained how they were going to College to do life skills and another person showed the Inspector their picture communication cards explaining how they were going to spend their day. There is a timetable displaying the plan of activities for each day and each resident has an individual timetable. An alternative venue to college is currently Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: being sought for one resident. Residents have a homecare day each week. Activity timetables dated May 2009 for two residents were examined. These included activities such as regular attendance at College, a music & club night once a week and Aromatherapy session fortnightly. Also identified was laundry, walk out, home care day and free-time sessions during the week. Personal shopping, going to the Cinema and bowling fortnightly. A separate record is kept of whether these activities are achieved and examination of this indicated the activity programme was fulfilled. The appointed Manager showed how other ideas for weekend activities are to be tried out including fishing and using a dry ski slope; these activities are illustrated on residents timetables in pictorial format. The appointed Manager said all residents have families and are supported to maintain contact with them. Social networking groups are maintained with other homes within the organisation. Monthly house meetings are held with residents and the minutes produced in pictorial format. Information contained within the homes Annual Quality Assurance Assessment [AQAA] indicates that College courses are accessed for residents to meet their individual needs and choices with the support of a College Co-Ordinator who has attended informal meetings at the home. Community activities are regular and the home recognise the importance of researching different activities. Residents have bus passes and regularly use these to travel to and from College. One resident attends church each week and one occasionally. Two residents attend work experience for an hour each week; one at a local florist and another at a local cafe. It was explained that the activity schedule would be updated and compiled to incorporate seasonal activities, a summer holiday activity schedule and College summer school. Annual holidays take place to destinations of residents choice or known preferences. The main meal for residents is served in the evening and a picture menu is displayed in the dining room. The appointed Manager advised that the main house shopping is done weekly with local produce bought as and when needed. The record of food showed a mixture and variety of meals served and it was said that alternatives are also available. Menu planning meetings are held weekly with residents to choose their meals for the following week. Pictorial food cards are used to assist residents as necessary in this process. Care Homes for Adults (18-65 years) Page 15 of 28 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. Residents are supported in meeting their health and welfare needs. Evidence: Information contained in the homes Annual Quality Assurance Assessment [AQAA] states that all residents have a health action plan documenting residents health support needs. Records relating to two residents that were viewed showed these documents were in place, although it was noted they were undated and unsigned which was raised with the appointed Manager at the time of the inspection to address. Residents also have a selection of care plans that include healthcare information, description of behaviours, personal care, current medication and dietary needs. Patient passports were in place and weight records. A record is kept of visits, appointments to health care professionals and outcomes. All residents are registered with a local GP and other professionals such as a Chiropodist, Dentist and Optician. One person is currently being supported by a Dietician. Residents have access to professionals within the local community Learning Disability team such as an Occupational therapist, Speech and Language therapist and a Learning Disability nurse. The Annual Quality Assurance Assessment [AQAA] states Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: all staff receive medication training and no staff member can administer medication unless trained. It indicates that a comprehensive protocol is in place for the administration of medication. Residents medication is administered in accordance with GPs instructions and is reviewed regularly by the GP or relevant health care professional. The management and storage of medication was examined and found to be satisfactory. Residents do not currently self administer and no controlled drugs are used. It is the homes policy that two trained staff manage residents medication together with one person witnessing and both staff signing residents medication charts. Medication blister packs are used. Medication recording sheets were in order and medication was stored securely. Records of medication coming into the home and returned to the Pharmacy are maintained. When required medication protocols are in place; the guidelines have been approved by the GP. The appointed Manager advised that the GP updates and reviews these either 6 monthly or yearly including any homely remedies used. There is a photo of each resident on their medication charts. Drug review sheets, drug identification sheets and information on how each resident takes their medication is in place. A weekly audit of medication is maintained. The appointed Manager advised that staff are trained in medication yearly as well as doing knowledge sets through the E.learning training system. The homes medication policy and procedure according to the AQAA is dated July 2007. It was confirmed that a previous medication requirement made at the last inspection in May 2007 had been met. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems in place to protect residents from harm and abuse. Evidence: Examination of records and discussions with the Appointed Manager confirm that appropriate records, action and timescales are followed and maintained in dealing with any complaints received. The Annual Quality Assurance Assessment [AQAA] states there is a complaints policy and procedure that all staff have read and signed. The complaints procedure is incorporated into the Service Users Guide and in the rights and information book that has been explained to residents. How to make a complaint is discussed in residents meetings. Information about how to make a complaint and prevention of abuse is available in easy read format and displayed on the residents notice board. The organisation has policies and procedures in place for safeguarding, complaints and Whistle-blowing. Over the last twelve months five safeguarding alerts have occurred that are now closed; appropriate reporting and investigation protocols were followed in line with multi agency procedures. The Annual Quality Assurance Assessment [AQAA] identifies that all staff have been trained in the Protection of Vulnerable Adults and are updated annually. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: In respect of finances, the Annual Quality Assurance Assessment [AQAA] identifies that residents have financial account booklets with audits carried out yearly, checks at handovers and some spot checks. The appointed Manager explained that six residents have their own bank accounts and two people have savings accounts. The monetary affairs of two residents is managed by their families. Virtual accounts are kept for two residents and it was explained these accounts are held in the organisations head office. The appointed Manager showed the latest printout from head office in relation to these accounts dated 14th April 2009. The home maintains client transaction books and another separate record. This lists how money is spent in respect of residents Disability Living Allowance and Personal Allowance. The record also includes monies credited including the source ie from bank. It was suggested to the appointed Manager to obtain regular printouts from head office in respect of residents current monetary affairs and ensure that information recorded in residents care plans is up to date and accurately matches the financial arrangements in place and monetary details for each resident. Care Homes for Adults (18-65 years) Page 19 of 28 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. Residents live in a homely and comfortable environment. Evidence: Several areas of the home were seen including communal areas and some residents bedrooms. The home was found to be clean and free from odours. There is a large open plan lounge and separate dining room. There is also a small quiet room that is used for residents reviews and visitors. There is a garden laid mainly to lawn at the rear of the home with a greenhouse and vegetable plot. Eight bedrooms have en-suite facilities with a toilet and shower and the ninth bedroom has an en-suite toilet with personal shower facilities close by. Bedrooms viewed were seen to be homely and personalised. There is one general bathroom on the first floor. There is a lift, however this is not operational and used only for storage. The appointed Manager advised that the flooring in the dining room was to be replaced with lino and the hall, stairs, landing, lounge and a residents bedroom carpet were to be replaced by the end of the year. There are also plans to redecorate two residents bedrooms. The kitchen was satisfactory in appearance; the worktops have recently been Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: replaced. The Laundry room is located off the kitchen in a separate room. Controls Of Substances Hazard Health [COSHH] were stored safely and securely. Information contained in the Annual Quality Assurance Assessment [AQAA] identifies that residents are encouraged to have as much input into the choice of decor, furnishings and bedding in their bedrooms and communal areas as possible. Maintenance issues are managed and reported as soon as known about. Care Homes for Adults (18-65 years) Page 21 of 28 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. Residents are supported by a supervised and effective staff team. They are protected by the organisations recruitment protocols. Evidence: The number of staff on each shift during the day was reported as being a minimum of three staff on duty for the early and late shifts and one person on a middle shift from 8.30am in the week, with a later start at weekends to support residents activities. The appointed Manager said he was supernumerary to these care staffing levels. At night there is one waking staff and one sleep-in. Staffing levels were confirmed as satisfactory and sufficient in fulfilling residents lifestyles. The Annual Quality Assurance Assessment [AQAA] identifies that nine staff have a National Vocational Qualification [NVQ] in care at level two or above and all senior staff have NVQ level 3 or above. The appointed Manager said that the organisation has replaced its training department by introducing a new computer training package for staff called E.learning. It was reported by the appointed Manager that during this change over there was some slippage of staff training, however it was confirmed the home were now back on track in working towards ensuring all staff are upto date with mandatory training and a staff Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: training matrix to monitor this is in place. It was conveyed that E.learning was ok for updates and time will tell in respect of how this type of training fulfills staffs training and development needs. It was suggested this be monitored via the homes quality assurance systems and through staff supervisions. The appointed Manager advised that practical training would also continue to be accessed via the Local Authority alongside E.learning. The appointed Manager reported he was due to attend training in the Deprivation Of Liberty [DOLS] with other Managers in the organisation at the end of the month and after this would be looking to train the staff team in subject. It was reported by the appointed Manager and a senior carer that monthly staff supervision sessions take place. Regular staff meetings are also held and this was evidenced through staff meeting minutes. Recruitment information examined for the two most recently employed staff were satisfactory. It was however discussed with the appointed Manager the quality of a reference obtained for one of these staff and how this could have been explored further including obtaining another reference. The Annual Quality Assurance Assessment [AQAA] identifies that all staff posts are subject to a six month probationary period. As part of the recruitment process prospective staff are introduced to residents with interactions noted and observed by senior members of staff, where ever possible to enable residents to be included in the interview process. All staff are given comprehensive job descriptions, Social Care Council code of practice terms and conditions, disciplinary procedure, complaints policy and staff handbook on starting employment. All staff undertake an induction in-line with the skills for care common induction standards. Care Homes for Adults (18-65 years) Page 23 of 28 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. Residents benefit from living in a home where their health, safety and welfare is protected. Evidence: The appointed Manager has been in post since September 2008. He holds an RMN and RNMH nursing qualification. He explained the reasons as to why he had not yet applied for registration with the Commission and how he had been pursuing a place to do the Leadership and Management skills training course without success to date; although intended to continue until he secured a place on this training. It was agreed with the appointed Manager not to delay in applying to the Care Quality Commission [CQC] for registration and to submit an application. The appointed Manager said he was well supported in the home by having four senior carers and a senior Manager who had previously been the Registered Manager of the home whom he saw about two to three times a week. The composition and dynamics of the staff team were described as helpful, supportive with a good skill mix. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: In respect of Quality Assurance, it was confirmed that yearly questionnaires are sent to families and professionals; the last occasion being in December 2008. The appointed Manager said that not many of these questionnaires had been returned and due to the lack of response, those that had been returned had not yet been evaluated. Residents surveys were distributed on 24/4/09, however these had not yet been returned. It was evidenced that a previous evaluation of quality assurance questionnaires from interested parties was last done in 2007. It was discussed with the appointed Manager to pursue obtaining feedback and evaluate information received on a continuous and ongoing basis in order to support and enhance the homes Quality Assurance processes and self monitoring. It was evidenced that monthly Regulation 26 visits and reports took place in a format that covered the national minimum standards with action plans and dates drawn up according to information assessed. The Annual Quality Assurance Assessment [AQAA] identifies that health, safety and fire matters receive attention, with checks and maintenance matters in order. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 Care Homes for Adults (18-65 years) Page 27 of 28 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 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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