Inspection on 05/08/09 for 111 Hempstead Road

This is the latest available inspection report for this service, carried out on 5th August 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 Hempstead Road 06/09/06

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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 Hempstead Road 111 Hempstead Road Hempstead Gillingham Kent ME7 3RH     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: Eamonn Kelly     Date: 0 5 0 8 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 30 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 30 Information about the care home Name of care home: Address: 111 Hempstead Road 111 Hempstead Road Hempstead Gillingham Kent ME7 3RH 01634363750 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.mcch.co.uk MCCH Society Ltd care home 2 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 2. 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 Hemsted Rd provides accommodation and personal support for two people with learning and physical disabilities. The owner organisation provides a range of services, for example, twenty-four hour residential care, community support, supported living and employment and vocational opportunities. Its website www.mcch.co.uk describes these services. It states that MCCH provides a wide range of services for people with disabilities which include learning disabilities, mental illness, autism, Asperger syndrome and other complex needs. The premises are close to Hempstead Valley Shopping Centre and to local Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 2 Brief description of the care home amenities such as convenience store, chemist, library and pub. The service has suitable communal space for residents, visitors and staff and the garden is suitable for use by residents. All accommodation is on a ground floor. Information about weekly fees and other charges may be obtained from the manager. In addition, written information about facilities and services may also be obtained from the manager. Care Homes for Adults (18-65 years) Page 5 of 30 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 quality rating for this service is 2-Star. This means that people who use the service experience good quality outcomes. The inspection took place on 5th August 2009. It comprised discussions (by phone) with the manager, Brett Moorcroft, with two support workers and with the former manager, Kathryn Allison. Both residents contributed to the inspection visit. Care practices were discussed and all parts of the premises were visited. Some records were seen during the visit principally those addressing the personal and healthcare support of residents. The Commission received an annual quality assurance assessment (AQAA) from the former manager who is now managing another service within the MCCH group. This provided information about how residents are currently supported and how the service Care Homes for Adults (18-65 years) Page 6 of 30 is being developed. The information in the AQAA was helpful in the prepatation of this report. The previous inspection report (completed in September 2007) and the Commissions annual service review (completed in July 2008) were checked as part of this inspection. The requirements contained in the previous inspection report have been addressed. The issues referred to in the annual service review, based on planned modernisation of the service that was outlined in the 2009 AQAA, have also been addressed. The evidence of this inspection visit indicated that significant progress is being made in the interests of resident welfare and comfort and towards meeting the overall objectives of the service. This report contains no recommendations or requirements. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? The 2008 AQAA stated that improvements as follows were anticipated: 1. Encouraging the housing provider to progress a programme of maintenance and renewal for the premises. (This included redecoration of bedrooms, removal of ceiling hoists, upgrade of the bathroom and replacement of the boiler.). 2. Improving the written guide to the home. 3. Developing residents support plans. 4. Obtaining an assessment tool for assessing the nutritional content of menus. Care Homes for Adults (18-65 years) Page 8 of 30 5. Working with residents to implement realistic goals, however small, to support their independence. 6. Evaluating the effectiveness and safety of medication administration and storage procedures and implementing any required changes. 7. Improving chiropody practices specifically aimed at having these services carried out by staff of the home. 8. Developing procedures (referred to as Reach) for measuring the quality of services. These areas were part of the wider improvements carried out for improving the lives of residents. 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 9 of 30 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 30 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. Residents have their individual aspirations and needs assessed before they enter residential care. Evidence: The information available to potential new residents and their representatives has been updated. Advocates are also able to obtain information about the service and other associated services provided by the group from the manager. These and all procedures are being reviewed as part of current modernisation plans under consideration. The AQAA (annual quality assurance assessment) prepared by the manager to assess the current service to residents and to identify areas for improvement states that consideration is being given towards whether one or both residents could benefit from a more independent way of living. The evidence from residents files seen during the inspection and discussion with support workers on duty was that careful consideration is given during the time when Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: an admission is being considered. This includes carrying out a range of activities involving the potential resident, advocates, medical practitioners and care managers. Following this, a series of observations is carried out to enable staff to compile a care plan and relevant risk assessments. From the examples of records seen and individual profiles discussed, these are subject to constant amendment as the needs of the resident are re-assessed over time and as the corresponding care plan and risk assessments are refined. Each resident is provided with a contract that outlines the main aspects of the responsibilities of both parties. The AQAA refers to ongoing efforts to provide residents with ever improving user-friendly versions of key documents. Care Homes for Adults (18-65 years) Page 12 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are helped to make decisions and to express themselves as part of developing their confidence and quality of life. Evidence: Each resident has an individual care plan formed from original and subsequent assessments of their needs. They are encouraged to make their own decisions and choices. Support worker on duty provided an insight into how this is being achieved in the case of both residents. Residents files seen during the inspection outlined the support needs of residents and included information all areas of their lives. Support workers explained how the staff team have the skills and ability to support and encourage residents to be involved in the ongoing development of their plan. They outlined a variety of ways used to help residents communicate their aspirations and difficulties. New communication methods are being implemented to assist Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: residents and staff in this objective. Residents are in their late sixties and early seventies; they have lived at the premises for many years and they have considerable support needs. They are in receipt of 1:1 support because of these needs and their increasing frailty. From the evidence of individual profiles discussed, it was clear that members of staff have a good knowledge of the types of support residents need and, from the evidence of the excellent support plans seen, the staff team are succeeding in helping residents exercise choice and make plans for the future. An example of the close support observed during the inspection related to a residents support plan being amended to show how advice from a nutritionist was being implemented and the new pattern of support was being brought to the attention of all staff. The evidence was that both residents have increasingly independent lifestyles with agreed levels of staff support. Consideration is currently being given by MCCH, within a person-centred framework, as to whether one or both residents might benefit from supported living arrangements within another part of the organisation. Residents are supported to take reasonable risks to allow them to participate in a range of activities. Risk assessments within their personal folders indicate how relevant risks are assessed and kept under review. These, on the evidence seen during the inspection, are kept up-to-date and focus on how residents develop their skills and have their future aspirations recognised and addressed. Examples of how support workers encouraged residents to undertake tasks, however small, were observed and it was apparent that residents benefitted from such participation. The AQAA suggests that the staff group intend to continue to develop even more sophisticated ways of encouraging residents with communication difficulties to contribute more effectively. The AQAA stated that the service has recently had an internal audit of residents records, including health action plans, communication passports and PCP (personcentred planning) files and that the service was provided with an action plan for recommended improvements to these documents. It is the stated intention for the serice to complete the action plan following an audit of information contained in residents support records and to take advantage of the opportunity to avail of PCP facilitator training for all members of staff. Care Homes for Adults (18-65 years) Page 14 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are helped to take part in activities they enjoy and to be a part of community life. Routines and activities developed with each resident give them opportunities to exercise preferences on a day-to-day basis. Evidence: Support workers outlined ways used to help residents communicate their aspirations and difficulties. New communication methods are being implemented to assist residents and staff in this objective. Residents are in their late sixties and early seventies; they have lived at the premises for many years and they have considerable support needs. They are in receipt of 1:1 support because of these needs and their increasing frailty. The AQAA refers to how members of staff work towards ensuring that activities are age appropriate and reviewed so that they are in step with current requirements of each resident. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: Both support workers gave examples of how they and their colleagues seek to improve the lives of residents. Existing and proposed activities are discussed and plans are either confirmed or revised. Each resident has an agreed full weekly timetable of activities and efforts are made to enable these to be carried out. It was felt by both members of staff that 1:1 care enable residents to receive the assistance they need at all times. Current activities include outings by taxi, bus or staff vehicle. Residents have trips to the pub accross the road for a meal. They have access to TV/DVD within the premises. They benefit from 1:1 staff support to go to the local town and places further away. Each resident has his bedroom maintained in a way they prefer and they receive differing levels of staff support in keeping their rooms safe and well maintained. Records and charts maintained showed how residents are encouraged to carry out some tasks as part of helping them to gain small skills. There was a great deal of evidence that daily routines are flexible to suit the different needs of residents and of how residents are helped in keeping touch with family members. There is a varied menu and examples of how residents are included in meal preparation and planning were observed during the inspection. The AQAA stated that there is emphasis on providing balanced meals that reflect individual taste and preference as well as healthy eating. An example was observed of how a nutritionist was involved in the assessment of a residents food and fluid intake: the residents support record was updated with how the changes were being implemented and all staff were informed of this. The AQAA contained useful information about how residents have care plans in place covering family contact, communication (including communication passports), promoting independence and life skills, leisure activities, daily routines and any restrictions due to assessed areas of risk. Risk assessments, the AQAA stated, are undertaken and recorded for all identified hazards related to daily living or activities undertaken. A resident attends hydrotherapy as part of his individual health development plan and both attend a social club once a week. The AQAA elaborates on how residents are supported to use facilities including the nearby convenience store, pub, library and shopping centre. Residents and staff have built up neighbourly relationships within the local community as a result of frequent visits to local services and facilities. The homes Statement of Purpose refers to local facilities and services and to how these are a major asset for residents. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: Residents mail is opened only with their permission and within their presence. One resident has a limited level of understanding and is unable to communicate his agreement: in this circumstance support staff open his mail on his behalf and record this within his daily record. Care Homes for Adults (18-65 years) Page 17 of 30 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 receive good physical, emotional and personal support. They are protected by procedures for administering medication. Evidence: The evidence from care plan records and discussion of individual profiles of both residents indicated that residents receive good healthcare support. This includes access to GPs and NHS healthcare facilities. Regular appointments are seen as important and systems are in place to ensure they are not missed. The home arranges for health professionals to visit residents at home when necessary. There is good quality planning and support for residents. Support workers outlined the current needs of both residents and it was apparent that they have a high level of awareness of residents emotional needs. Medication is stored in a locked cupboard in the staff room and MAR sheets are updated when medicines are administered. Procedures have been reviewed and changes made as a result. Where medication errors are identified corrective action is Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: taken and lessons are drawn to help prevent re-occurrence. The Commission has been advised via the notification procedure of examples. Support workers were confident that current procedures are effective. Residents individual plans record their personal and healthcare needs and outline how these are being met. Members of staff ensure that personal support is flexible and able to meet the changing needs of residents. They provided examples of how they know and respect residents preferences. The home has a detailed policy, procedure and practice guidance to help staff when caring for residents with degenerative or complex physical conditions. Members of staff receive practical support and advice and have opportunities to discuss any areas of anxiety and concern they may have about how residents are developing or otherwise. The service was advised to ensure the safety of residents where members of staff (who receive training to do so) carry out chiropody. There was evidence that the staff team reviewed all aspects of residents personal and healthcare needs over the past six months. This was evidenced through discussion of residents profiles. The extensive nature of care plan and healthcare records and AQAA reflections supported this conclusion. The AQAA referred to how risk assessments have been updated and to how they form part of individual care plans. It also stated that all carers receive epilepsy and general medication training with refreshers every three years and receive rectal diazepam training every year. A resident has recently been supported with access to the Falls Prevention Clinic for assessment following an increased level of falls due to his physical disabilities: assessments with the clinic are said to be ongoing at present. Care Homes for Adults (18-65 years) Page 19 of 30 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. Residents are protected from abuse by general and specific procedures practiced by staff. Evidence: According to the AQAA, no complaints were received since the previous inspection visit. Members of staff said they welcome comments from residents advocates about how care and support is provided. Policies and procedures for safeguarding adults are available, according to the support workers on duty, to all members of staff and these give specific guidance to those using them. Staff working at the service said they understand local authority procedures for Safeguarding Adults. The Commission is notified of incidents that occurred and reflection on these is reportedly used as part of quality assurance measures for the protection of residents. Carers said that these issues are included in the programme for assessing the success to the service (known as REACH). All staff receive regular supervision meetings and these are said to contribute to identifying areas where practice is good and where improvements might be possible for the benefit of staff and residents. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: The recruitment procedure contains the checks (including CRB checks) necessary to help contribute to the protection of residents and all members of staff receive training for their responsibilities under current POVA arrangements. Managers of services within the MCCH group are aware of the implications of the advent of the ISA (independent safeguarding authority). The AQAA stated that all members of staff are aware of the rights of residents and of how their interests must be identified and promoted. It outlines how the companys quality assurance system focuses on issues consistent with current care standards with emphasis on making residents quality of life progressively better. It also stated that all staff are to undertake safeguarding adults training updates over the next yearand and that they will be advised of implications arising from the Mental Health Act. Care Homes for Adults (18-65 years) Page 21 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises are suitable for the support of residents. Evidence: The AQAA stated that essential refurbishment is carried out routinely. Bedrooms are suitable for the needs of residents. Each person has his own bedroom that is well decorated and personalised with their own belongings. Residents are able to use the garden easily and, whilst it is a little in need of upkeep, it is a mojor asset for them. The premises were clean throughout. A declaration is made in the AQAA that all necessary checks are carried out and that the necessary safety certificates are in place and up-to-date. The premises have been recently decorated and some new furniture installed. Essential improvements have been made to the bathroom. The premises have, according to the AQAA, a fire risk assessment which complies with the Fire Safety Order. Fire door-guards have been fitted to all relevant fire doors. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: The AQAA outlined procedures relating to premises safety. Red bags for soiled clothing/linen are used in the management of laundry. Procedures/risk assessments are in place in respect of infection control. A Life Line system is in place to summon emergency assistance. The service has flexible space including a staff sleep-in room/ office that can be used as a private area for visitors. A weekly cleaning rota is in place which includes routine tasks as well as a monthly and six monthly rota. Maintenance works including emerency repairs are undertaken by Advance Housing Ltd. Staff carry out daily inspections of the premises and weekly visual inspections of the premises for hazards/faults. Care Homes for Adults (18-65 years) Page 23 of 30 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 in the care of members of staff that are skilled in meeting their support needs. Evidence: The Commission believes that residents are protected in a number of ways including via the required recruitment procedures. The AQAA contains the declarations necessary for this conclusion to be reached. According to the former manager of the service (who is now managing another service within the NCCH group), the manager of each service is involved in recruitment procedures. Managers, for example, ensure that CRB checks are taken up in every case and part of the recruitment procedure may be carried out in indidividual homes. All new members of staff have suitable induction and foundation training based on standards recommended by Skills for Care. According to the AQAA, all support workers are trained to NVQ Level 2 or above and others are completing NVQ training. Based on discussion with the former manager and support workers on duty, it was evident that the manager/support worker undertakes formal supervision in a planned way with all members of staff. The stated purpose is to identify practice standards relevant to the needs of residents and staff and to progress the objectives of the staff Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: team and aims of the service. The AQAA included an analysis of the effectiveness of recruitment and staff development procedures. From the documents seen, it is possible to conclude that all relevant checks are carried out, there is a process for involving some residents in the recruitment process (but in this instance residents are unable to take part)and support workers receive good guidance and on-going support. The AQAA, for example, stated that in addition to the statutory training provided for every member of staff specific training to meet the needs of each resident is given. Examples of the knowledge and skill levels needed by staff were discussed during the inspection and it was clear that all staff receive specialist training as needed according to the changing needs of residents. The AQAA stated that managers have the following management aids to assess the effectiveness of how well staff and residents are supported: 1. Annual supervision planner 2. Supervision records and staffing files. 3. Appraisal records, target and development plans 4. Training certificates 5. Training analysis 6. Job descriptions 7 Copy of a Code of Practice including a staff declaration that they have read and understood the main issues and policy documents. 8. Internal communication systems. 9. Company recuitment policy and procedures. 10.Staffing rotas. 11.REACH (quality assurance outcomes). 12.Visits by and support from other professionals from within the MCCH group. 13 Support with issues arising from staff concerns associated with modernising of services. 14.Pre-employment checks. Care Homes for Adults (18-65 years) Page 25 of 30 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 live in an environment that is well managed. Residents and members of staff are benefiting from improvements in the way the service is conducted. Evidence: The AQAA stated that policies are gradually all being updated with more accessible formats being introduced. Quality assurance questionnaires have been developed and are completed by residents advocates and health/social care professionals with an annual report compiled from the results. The former manager said that managers in branches of the organisation and the registered responsible person for the overall service make assessments of this feedback and use it to progress the quality of the service. Other procedures include reviews of care plans, staff meetings and regular 1-1 supervision. The service has a development plan and environmental risk assessments are regularly conducted to ensure the safety of service users. Risk assessments for individuals form a key part of support in place for residents. A support worker outlined how support workers take a special interest in, for example, keeping care plans Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: updated. An example of the effectiveness of these procedures was outlined earlier in this report. The medication system has been thoroughly reviewed by the former manager and support worker and improvements were made for the safety of residents and benefit of staff. The AQAA described how emphasis is given to carrying out health and safety audits affecting the safety of premises and individuals. All staff are working to improve services and to provide an ever-improving quality of life for residents. Care plan and healthcare records seen indicated that there are procedures for meeting the needs of respective residents and for reviewing the need to update procedures. Declarations are included in the AQAA about the required checks to premises and associated procedures and safety certificates. The manager has the experience and qualifications to run the care home in line with current legislation and standards. He has previous experience in maaging a similiar residential home. From evidence seen during the inspection and from references in the AQAA, the use of a person centred approach is improving the lives of residents and giving support workers an effective framework to carry out their work professionally. The AQAA contains a declaration that there is a twice daily hand-over of issues associated with clients monies. All finances are recorded and each resident has an individual finance book and lockable cash box. Local Authority finance officers control and audit residents main account; residents receive their monthly personal allowance. The AQAA stated that detailed procedures are in place to ensure that financial irregularities do not occur. Care Homes for Adults (18-65 years) Page 27 of 30 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 28 of 30 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 29 of 30 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. 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