Inspection on 11/01/10 for 146 Lower Robin Hood Lane

This is the latest available inspection report for this service, carried out on 11th January 2010.

CQC found this care home to be providing an Excellent 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

146 Lower Robin Hood Lane 20/12/06

146 Lower Robin Hood Lane 03/02/06

146 Lower Robin Hood Lane 23/06/05

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 13/03/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: 146 Lower Robin Hood Lane 146 Lower Robin Hood Lane Walderslade Chatham Kent ME5 9Lb     The quality rating for this care home is:   three star excellent 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: 1 1 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 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: 146 Lower Robin Hood Lane 146 Lower Robin Hood Lane Walderslade Chatham Kent ME5 9Lb 01634685656 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 5 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 5. 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 The service provides care and accommodation for up to five people. The premises are close to amenities in the local area. The service specialises in supporting people who have become a little older. Each resident has his/her own bedroom. They have access to a suitable garden. Residents are helped with obtaining suitable electronic aids to alleviate their health Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 5 Brief description of the care home conditions. They have good access to health and social care. Information about weekly fees and possible other charges may be obtained from the manager. A copy of a written guide to services and facilities 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: three star excellent 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 3-Star. This means that people who use the service continue to experience excellent quality outcomes. The inspection took place on 11th January 2010. It comprised discussions with four support workers and four residents.The manager, Mrs Karen McCaw, was not present. 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. We received an annual quality assurance assessment (AQAA). This provided information about how residents are currently supported and how the service is being developed. The information in the AQAA was helpful in the preparation of this report. Care Homes for Adults (18-65 years) Page 6 of 30 The previous inspection report and annual service review were checked as part of this inspection visit. The requirements contained in the previous inspection report have been addressed. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? Recommendations from Kent Association for the Blind are being followed and further advice is being sought. Placement are reviewed six monthly. There are strict guidelines in place to ensure that residents are not charged for anything that is agreed to be covered under the personal or local authority contract. The licence agreement is now, according to the AQAA, in audio format. Residents had separate holidays in 2008 and 2009. Care Homes for Adults (18-65 years) Page 8 of 30 Person centered planning has been continued to enable the staff team to focus on Personalisation. Residents are being helped to develop memory boxes which serves as a reference for staff to discuss with them, for example, trips out and other seasonal events which they have enjoyed. Through a procedure called objects of reference, residents are helped to develop more independence for personal development. A speech and language therapist has been employed for advice with one resident. Communication passports and Medway Health Action Plans are in place for each individUal resident. Additional in-house activities with an activity co-ordinator visiting have been arranged. The manager has changed the staff rota to ensure that staff are available for monthly activities that require a late night. Medication arrangements have been reviewed and updated. Photographs of residents have been placed in the medication cabinet to ensure new staff (and, if employed, agency staff) are able to correctly Identify residents witout delay. The service continues to follow Medway Councils Financial protocols and provide staff training around individualised budgets. It continues to monitor and act on any complaints and concerns expressed by residents or others. 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 and these assessments form the basis of on-going care and support. Evidence: The information available to potential new residents and their representatives has been updated. Advocates are 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. 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 residents could benefit from a more independent way of living. The evidence from residents files seen during the inspection and discussion with the manager and support workers on duty was that careful consideration is given during the time when an admission is being considered. This includes carrying out a range of Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: 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. The present situation is that there is one vacancy at the service and some residents may in time move to other locations to give them a greater level of independence. Residents care plan folders are subject to constant amendment as their needs are reassessed and as the corresponding care plan and risk assessments are refined. There was evidence that risk assessments are very carefully drawn up and amended as necessary. 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. The manager and support workers on duty provided an insight into how this is being achieved in the case of the four 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. During parts of this discussion, a resident was able to make observations about her views of the service. Some of the residents views were communicated via a light writer. The resident also has a printer for this system and other electronic aids. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: Support workers outlined a variety of ways used to help residents communicate their aspirations. New communication methods are being implemented to assist residents and staff. 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 and risk assessments seen, the staff team are succeeding in helping residents exercise choice and make plans for the future. The evidence was that residents have independent lifestyles with agreed levels of staff support and guidance. Consideration is being given by MCCH, within a person-centred framework, as to whether residents might benefit from supported living arrangements within another part of the organisation. Two residents outlined how they would like to avail of these opportunities. Residents are supported to take reasonable risks to allow them to participate in a range of activities. Risk assessments, as stated above, indicated how relevant risks were 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 risk assessments covered all aspects of how staff should be aware that residents were vulnerable; members of staff take responsibility for identifying such areas and keeping the risk assessments relevant. 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. 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. Routines and activities developed with each resident give them opportunities to exercise preferences on a day-to-day basis. Residents are helped to take part in activities they enjoy and to be a part of community life. Evidence: 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. 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. Current activities include outings by taxi or bus. Residents have trips to pubs and other locations for meals. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: They have access to TV/DVD within the premises. They benefit from staff support to go to the local town and places further away. Each resident has his/her bedroom maintained in a way they prefer. The evidence was that they receive differing levels of staff support in keeping their rooms safe and well maintained. 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. At the time of the inspection visit, there was snow and poor weather conditions and it was thought best that residents should remain indoors for their safety at this time. There was a varied menu and examples of how residents are included in meal preparation and planning were discussed 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. Health action plans are being introduced and nutritional assessment tools are part of this process. The AQAA contained 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. The evidence was these these assessments are relevant and kept up to date. The AQAA stated that residents are supported to use facilities including nearby shops, pubs and and shopping centre. According to information provided by staff, residents and staff have built up sustained relationships within the local community as a result of frequent visits to local services and facilities. Care Homes for Adults (18-65 years) Page 16 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 excellent 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 residents indicated that they receive good healthcare and personal support. This includes access to GPs and NHS healthcare facilities. Regular appointments are seen as important and the evidence was that systems were in place to ensure they are not missed. The home arranges for health professionals to visit residents at home when necessary and residents are also assisted to attend hospital and GP surgeries. Medication was stored in a locked cupboard. A support worker outlined how close attention is paid to administering medicine effectively and to keeping MAR sheets properly completed. Procedures have been reviewed and changes made as a result. Where medication errors were identified corrective action was taken with lessons learnt to help prevent re-occurrence. The Commission has been advised via the notification procedure of examples of medication errors identified and corrective Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: action taken. Support workers said they were confident that current procedures are effective. According to the examples seen and discussed with staff and one resident, residents individual plans record their personal and healthcare needs and outline how these are being met. The home has a detailed policy, procedure and practice guidance to help staff when caring for residents with degenerative or physical conditions. A resident is blind. Another has cerebral palsy. The evidence was that a programme of support is in place for each person. Discussions with staff indicated that members of staff have a good knowledge of the ways support should be given. 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 helath and support they may need. 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, meeting all residents, discussions with a resident via her light writer and information provided by three members of staff. The extensive nature of care plan and healthcare records, risk assessments and AQAA reflections supported this conclusion. Care Homes for Adults (18-65 years) Page 18 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: 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. Support workers said that these issues are included in the quality assurance programme for assessing the success to the service. All staff receive regular supervision meetings. Staff on duty said these contribute to identifying areas where practice is good and where improvements might be possible for the benefit of staff and residents. According to the AQAA, no complaints were received since the previous inspection visit. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: Members of staff said they welcome comments from residents advocates about how care and support was provided. The evidence was that recruitment procedures contain the checks (including CRB checks) necessary to help contribute to the protection of residents. A member of staff stated that MCCH have recently undertaken a range of checks for all staff relating to identity and CRB procedures. Three members of staff outlined how staff receive information about their responsibilities under current ISA arrangements. All staff who work alone at any time, for example, at night must have completed an NVQ qualification. The evidence was that 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 outlined 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 20 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 good 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: Bedrooms were suitable for the needs of residents. Each person has his/her own bedroom that is well decorated and personalised with their own belongings. Residents, visitors and staff have access to a suitable garden. The premises were clean and well maintained at the time of this inspection visit. The AQAA stated that essential refurbishment is carried out routinely. The premises were in very good condition. A declaration was made in the AQAA that all necessary checks are carried out and that the necessary safety certificates are in place and upto-date. The premises have, according to the AQAA, a fire risk assessment which complies with the the most recent Fire Safety Order. Fire door-guards have been fitted to all relevant fire doors. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: The AQAA outlined procedures relating to premises safety. Residents have access to specialist equipment as a result of assessment and reviews of their support needs. Care Homes for Adults (18-65 years) Page 22 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: As a result of discussions with managers at several MCCH services during other inspection visits and with the manager of this service, the evidence is that residents are protected in a number of ways including via the required recruitment procedures. The AQAA contained the declarations necessary for this conclusion to be reached. According to the manager, 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. This includes, in some instances, residents taking part in recruitment. All new members of staff have 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. The members of staff on duty provided an outline of this process and referred to its Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: importance in ensuring that staff receive godd basic training at the beginning of their employment. Based on discussion with the former manager and support workers on duty, it was evident that the manager/support workers undertake 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 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 was possible to conclude that all relevant checks are carried out, there is a process for involving some residents in the recruitment process 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. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: 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. Members of staff met on this occasion stated that there are a minimum of two staff on duty at all times apart from at night when one support worker is on duty (awake). There could, at times, be up to four members of staff on duty during the day and evening. Members of staff referred to the mandatory and additional training all staff members must receive. 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 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 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. The examples of risk assessments seen and the close involvement of support workers indicated that close attention is given to the safety and comfort of residents. The manager and support Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: workers outlined how support workers take a special interest in, for example, keeping care plans updated for their benefit and that of residents. The medication system has been reviewed by the manager and improvements were made for the safety of residents. 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. Declarations were 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. She has previous experience in managing a similiar residential home. The registration certificate is very out of date. The manager should take immediate steps to progress her registration with us. The former service manager gave us an undertaking in this regard. 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. 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 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!