Inspection on 19/01/10 for 165 Jemmett Road

This is the latest available inspection report for this service, carried out on 19th 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

165 Jemmett Road 24/02/06

165 Jemmett Road 23/08/05

165 Jemmett Road 15/02/05

165 Jemmett Road 01/02/05

165 Jemmett Road 16/02/04

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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: 165 Jemmett Road 165 Jemmett Road Ashford Kent TN23 4RH     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: Robert Pettiford     Date: 1 9 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: 165 Jemmett Road 165 Jemmett Road Ashford Kent TN23 4RH 01233664753 01233664753 strevett@kentautistic.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): The Kent Autistic Trust Name of registered manager (if applicable) Type of registration: Number of places registered: care home 6 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 6. 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 165 Jemmett Road is a purpose built detached property owned by a housing association and managed by the Kent Autistic Trust. The fees are according to assessment. The home is in a residential area of Ashford, within 15 minutes walking distance of the town centre, with easy access to public transport, health and adult education centres, shops, churches, a swimming pool and other amenities. The house provides accommodation on 2 floors. There are 6 single bedrooms for residents, lounge, dining room, kitchen and bathrooms. In addition there is a staff sleeping in Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 6 Brief description of the care home room, office/sleep in room, laundry, storage areas and a large enclosed garden. Staffing comprises a manager, team leaders, support staff and day care staff. 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 inspection took place at 7:30AM on 19th January 2010. We agreed and explained the inspection process with the Manager. The focus of the inspection was to assess the home in accordance with the Care Home Regulations 2001 and the National Minimum Standards for Younger Adults. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. We used a varied method of gathering evidence to complete this inspection, pre inspection information such as the previous report and discussion and correspondence with the registered provider and manager was used in the planning process to support us to explore any issues of concern and verify practice and service provision. The home has completed an annual quality assurance assessment questionnaire (AQAA), which Care Homes for Adults (18-65 years) Page 6 of 30 was received on time. This provided us with information relating to What the home considers it does well, What we could do better, What has improved within the last 12 months and plans for improvement. The judgements have been made using the Key Lines of Regulatory Assessment (KLORA), which are guidelines that enable the CSCI to be able to make an informed decision about outcome areas. Further information can be found on the CSCI website with regards to information on KLORAs and AQAAs. Documentation and records were read. Time was spent reading a sample of written policies and procedures, reviewing care plans and records kept within the home. Other areas viewed included risk assessments, pre admission assessments, rotas, training records and recruitment records. In addition an environmental tour took place. We identified two residents for case tracking. In addition we had the opportunity to speak with several of the residents and a number of staff. Additional evidence was gained to inform judgements following the observation of many of the residents and their interactions with staff. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Care Homes for Adults (18-65 years) Page 8 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that their needs will be properly assessed prior to moving to the home. Prospective residents also have the benefit of a trial period at the home. Evidence: Records held showed that residents have an assessment, which identifies their individual needs prior to or on admission to the home. The residents, their families and health/ social care professionals provide the information. This is then reflected into the care plans and these are developed in agreement with the individual where possible. The assessment focuses on achieving positive outcomes for people and this includes ensuring that the facilities, staffing and specialist services provided by the home meet the needs of the individual. Before agreeing admission the service carefully considers the needs assessment for each individual prospective person and the capacity of the home to meet their needs. The assessment process recognises cultural needs and the importance of promoting equality and diversity rather than just meeting needs in a reactive manner. Prospective Residents have the benefit of a trial period at the home to assess whether Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: the home can or cannot meet their needs. The AQAA provides further evidence and states the home take time when looking at prospective placements conducting a full assessment of individual needs and the needs and compatibility with the other people living in the home. This process gathers information from all parties currently involved with the person including schools, colleges, family, care manager, G.P. The home encourage people to come and visit the home before admission and provide information for them to read or take away with them. This includes a statement of purpose and a service user guide. After the selection has been made and a place has been accepted, the manager plans transition carefully to help the move go smoothly. This is a very emotional time for the family and the individual themselves and they work hard to ensure that the person seeking a service is supported all the way by a competent, keen staff team. The AQAA also states the home operates a Key worker system to enable individuals to have a named person they can build a relationship who they know will be able to support them. This is not meant to exclude others but, to reassure and guide. Care plans are individual and person centred; Staff support the resident to set goals for the coming year so individual wishes can be explored in a safe, appropriate and structured manner. The home supports people with Autism who do not like sudden or unexplained change but, they do still have ideas and wishes. Ideas and plans are presented in a format that they will understand and accept. The home states they are mindful that they are here to support and encourage. They assess new goals or requests and focus how they can make things happen for a person. 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 benefit from having clear individual plans that are comprehensive, identify their needs and are specific to the individual service user. Care plans showed that residents are enabled to make decisions and choices. Residents are enabled to take responsible risks through a thorough risk assessment process. Evidence: The key principles of the home for delivering a quality service are based on the belief that residents should be able to take control of their lives. The staff of the home are strongly committed to this and supporting all service users including those with limited communication or intellectual skills to make informed decisions, understand the range of options which are available to them and have the right to take responsible risks. Evidence of this was gathered from talking to residents,staff,management and reviewing all available information. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: The home and its staff are committed to supporting the residents in accordance with their needs and goals. This was evidenced through the care plans, which detailed the areas of support that the resident needed and how this support is provided by the staff. There were clear guidelines in respect to routines and supporting the residents with their needs. The manager confirmed that these are reviewed with health care professionals, relatives and residents where possible on a regular basis. We viewed a sample of two care plans, which showed short and long term goals. The plan focuses on current need. The plans of care follow the principles of person centred planning. Staff have the necessary training and skills to support and encourage the individual to be fully involved. A key worker system provides additional support enabling one to one involvement. Residents rights to make decisions are respected and the care plans reflected their ability to make an informed judgement where possible. Care plans included information concerning the preferred lifestyle and choices. We visited the home at 7:30AM. During the inspection we noted that residents were seen making choices about their lives and were seen to be part of the decision process where possible. A relaxed atmosphere was noted with the residents interacting with staff. We found that the home has a genuine commitment in evolving the resident in the day-to-day running of the home. Staff were responsive and receptive to the residents input. Examples of such included choosing activities and planning of the day ahead. There were guidelines in respect to routines and behaviour. The member of staff confirmed that these are reviewed with the residents on a regular basis and the families are supported to be involved. We requested that care planning is reviewed to further evidence that residents are fully involved in the process and contribute towards setting their hopes aspirations and goals. Care plans include a comprehensive risk assessment. Management of risk takes into account the specialist needs and age of people who use the service, balanced with their aspirations for independence, choice and normal living. Where there are limitations on choice or facilities, it is in the persons best interest. The resident understands and agrees the limitations where possible. Risk assessments are in need of review and it was suggested that one format is adopted to aid consistency. 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 can be confident that they are offered a wide range of opportunities for personal development and to learn new skills and feel part of the wider community. Residents engage in a higher than average level of activities which are appropriate to their needs and capabilities. Residents are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. The residents benefit from the appetising meals and balanced diet offered at the home. Evidence: Residents are enabled to participate and contribute to meeting their own self care Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: needs and day to day chores around the house as their capacity allows. Discussion with staff confirmed that the level of activities were of a high level and that they enjoyed a good level of stimulation through leisure and recreational activities both inside and outside the home. We joined residents at 7:30am while they were getting ready for the day ahead. We had the opportunity to speak to several of the residents who expressed their opinion of the home and the activities they participated in and enjoyed. Other residents were observed participating and interacting with staff. Residents have been enabled to and encouraged to participate in hobbies and activities which they had an interest in, such as maintaining and building on personal collections and specific recreational activities. The service actively encourages and provides imaginative and varied opportunities for Residents to develop and maintain social, emotional, communication and independent living skills. The home greatly benefits from a central day service run by the provider, additional staff are involved in providing activities. The staff have a strong ethos and focuses on involving Residents in all areas of their life, and actively promotes the rights of individuals to make informed choices, providing links to specialist support when needed. Evidence of this was observed from direct observation and comments made. It was confirmed that residents are enabled to maintain contact with relatives and friends where they wished to do so. Examples of such included provision for relatives and friends to visit the home and support being provided to enable services users to visit relatives or friends outside the home. Residents were consulted with regard to whom they saw and when and were under no compulsion to accept visitors should they not wish to do so. From observation, records viewed it was evident that residents were offered a choice of menus that meet their dietary needs and individual preferences. Meal times are flexible to suit the residents activities and schedules. Residents are able to choose where to eat, and also have facility to make drinks, meals and snacks for themselves and others with staff support should they wish. Residents on evidence seen have had been involved in planning and choosing what to eat where possible. One service user explained the menus and how his choice and preferences influenced the menu. The AQAA states that everyone in the home has a care plan designed in a very person centred manner. These plans are constantly monitored and reviewed to ensure everyone gets the opportunity to experience new and exciting things as they become Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: available. Everyone in the home is supported to live a full and varied life designed around their personal needs. Everyone at the home has a key to their room and should they wish to can take control of the care of their own belongings. There is a key pad to the main entrance door but, the code is given to those that it is safe to do so. There are Risk assessments in place for those who do not have the code outlining why that decision was made. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents feel well supported by the level of help given and that their healthcare needs are addressed. Residents can feel confident that their wellbeing will be protected by the homes policy and procedures with regard to the handling and administration of medication. Evidence: The care plans fully documented the personal support required for individual Residents. They reflected their choices and preferences and staff were observed offering guidance where needed. Times of getting up / going to bed, having baths, eating meals and other activities are flexible to allow for different residents daily routines. All residents are allocated a key worker and we observed excellent interaction between staff and residents. Staff understand the key principles of giving personal support and are responsive to the varied and individual requirements of the residents. It is recognised that the delivery of personal care is highly individual and must be flexible, consistent and reliable. Attention is given to ensuring privacy and dignity when delivering personal Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: care and staff are sensitive to changing needs of residents. When ever possible residents are able to have choice about who delivers their personal care. Where possible residents are supported and helped to be independent and responsible for their own personal hygiene and personal care. The care plans fully documented all physical and emotional healthcare needs and where able residents filled in or were supported to fill in appropriate forms. Within the care plans records of health care provided by G.P, chiropodist, dentist, and opticians were evident. All residents have the opportunity to have regular healthcare check ups to ensure a proactive approach to healthcare is achieved. Residents physical and emotional health is monitored on a daily basis. Through their daily records and these correspond with support assessments held in the care plans. This system ensures that all Residents receive continuity of care and supports potential complications and problems at an early stage. It is evident through records that the emotional health support is of a high priority to this home and the staff are pro-active in maintaining and supporting residents with their emotional needs in order to maintain their quality of life. We viewed the storage arrangements and some records including Medication Administration Record (MAR) sheets, and the protocols for the administration of PRN/As Required Medication within the home. The manager confirmed that all staff who dispense medication have received the appropriate training. The MAR sheets (drug record sheets) were being completed properly. MAR sheets did have a signature list to evidence who gave the medication signed for on the MAR sheet. The home has a very limited amount of Prn or as required medication. Staff, are given the training need to ensure that they provide an excellent standard of care. They are expected to complete hands on training before they support individuals alone and there are competency based risk assessments completed in respect of medication, lone working etc. None of the individuals at the home administer their own medication. There are some complex needs that require a fair amount of Medical and Psychiatric support on a regular basis. The home also have residents that do not like a doctor or other professional to examine them. Staff, are competent to deal with these appointments and support the individual to ensure they are receiving their needs are expressed in a manner that will help gain the correct treatment. There are personal care plans in place to ensure a consistent approach across teams. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: There is daily monitoring of peoples general health and any concerns are addressed as soon as they arise. This is more difficult with the individuals independent with the personal care so staff have built on relationships to give them the confidence to say if they have any problems. They keep full records of all appointments in the form of Professional Consultation reports. These outline the reason for the consultation together with any treatment prescribed, advice given and any follow up visits required. They hold monthly service meetings where concerns, treatment, progress and advice given are discussed and acted upon. Minutes of these meetings are kept in the home. All reports relating to health needs are kept in the service user files and are incorporated into the yearly review meeting Care Homes for Adults (18-65 years) Page 20 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 and their relatives know that their concerns and complaints are taken seriously and can feel confident that they are protected from the risks of abuse. Evidence: A copy of the complaints procedures was reviewed. The procedure included details of how to complain, timescales for response and information for referring a complaint to the service provider. The home was recommended to make the complaints procedure more widely distributed, and highly visible within the service and make is more readily available in different formats. Surveys commented that complaints are managed and dealt with in a sensitive and proactive way. Residents within the service have an understanding of how to make a complaint as their capacity and understanding allows. Confirmation of this was evident upon speaking to one of the residents. The homes Policy for the Protection of Residents and staff Whistle blowing procedure was discussed. These include procedures for the reporting of suspicion or evidence of abuse with a format for the recording of any allegations and action to be taken. Full training has been provide for all staff. The home promotes an open culture where Residents feel safe and supported to share any concerns in relation to their protection and safety. Policies and procedures regarding protection are in place. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: The home needs to fully ensure through training, supervision, review and quality monitoring that care staff fully comply with the policies and procedures provided in relation to protecting and safeguarding the rights of people who use the service. Criminal Record Bureau Checks (CRB) have been obtained for all staff. The AQAA states the home takes care to ensure that all staff understand the importance of listening. They are most likely to be who individuals come to with concerns or when needing to disclose abuse. All our staff receive Protection of Vulnerable adults training in their first week with us as part of their induction. They are trained in recognising the many different forms of abuse and how to proceed should they suspect abuse is taking place. Care Homes for Adults (18-65 years) Page 22 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. Service users benefit from living in an excellent well maintained environment which provides a homely warm atmosphere with safe access to comfortable indoor and outdoor communal areas Evidence: The manager stated that the home meets with the requirements of both Fire and Environmental Health Departments. It was apparent that the individual and collective needs are being met in a comfortable environment. The standard of internal decoration and fixtures and fittings are well maintained generally with some improvements needed which have been identified. The home benefits from a selection of communal areas thus affording residents space should they so wish desire. The premises are kept clean, hygienic throughout and systems are in place to control the spread of infection, in accordance with relevant legislation, published professional guidance and the purpose of the home. The AQAA states The home is a pleasant space that provides a warm environment that is geared to the needs and wishes of the individuals whose home it is. It does need to be modernised/refreshed in some areas. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents care, social and emotional needs are promoted by the employment of caring and suitably trained staff in such numbers to support their needs. Residents are protected from potential abuse by the homes robust staff recruitment procedures. Evidence: From discussions with the Manager, observations and reviewing the staff rotas more than sufficient staff were on duty at the time of inspection to meet the residents needs. We were informed that staffing numbers would be reviewed and staff increased should the needs of the service users change long term. The staff training records indicated planned and undertaken training. The manager evidenced that individual and group staff training needs had been identified. A wide range of training has been completed by all staff . The manager present confirmed that the induction programme adopted complies fully with the recommendations of the Skills for Care Councils current guidance. First Aid, Food Hygiene, Health and Safety and other core courses are undertaken for the majority of staff to maintain current qualifications and for protection of residents. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: Courses also include training in managing Challenging Behaviour. The service has a recruitment procedure that has the needs of people who use the service at its core. The recruitment of good quality carers is seen as integral to the delivery of an excellent service. The service is highly selective, with the recruitment of the right person for the job being more important to the filling of a vacancy. We viewed details of the homes recruitment procedure and a number of records relating to staff members recruited. The home undertakes a recruitment practice including submission of an application form detailing all previous work history, requests proof of I.D and copies of qualification certificates, seeks written references. All staff appointments are subject to a probation period, which is subject to review. All staff have a contract of employment and job description. From documentary evidence seen with staff completing basic courses and over the required minimum 50 of the staff achieving a NVQ (National Vocational Qualification) Level 2 or above care qualification. Before people are offered a position the AQAA states they invite applicants to attend a taster session. From their point of view it gives them an opportunity to meet the staff and individuals and to see first hand the environment they would be working in. It would not be appropriate for the individuals within the home to be part of the interview stage so these tasters give them the chance to meet possible new recruits in a more relaxed setting. Feedback from these sessions gives everyone in the home the chance to have their say in the selection process if they choose to do so. As a service they provide a full induction for all new staff that includes an Autism workshop, training around the philosophies of the trust, behavioural management and also get people started on their mandatory training such as health and safety, manual handling and Epilepsy awareness. Ongoing training is provided throughout employment for all mandatory training and courses specifically designed for or organised by the trust geared towards our client group. They also operate a system of hand on and competency based training that all staff must complete before undertaking a particular role alone. Staff are encouraged to apply for training they have come across that they feel would be of benefit to their work and NVQ training is offered to the level required for their post. Some extra courses that people have asked for include; Signalong, Sensory and Indian head massage; all of which have been provided. 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 excellent 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 well run and managed home. Residents and or their relatives can be fully confident that their views and opinions effect how the home is run and that their best interests are safeguarded by appropriate policies and procedures. Residents can always feel fully confident that their health and safety/ welfare is protected by robust policies/ procedures and safety checks. Evidence: The manager is actively involved in the day-to-day management of the home and works wellwith staff and residents and has their confidence. At present she is not registered. However an application will be sent to the Commission shortly. From observation and staff feedback the manager offers a clear sense of direction and leadership, which staff and residents understand. Residents, their relatives and staff are encouraged to comment on the services the home offers and to voice any Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: concerns they may have. There is strong evidence that the ethos of the Home is open and transparent. The views of both residents and staff are listened to, and valued. The AQAA states the homes offers a specialist service for people with ASD (Autistic Spectrum Disorders). They state they continually strive to better our understanding of the people they support. They offer full initial and on going training for all and actively encourage people to seek further training. Staff enjoy there work and maintain high standard of care with patience, understanding and enthusiasm at all times even when things do not go according to plan. Quality assurance was discussed and the views and opinions of many of the residents and stakeholders sought. The residents spoken with confirmed a great deal of satisfaction living within the home and felt confident that their views and opinions were valued by both staff and management. The manager confirmed that the home does undertake quality assurance by means of asking residents to complete questionnaires where possible. The home operates a keyworker system to identify an individual staff member to directly to work with a service user on a one to one basis. The home has a quality assurance system. Spot checks and quality monitoring systems provide management evidence that practice reflects the homes policies and procedures. The registered provider of the home does regularly visit the home and complete what is known as a Regulation 26 visit. This requires the provider to assess the quality of care within the home and ensure that it is meeting with the required National Minimum Standards. The quality of such Regulation 26 visits were seen to be excellent. The visits focus on outcomes for residents with regard to quality of care, staffing, adult protection, recruitment, audits of policies and procedures and that they are followed, staff training, activities, health and safety etc. The home has a full range of policies and procedures to promote and protect residents health and safety. There is full and clearly written recording of all safety checks and there is no evidence of a failure to comply with other legislation. There is a good understanding of risk assessment and this is taken into account in all aspects of the running of the home. The quality assurance system confirms that the findings from risk assessments have been actioned and the home continuously improves its systems for health and safety. 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. 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