Inspection on 23/03/10 for 24a Lower Hanham Road

This is the latest available inspection report for this service, carried out on 23rd March 2010.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

24a Lower Hanham Road 15/04/08

24a Lower Hanham Road 21/03/06

24a Lower Hanham Road 23/08/04

24a Lower Hanham Road 11/05/04

24a Lower Hanham Road 19/01/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 29/06/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: 24a Lower Hanham Road 24a Lower Hanham Road Hanham South Glos BS15 8HH     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: Grace Agu     Date: 2 3 0 3 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: 24a Lower Hanham Road 24a Lower Hanham Road Hanham South Glos BS15 8HH 01179605928 01179709301 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: admin@aspectsandmilestones.org.uk Aspects and Milestones Trust care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The manager to complete NVQ training at Level 4 in Care & Managerment by December 2005. Date of last inspection Brief description of the care home 24 a Lower Hanham Rd is managed under Aspects and Milestones Trust. The home is registered to accommodate 5 people with learning difficulties, aged 19 to 64 years, and 65 years and over. The home is approximately half a mile away from the main Hanham shopping area. There are a range of shops and community facilities, and is on a bus route to the centre of the city. The building is a detached dormer bungalow in an established residential area. There are 4 bedrooms on the ground floor with an ensuite bathroom. The other room has a shower. The home is accessible for people who use a wheelchair, and has suitable adaptations for people to be as independent as possible. The range of fees for the home is GBP900.00 to GBP1,000.00. However, fees for people considering to move into the home would be assessed individually. 5 Over 65 5 Care Homes for Adults (18-65 years) Page 4 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: This was an unannounced visit which was undertaken as a part of a key inspection over seven and half hours to review the requirements made at the last inspection and also to review the care practice to ensure that it is in line with the legislation and that best practice is followed at the home. At the last inspection eight requirements and three recommendations were made in relation to care planning, environment, staff training and ensuring that the risk assessments in relation to care of the residents at the home. It was pleasing to note that the home has made efforts to ensure that the requirements were met. Information about care of the individuals living in the home and the services provided at the home were obtained through review of records, including policies and Care Homes for Adults (18-65 years) Page 5 of 30 procedures, care files, staff training and quality assurance records. We met with Ms Silvia Boyo on arrival and Brian later both senior staff members who offered tremendous assistance and cooperation throughout the visit. We also spoke with people who use the service. No relatives were seen at the home during the inspection. Care Homes for Adults (18-65 years) Page 6 of 30 What the care home does well: What has improved since the last inspection? It was pleasing to note that all the requirements made at the last inspection have been met. The home told us told us in the Annual Quality Assurance Assessment that one service user had been supported to lease his own car and a new house vehicle has been arranged for the other residents to ensure their access to chosen groups and activities. Care Homes for Adults (18-65 years) Page 7 of 30 One resident has started college courses twice each week. One of the shower rooms has had is ventilation improved. three of the four personal television sets have been upgraded in line with the Digital service change over. New floorcovering has been fitted in the upstairs bathroom. The computer has been re-sited in the lounge so that all the residents can access and use it for planning, with staff support. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 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 9 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. The home has a detailed and well-planned admission process to enable prospective residents to make an informed choice about moving into the home with the assurance that their needs would be met. Evidence: There has been no new admission to the home since the last inspection. However if there were a proposed admission, residents would be assessed at an early stage to consider if the home could meet their care needs. Information from the the Annual Quality Assurance Assessment (AQAA) states that the home arranges for the prospective resident to visit the home during the day and overnight stays to determine if they are compatible with the other residents. This was evidenced in the Aspects and Milestones admission procedure at the home. There was a comprehensive care management assessment in place in the four residents care files reviewed. These care files evidenced measures in place to meet specific assessed needs, staff members that we spoke with on the day were aware of Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: their roles and responsibilities and how to support all individuals living in the home to meet their needs. The home has a Statement of Purpose and a Service Users Guide, which has information about the services provided at the home. For example how to make a complaint, any support that would be given in relation to the individuals health, specialist services provided, quality of accommodation, qualification and experience of staff. These two documents have been reviewed to ensure that accurate information is given to prospective and existing service users. Each resident had a License Agreement in the care file; this document was written and in a picture format and contained fees to be charged. We noted residents who are able signed documents and the other two were signed by their representatives. This is confirmation that the requirement made at the last inspection had been met. A signed vehicle license agreement in relation to how the residents contribute to the house vehicle usage was noted in the care files reviewed. Care Homes for Adults (18-65 years) Page 11 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individualised care plans are provided for the service users to reflect their assessed needs and they are supported with risk assessments to live as independent lives as practicably as possible with the assurance that information about them will be kept confidential. Evidence: We reviewed in detail the care documentation of one individual and checked specific information about three other individuals living in the home to confirm that the requirement made at the last inspection had been met. The care file had comprehensive care management assessment. The care needs indicated in the care management assessment had been reflected in the Essential Lifestyle Plan and Health Plan of the individual including their involvement in developing those plans. The personal profile of the individuals and assessments were well written providing Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: staff with information on how to determine the individuals preferences and dislikes. Staff told us that this document is a working tool that enables people such as bank staff who may not be familiar with the residents to provide personal care in a consistent way. There are risk assessments with regards to various areas of health and personal care and these were reviewed regularly. However we were unable to find documentation in relation to risk assessments in one of the care files we looked at for specific information in order to confirm that the requirement made at the last inspection had been met. Staff we met on duty were able to demonstrate awareness of risk for individual residents in the home, which includes the balance between maintaining the safe environment and enabling people who use the service to express choice. At a discussion with one staff member, we were informed that through observation such as facial and/or vocal expression staff enable one individual with non verbal communication to make choices. We noted this level of interaction before the meal was prepared at lunch time. We had the opportunity to observe staff feeding this person at lunchtime.The staff member was able to discuss the physical and mental wellbeing of the individual and confirmed that the General Practitioners and other health professionals would visit the home whenever required. Staff also acknowledged that they support the residents to make choices and decisions and that occasions may arise when they may make choices and decisions on behalf of the residents and are mindful about how they do this in order to safeguard the peoples welfare and rights. There was evidence that residents are supported to be involved in decision making at the home through residents meetings. None of the residents is likely to go missing as total support is required for all the individuals and staff always accompany the residents on all external activities. The home has a confidentiality policy. Care Homes for Adults (18-65 years) Page 13 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home are encouraged and supported to engage in leisure activities and maintain links with the community, family and friends. Healthy diet is provided for the individuals at their chosen times ensuring that their individual rights are respected. Evidence: We met three residents at the home on the day of our visit. They looked well cared for in a relaxed and positive atmosphere, one resident was noted accessing her/his room and kitchen with a minimum of institutional rules and routines. Staff were seen interacting with residents in informal, however, sensitive and respectful manner. This is a demonstration of good practice and shows that the home includes the residents in the daily routines. Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: Evidence from discussions, reviews of the care files and the information seen in the visitors book at the home confirmed that the home supports the residents to keep in touch with families, friends and representatives. On arrival we noted one resident waiting to be taken home to spend the day with their parent. The individual was clearly very excited and was very happy when a staff member relayed a telephone message from home to remember to take their puzzle with them. The staff member told us that the persons family are very supportive. Another individual told us My sister lives in a home and we visit each other every weekend. I bought her a surprise present for Easter The home enables and supports residents to participate in activities based on individual assessment and capabilities. From what staff told us and evidence from the care files one resident attends the day centre at Blackhorse in Downend on Mondays, Thursdays, and Fridays mornings and studies art at college on Friday afternoons. The person also goes out every Tuesday and Wednesday with a personal carer either for shopping or any other activity of their choice. One individual works in a farm on Monday, Tuesday, Wednesday and Friday and spends Thursday cleaning their room and going out for lunch and shopping. Three of the residents went on planned holidays last year, staff told us that one individual was not able go on long holidays due to a medical condition however this individual is supported to go on day trips and attend church on Sundays. Staff told us that this persons family plan to take him to France on a Church excursion with staff support. The residents menu was reviewed and was found satisfactory. A staff member spoken with stated that the residents are supported to use the kitchen and participate in planning the menu every Friday. One resident was noted making their breakfast in the kitchen on the morning of the visit. One staff member told us that the residents have a healthy appetite and that staff know individuals preferences. There was documentation regarding assistance required with eating and drinking for a particular resident and a speech and language therapist had reviewed this recently. There was a record of procedures to be followed and a risk assessment in relation to choking. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: There were snacks and fresh fruit available in the kitchen. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home supports the residents as required and ensures that the emotional and physical health needs are met. It protects the residents from potential harm through satisfactory medication practices. Evidence: Evidence from the care files reviewed and discussions with a staff member show that the residents are supported with their personal and emotional care and how these are carried out. The staff member was able to describe in full detail how one individual is supported routinely including the level of support provided by staff to ensure that the individual maintains independence. The care files has an Essential Lifestyle Plan and Health Action plan which provides staff with information about the needs of the residents including actions to be taken if they were exposed to challenging situations. We noted that residents have been involved in developing this plan. Each individuals plan contains information which each person considers to be important about them, explains who supports them with Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: their health care and how this is monitored. The Annual Quality Assurance Assessment (AQAA) stated the plan is reviewed every six months. We noted that three care files contained detailed risk assessment in terms of their activities and personal care. However we noted that one individual had no risk assessments in place to enable staff to support the person while maintaining their independence. Staff told us that the risk assessments had been completed by the acting manager but were unsure why they were not in the care file. These documents have been sent to the Care Quality Commision for verification before this report was completed. Review of the care file and discussions with staff members shows that residents are supported to visit their General Practitioner(GPs) to attend urgent or routine. appointments also other health professionals as required. Entries noted in the daily report evidenced how support and personal care was provided to reflect the care plans in place. We observed staff interacting with the residents in a respectful and dignified manner. There are clear procedures and appropriate arrangements in place for the receipt, storage, administration and disposal of medication in the home. The system was found generally satisfactory. Staff files reviewed showed that staff working at the home have completed a training update on medicine administration competency. Staff are aware of how to support individuals towards the end of life and time of death. 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 and harm through robust policies, the Home provides detailed information to enable residents to complain. Evidence: Staff are aware of the Homes policies and procedures in relation to reporting incidents of abuse and have received training on Protection of Vulnerable Adults from Abuse (POVA). There is also a copy of the Bristol City Council policy on POVA at the home to ensure awareness of the protocol to be followed if incidences of abuse occur. There is a complaints procedure available in the home. The document contains information about the Care Quality Commission and is in an appropriate format relevant to the resident group. Two complaint were recorded in the complaint book since the last inspection. Staff told us that one of the complaints had been referred to the head office and is yet to be resolved. One of the care workers we met met on the day of the visit stated that the home enables the residents to complain through good knowledge of the individuals and interpretation of the behaviour to enable staff to make a complaint on their behalf. Some residents are able to complain to staff about anything that they are not happy Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: about and are supported to make their views known until the issues are resolved. Each resident has a complaint procedure in their care files and staff told us that the complaint procedure is also explained to the residents on a one to one basis, during resident and staff meetings. The home is in regular contact with relatives and ensures that issues are quickly resolved whenever they arise. We were unable to view staff files due to lack of access to the cupboard as the acting manager was on annual leave. Staff members we met on duty told us that they have been at the home for a long tome. We believe that Aspects and Milestones has a robust recruitment procedure that offers adequate protection to the residents. Evidence from staff training record shows that staff have attended training on abuse prevention. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Generally the environment is clean and comfortable for the residents with suitable specialist equipment where they feel safe to live. However one radiator needs attention as well as the fridge and the freezer. Evidence: 24a Lower Hanham Rd is managed under Aspects and Milestones Trust. The home is registered to accommodate 5 people with learning difficulties, aged 19 to 64 years, and 65 years and over. The home is approximately half a mile away from the main Hanham shopping area. There are a range of shops and community facilities, and it is on a bus route to the centre of the city. The building is a detached dormer bungalow in an established residential area. There are 4 bedrooms on the ground floor with an en-suite bathroom. The other room has a shower. The home is accessible for people who use a wheelchair, and has suitable adaptations for people to be as independent as possible. The home was found to be clean tidy and free from unpleasant odours. Residents met on the day were found relaxed and enjoying the company of one another. The bedrooms viewed were well furnished and decorated to each residents choice. Two bedrooms have en-suite facilities consisting of a toilet, wash hand basin and a Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: walk in shower. the remaining bedrooms have wash hand basins and bathrooms and toilet close to their bedrooms for easy access. All bedrooms viewed were personalised, colour coordinated, clean and pleasantly furnished. The toilets and bathrooms had grab rails and various manual handling equipment and aids to assist the staff with meeting residents needs. While touring the building we noted that the radiator on the ground floor bathroom has rust with flaking paint on the top surface which we believe could be potential hazard to residents and staff when the area is in use. We require that this radiator along with other radiators in the home are looked at with the view to repairing or replacing them to prevent any injury. The kitchen was found clean and tidy. There was regular recording of fridge and freezer temperatures. However the readings were above normal based on Aspect and Milestones guidance. We also noted that both needed urgent defrosting. The freezer looked very tired and the seal on the fridge appearred loose. We believe that replacing both pieces of equipment would safeguard residents food from any hazards. The laundry area was found to be clean and of good standard. 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. The residents enjoy a good and warm relationship with competent staff. The homes recruitment policy and procedure offer protection to the residents living in the home. Evidence: Staff records viewed showed that staff have attended medication competency training, first aid, food hygiene training and manual handlin along with health and safety and personal care training. There was also evidence that staff have attended epilepsy seizures training, vulnerable adults, sight loss, positive behaviour and Administration of Buccal Midazolam and Rectal Diazepam. Some training records we saw evidenced that staff have obtained National Vocational Qualification. On the day of the inspection, one resident met at the home was noted being supported by one staff member to attend Day Centre activities. The relationship between the staff member and resident was warm and friendly. One staff member that assisted with the inspection process by showing us round the building stated that all staff working at the home are aware of residents needs and are able to give appropriate support to each individual. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: The rota showed that the home is adequately staffed to meet the residents needs. We were unable to view staff records due to the acting manager being on annual leave however, staff told us that they are aware of their roles and responsibilities. One staff member spoken with on the day stated that there was good communication between all staff and that this has enabled them to provide support and good care to meet the complex needs of both individuals. To enable us to form a judgement about how the staff care for the people living in the home we sent comment cards to the residents and staff. This is some of what they told us: I get on well with the staff, everybody gets on, its nice and clean People who live here could be more happy. Staff help me to do stuff I cant do for my self. The home gives support to both staff and residents. The home is always trying to meet residents needs. The home could give more financial support for residents transport. The home meets the needs of its residents especially around accessing activities and their Community. Discussions with staff members and evidence from staff records showed that the staff have received regular supervision to enable them to perform their duties effectively and to discuss issues of concern in relation to residents needs. Aspects and Milestones recruitment and selection policy and procedure is robust and offers adequate protection to the residents living at the home. The policy states that it would ensure that two references must be obtained before any staff member is allowed to work with the residents. Care Homes for Adults (18-65 years) Page 24 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. The home has no registered manager however, the home ensures that residents are adequately protected through appropriate health and safety measures. Evidence: While the home has no registered manager staff told us that the Acting Manager, Steven Barnes, had worked at the home for a couple of years before his appointment. Records show that Steven has undertaken training on Communicating with staff, Safeguarding Adults from Abuse, Understanding Autism and has obtained NVQ at level 3 in Promoting independence. The acting manager was unavoidably absent due to annual leave. Staff told us that the acting manager is approachable, flexible and keeps staff happy. However, it could be difficult sometimes to make difficult decisions when on duty with no registered manager. Staff also told us that a new manager has been appointed and is due to start in April. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: Staff members met on the day showed an in-depth knowledge of all the residents discussed and provided explicit information on complex needs of the individuals living at the home. One staff member stated that the manager is a good manager, is approachable and would listen to any concerns staff may have. Staff work as a team, there are regular staff and resident meetings. There were recent records of annual gas safety inspection, portable electrical equipment testing and the testing of fire equipment. The Five Yearly Electrical Installation Safety inspection had been undertaken and the certificate was noted in the file. We are aware that the home has various risk assessments in relation to the environment however in order to minimize accidents to residents and staff it could be better if the generic risk assessment includes the lounges, bedrooms, kitchen and laundry areas. The fire logbook was up to date and in order. The record shows that the inspection of fire fighting and fire alarm systems had been carried out. There was evidence that staff have attended fire safety training and in general have attended fire drills however the home needs to ensure that all staff have attended a fire drill at least twice a year as stated in Aspects and Milestones guidance. Evidence of measures used to monitor the quality of service provided at the homeincluded regular care plan reviews, risk assessment reviews and regular staff supervisions staff meetings, staff training and residents meetings. The monthlyunannounced visits to the home take place by the provider and these reports were viewed during this visit. The homes policies and procedures reviewed included Confidentiality, Challenging behaviour, Infection control, Medication, Protection of Vulnerable Adults and Manual Handling. We noted that some of the policies have been reviewed to ensure that staff are kept up to date in terms of information regarding how to provide continuity of care to the people living in the home. We recommend that all the policies are reviewed for the same reason given above. Accidents records were seen in residents care files and followed up, when required. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: Regulation 37 notification form is used to inform the Care Quality Commission of serious injuries to the residents and other matters as required by the regulations. The residents money reviewed was satisfactory. One staff member explained how the home deals with residents money. This is stored in a safe and locked cabinet and receipts are obtained and are recorded for every item paid for. The amount recorded in the book corresponded with the amount found in individual boxes. Other residents information was noted securely locked away. 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 1 24 13 Repair or replace the radiator on the ground floor bathroom. To prevent injury to staff and residents. 31/05/2010 2 29 23 Repair or replace the fridge and freezer. To ensure food stored in them are well preserved. 30/04/2010 3 42 13 Ensure that the generic risk assessments includes the bedrooms, lounge, kitchen and laundry areas. To protect residents,staff and visitors. 30/04/2010 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 1 40 Review all the homes written policies to ensure that staff are aware of current legislation. Page 29 of 30 Care Homes for Adults (18-65 years) Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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