Inspection on 07/07/09 for 3 Brae Walk

This is the latest available inspection report for this service, carried out on 7th July 2009.

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

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

Other inspections for this house

3 Brae Walk 18/08/06

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 12/10/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 3 Brae Walk 3 Brae Walk The Wheatridge Gloucester Gloucestershire GL4 5FA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Adam Parker     Date: 0 7 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 31 Information about the care home Name of care home: Address: 3 Brae Walk 3 Brae Walk The Wheatridge Gloucester Gloucestershire GL4 5FA 01452530119 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Brandon Trust care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 The maximum number of service users who can be accommodated is 6. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Learning disability (Code LD) Date of last inspection Brief description of the care home 3 Brae Walk is a detached two-storey house in a residential area about two miles from Gloucester city centre. There are two bedrooms on the ground floor for people with mobility difficulties. There are a further four bedrooms on the first floor. The home has a lounge, a kitchen-diner and a landscaped garden. Some of the bedrooms have ensuite facilities. There are bathrooms on the ground and first floors which are fitted with aids and adaptations. The home is run by the Brandon Trust, which also runs other care homes in Gloucestershire and the South-West. Prospective service users are offered the opportunity to visit the home and have access to the Statement of Purpose and Service Users Guide. Information about the fees can be obtained from the home. Care Homes for Adults (18-65 years) Page 4 of 31 Brief description of the care home Inspection reports can also be obtained from the home and from our website, cqc.org.uk. Care Homes for Adults (18-65 years) Page 5 of 31 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: We asked the home to complete an Annual Quality Assurance Assessment, known as the AQAA. This was their own assessment of how they were performing. It also gave us information about what has happened during the last year, and about their plans for the future. We sent out surveys so that these could be completed by the people who lived in the home and by the staff. We had surveys back from six people who lived in the home and three staff members. We also received a survey from a health care professional. We looked at all the information that we had received about the home since the last inspection. This helped us to decide what we should focus on during our inspection. We visited the home on the 7th July 2009. We talked to the registered manager and three members of staff. We looked at some Care Homes for Adults (18-65 years) Page 6 of 31 of the agencys records. We met with the people who lived in the home. The judgments contained in this report have been made from all the evidence gathered during the inspection, including the visit. The last inspection of the home was on 23rd and 27th July 2007. What the care home does well: What has improved since the last inspection? We made several recommendations at the last inspection that had been addressed. We suggested that the Trust should review and update the admissions policy. The manager had devised a new admission process which had been used for the last person who moved in. Information about this was recorded in their assessment. The risk assessments had all been typed and gave clear information to staff about how to support people to take risks. Care Homes for Adults (18-65 years) Page 8 of 31 A new medication policy and guidelines for giving medication had been produced. This took into account the National Minimum standards and guidance from the Royal Pharmaceutical Society and the Royal College of Psychiatrists to make sure that practice was up to date. A system for auditing medication had been introduced to make sure that people only take medication which is up to date. Entries in the financial records were consistently signed by two members of staff to show that peoples money was being managed correctly. The carpet in the lounge had been replaced. On the day of our visit the carpet was being cleaned. This gave a fresh, clean feel to the hallway and lounge. The senior carer had produced an option appraisal about how to develop the service in the next few years taking into account issues relating to aging and mobility. The report considered various options about how to use the accommodation effectively to benefit people. Three people had had their rooms decorated recently and had chosen the colours. Two people had changed rooms to give them increased comfort and more personal space. One of these people told us that they liked their new room and were pleased with the change. The patio and path areas in the garden had been relaid. This made a safe, usable area and there was a table and chairs so that people could sit out. The recruitment policy had been updated and it covered checks of the Protection of Vulnerable Adults (POVA) list, Protection of Children Act (POCA) list and Criminal Records Bureau (CRB) checks. This would ensure that new staff had all the right checks and people were protected from being supported by unsuitable staff. Portable appliances had been checked to make sure that people were kept safe and they were due to be tested again in October 2009. Health and safety audits had been occurring monthly to make sure that all parts of the home were safe for people to use. 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get Care Homes for Adults (18-65 years) Page 9 of 31 printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 10 of 31 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 11 of 31 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. People and their representatives had the information that they needed to make an informed decision about whether the home was the right place for them. Peoples needs were assessed when they moved into the home so that their needs would be met. Evidence: We looked at the statement of purpose and service user guide. We saw that these were detailed and contained all the required information. Both were written in simple language and had pictures. The address for contacting the Care Quality Commission had been updated. We looked at the files of three people. They had lived in the home for some time and their needs had been assessed when they moved in. The manager told us that a care manager had conducted reassessments of need for each person. We saw that two of the people had community care assessments and care plans. Care Homes for Adults (18-65 years) Page 12 of 31 Evidence: We made a recommendation at the last inspection that the Trust should review and update the admissions policy. The policy document still needed to be updated. However, the manager had devised a new admission process which had been used for the last person who moved in. Information about this was recorded in their assessment. Care Homes for Adults (18-65 years) Page 13 of 31 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. Each persons assessed needs were reflected in care and support plans and these were reviewed and changed as necessary so that their needs would be met. People were assisted to make choices and decisions about their lives. People were supported to take risks to promote their independence. Evidence: We looked at the records of three people. We saw that each of them had a detailed care plan about all aspects of their personal care. Two people also had more specialised care plans to support them with their health care needs. All the care plans were reviewed each month and changes were recorded. The manager told us that they were working on developing a person centred plan (PCP) for each person as well as a care plan. We saw that two of the people had PCPs. During our visit we saw staff offering people choices for example about activities, food and drinks. There were also examples in the daily records of how people made choices. Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: We saw that the care plans contained information about restrictions where relevant, including the rationale and evidence of regular review. Six people who completed surveys told us that they made decisions about what they did each day. They told us that they could do what they wanted during the day, the evening and at weekends. We saw that each person had a series of risk assessments with action to be taken to reduce risks. These were reviewed each month. We made a recommendation at the last inspection that the risk assessments would benefit from being typed. These had all been typed and could be read clearly. Care Homes for Adults (18-65 years) Page 15 of 31 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 were supported to take part in a range of activities in the home and community which reflected their needs and interests and promoted their physical and mental wellbeing. This included maintaining contact with family and friends. The rights of the people living in the home were respected, helping them to feel valued and included. People were offered a varied and balanced diet and they had a choice of meals. Evidence: The manager told us in the AQAA that there were regular in house and outside of house activities including day centre attendance, music sessions, trips out to theatre, local shops and Vital therapy. Staff told us that two people went to a resource centre during the day. They said that other people were retired and preferred not to take part in structured activities. They Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: told us that these people liked to go out for meals and trips. On the day of our visit people had been out to the garden centre and had coffee and cakes. A member of staff said that people go out everyday. They said that a member of staff always took one person out when they did the food shopping. This persons daily notes showed that they went out every day, for a drive or to go shopping. We looked at the daily records of three people. These showed a range of activities every day including attending the resource centre, reflexology, drives out, time in the garden, in-house music sessions, watching television, trips to Gloucester and Tewkesbury, shopping, vital therapy and barbecues. We saw that peoples choices about leisure activities were recorded in their care plans. The manager also told us in the AQAA that staff supported people to maintain family contact and build relationships with people outside of the home. Staff members told us how people kept in contact with their families and how they supported people to maintain contact. We saw examples in the personal records of how people kept in contact with their family and friends. We looked at the menu and saw that a varied and balanced diet was being served. The manager and staff members said that people chose the meals in residents meetings. We saw records that confirmed this. Information about specialist needs in relation to food was recorded in peoples care plans. One person had a separate care plan for individual feeding support. Care Homes for Adults (18-65 years) Page 17 of 31 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. People received support in ways that they preferred. Peoples health care needs were being met. People were protected by the medication practices. Evidence: When we looked at the care plans we saw that these contained information about how people liked to be supported and their preferred routines. The manager told us in the AQAA that each person had a health action plan. When we looked at the records of three people we found that each person had a health action plan which showed how their health care needs were to be met. The records showed that each person was registered with a GP. We saw that appointments with health care professionals were recorded with information about the outcome. People saw the GP, community nurse, physiotherapist, occupational therapist, continence nurse, consultant psychiatrist, orthotist, dietitian and optician. A health care professional who completed a survey told us that the service sought advice and acted upon it to meet peoples health care needs and improve their wellbeing. Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: Following a recommendation at the last inspection a new medication policy and guidelines for giving medication had been produced. This took into account the National Minimum standards and guidance from the Royal Pharmaceutical Society and the Royal College of Psychiatrists. Each person had a medication profile in their personal file which recorded all the medication that they took. They also had pictorial care plans to show how their medicines were to be given. Medication was stored in a locked cupboard. The manager showed us an old cupboard for storing controlled drugs that was available to be put up. It was not clear whether this complied with the new regulations for the storage of controlled drugs. The manager said that no-one was taking controlled drugs. There were agreements with the GP about homely remedies that could be taken and how as required medicines should be given. A monitored dosage system was used. There were printed medication administration (MAR) sheets provided by the pharmacist. These were used to record medicines received into the home and administered to people. These were well maintained. We also saw that some handwritten additions had been made to the MAR sheets which were signed by two members of staff and dated. This meant that it was possible to cross reference them with instructions in the care plan. One person had medicines given by a special method and staff had received training about this. The health care professional who completed a survey said that staff usually supported people to take their own medication or managed it correctly where this was not possible. Care Homes for Adults (18-65 years) Page 19 of 31 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. Peoples complaints were taken seriously and their views were listened to and acted upon. People were protected from abuse, neglect and self harm. Evidence: When we looked at the statement of purpose we saw that this included a copy of the complaints procedure. This was in simple language with pictures. Four people out of six who completed surveys said that they knew how to make a complaint. One said that they did not know how to complain but they said that they knew who to speak to if they were not happy. The other did not answer these questions. The manager and a member of staff said that people were encouraged to discuss concerns and complaints in residents meetings that happened on Sundays. We saw the minutes of these meetings which confirmed that people were given the opportunity to air concerns and complaints. There was a record of any complaints and two complaints had been received from people who lived in the home since the last inspection. Brief details of the complaint, the investigation, any action taken and the outcome, including whether the complainant was satisfied, were recorded. Six people who completed surveys said that staff always listened and acted upon what they said. We saw that there was a policy about safeguarding adults from abuse. This included referring any allegations of abuse to social services in line with No Secrets guidance. Two staff told us that they had received training about prevention of abuse. The Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: training records confirmed this and showed that the training was updated. We made a recommendation at the last inspection that the Whistle Blowing policy was updated as it was written in 2000. This had not been updated. We saw a member of staff checking peoples personal money. She said that staff kept small amounts of money for people and each person had their own purse. We saw that a record was kept of all transactions. The staff member told us that two staff always signed the record and we saw that this was the case. A recommendation that entries in the financial records should be consistently double signed had been addressed. Care Homes for Adults (18-65 years) Page 21 of 31 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 accommodation was homely and there were aids and adaptations so that it was suited to peoples current needs. The laundry arrangements were suited to peoples needs and the home was clean and hygienic. Evidence: We looked at all of the communal areas and three bedrooms. We saw that the home was reasonably decorated throughout. The manager told us that there were plans to redecorate the accommodation. The atmosphere was homely. Aids and adaptations were provided as necessary and furniture appeared to be of good quality. We made a recommendation at the last inspection that the organisation should consider replacing the carpet in the lounge or have it deep cleaned. The manager told us that the carpet had been replaced. On the day of our visit the carpet was being cleaned. This gave a fresh, clean feel to the hallway and lounge. We also recommended that the organisation should assess and plan for issues relating to aging and mobility which may affect the suitability of the accommodation. The manager told us that the senior carer had produced an option appraisal about how to develop the service in the next few years. The senior carer showed us his report which Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: considered various options about how to use the accommodation effectively to benefit people. The manager told us in the AQAA that three people had had their rooms decorated recently to their specified requirements. They also told us that two people had changed rooms so that increased comfort and personal space has been acquired. When we looked at three bedrooms we saw that these were individually decorated and furnished. One person who had changed rooms showed us their bedroom. It was larger than their previous room which had become the office. They said that they liked their new room and were pleased with the change. We saw that there was a wet room on the first floor. There was also an adapted bathroom on the ground floor. The manager told us in the AQAA that a new bath had been installed in this bathroom and we saw this during our visit. When we looked at the bathrooms we saw that there were notices on the walls for the benefit of staff. We thought that these detracted from the homeliness of these rooms and that information for staff should be kept more discretely. There were two mop buckets in the upstairs wet room which also detracted from the homeliness of this room. We saw that the garden was well maintained and there was a summerhouse outside where one of the people who lived in the home liked to sit. We recommended at the last inspection that the patio slabs should be made safe as they were uneven. The patio and path areas had been relaid. This made a safe, usable area and there was a table and chairs so that people could sit out. When we looked around we saw that the home was clean and fresh throughout. There was a domestic type washing machine and a tumble drier in the utility room next to the kitchen. The manager told us that these were sufficient for the needs of people who lived in the home. Two people who completed surveys said that the home was sometimes fresh and clean and four people said that it was always fresh and clean. One person said, I help with the hoovering and polishing and also clearing up after tea. Care Homes for Adults (18-65 years) Page 23 of 31 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. People were supported by an effective staff team, who were appropriately trained, qualified and competent to meet peoples needs. People were protected by the homes recruitment practices. Evidence: When we looked at the statement of purpose we saw that it described the staffing levels. It said that there were two or three staff on duty between 7:15 a.m. and 14:45 p.m. and two staff from 14:00 p.m. to 21:30 p.m. with one member of staff sleeping in at night. Two staff members told us that these were the staffing levels. The manager told us that he worked fifteen hours a week in addition to this. He also worked several shifts and worked alongside the staff. On the day of our visit there were three staff on duty in the morning and two in the afternoon. The manager was on duty all day. The manager told us that there was one staff vacancy and these hours were covered by the organisations bank staff. Three staff who completed surveys said that there were usually enough staff to meet peoples individual needs. We saw that the statement of purpose contained information about staff qualifications. Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: It said that seven staff had National Vocational Qualifications (NVQ) at level two or above. The manager confirmed this. The manager had also told us in the AQAA that three staff had already completed NVQ level 3 and one was working towards level 3 while the senior was working towards NVQ level 4. There were nine members of staff and seven of them were qualified. Brandon Trust had a learning and development plan. Two staff told us that the training was very thorough. They said that staff had all the required training such as first aid and manual handling, and this was updated. They said that they also had more specialised training, for example, epilepsy, dementia, loss and bereavement, specialist feeding and equality and diversity. The manager told us that three staff were trained in person centred planning facilitation. They said that two staff were booked to do safeguarding and prevention of abuse training and two staff were booked for training about managing diabetes. Three staff who completed surveys said that they had an induction which covered everything they needed to know to do the job when they started. They also said that they had training that was relevant to their role and helped them to understand and meet peoples individual needs. They said that the training kept them up to date with new ways of working and gave enough knowledge about health care and medication. We asked the staff what the home does well. One said Sending staff on regular training days and updates so the standard of care is always high and we can improve on dealing with six service users. Another said Keep the staff up to date with all training etc. A health care professional who completed a survey said that the managers and staff usually had the right skills and experience to support peoples social and health care needs. When we looked at the training plan and staff training records we saw that staff had training about, first aid, food hygiene, manual handling, infection control, fire safety, health and safety, continence, medication, specialised methods of feeding, epilepsy, total communication, autism, loss and bereavement, dementia and health action planning. The records showed that training was also updated. The manager told us that no new staff had started work since the last inspection. They said that they were in the process of recruiting one new member of staff but had so far received no checks. The standard about recruitment was met when new staff had last been recruited in 2006. At the last inspection we made a recommendation that the recruitment policy should be updated. This had been done and it reflected current guidance about checks of the Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: Protection of Vulnerable Adults (POVA) list, Protection of Children Act (POCA) list and Criminal Records Bureau (CRB) checks. Three staff who completed surveys said that their employer carried out checks such as CRB and references before they started work. Care Homes for Adults (18-65 years) Page 26 of 31 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 was well-run and promoted positive outcomes for people. There were systems for checking and improving the quality of the service based on the views of people who lived in the home. Peoples health, safety and welfare were promoted by the measures in place. Evidence: The manager had completed the Registered Managers Award and the NVQ level 4 in health and social care. He kept his training up to date. The manager told us that there was a quality assurance system. He said that the organisation sent questionnaires to people who used the service, relatives and professionals to obtain their views about the service. He said that he collated these views and they contributed to the annual development plan for all services in the organisation. We saw a copy of the development plan for 2009-2010. The manager also said that they used the feedback to improve the service for people who lived in the home. Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: The manager had completed an Annual Quality Assurance Assessment (AQAA) and sent it to CQC before the inspection. This told us about what the service did well, what it could do better, what had improved since the last inspection and plans for improvement in the next twelve months. This was clear and provided the information that we requested. There was a health and safety policy. Staff received training about health and safety, manual handling, first aid and food hygiene. The manager and senior carer told us that there were monthly health and safety checks of each room and we saw records of these. We made a recommendation at the last inspection that the manager should check when the last monthly audit took place and when another was due. We saw from the records that these had been occurring monthly and the last one took place on 29th June 2009. We saw certificates to confirm that the boiler and items of equipment were serviced annually. A check had been made of the electrical wiring in 2007. We made a recommendation at the last inspection that the manager should check when the last portable appliance tests took place and whether some or all of the appliances needed to be checked again. We saw from the records that the portable appliances had been checked and they were due to be tested again in October 2009. There was a fire risk assessment and we saw records to show that there were regular checks of the fire safety measures. Staff received fire instruction. Care Homes for Adults (18-65 years) Page 28 of 31 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 29 of 31 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 1 2 2 20 The Trust should review and update the admissions policy dated 2000 so that it reflects the new admissions process. The registered person should check that the cupboard proposed for the storage of controlled drugs meets the current storage regulations (The Misuse of Drugs and Misuse of Drugs (Safe Custody) (Amendment) Regulations 2007). A cupboard which meets these requirements should be installed so that controlled drugs can be stored safely if they are prescribed. The policy about whistle blowing dated 2000 should be reviewed and updated if necessary so that practice is up to date and people will be kept safe. The notices and the mop buckets should be removed from the bathrooms so that the bathrooms look more homely and comfortable. 3 23 4 23 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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. 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