Inspection on 07/12/09 for 63 Collier Road

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

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

63 Collier Road 02/02/06

63 Collier Road 11/10/05

63 Collier Road 23/02/05

63 Collier Road 05/08/04

63 Collier Road 21/01/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 15/02/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: 63 Collier Road 63 Collier Road Hastings East Sussex TN34 3JS     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: Michele Etherton     Date: 0 7 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: 63 Collier Road 63 Collier Road Hastings East Sussex TN34 3JS 01424430743 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): rjralph63@tiscali.co.uk ASD Unique Services Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 3 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 3. 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 63 Collier Road is registered to provide long term specialist care for three adults with autistic spectrum disorders. The property is situated in a popular area of Hastings and the town centre is within easy walking distance. There is also a bus route close to the home. The proprietors also own another three care homes in the area. The fees for the service range from £1,080 to £1,180 each week. Additional charges are made for Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 3 Brief description of the care home hairdressing, toiletries, magazines and papers. Inspection reports are made available at the home and reference to the availability of reports is also included in the homes statement of purpose. 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: A key inspection of this service has been undertaken that has taken account of information received by the Commission about the service since the last inspection, and any information received from the service during this period. This has included an Annual Quality Assurance Assessment (AQAA). This information has been completed to an excellent standard and told us most of what we needed to know about the day to day operation of the service, changes and improvements in the last twelve months and plans for future development. As part of our inspection of the service we have undertaken a site visit and spoke briefly with the current service user and was able to observe him interacting with staff and the environment. We spent time with the manager from another service within the organisation who is providing management support at this time, this is working well and plans are underway to make this a permanent arrangement through the registration process. Care Homes for Adults (18-65 years) Page 6 of 30 We surveyed staff earlier in the year prior to the change of staff and service user group, and although responses were limited staff commented positively about the support they received and the quality of the organisation and service they work for, their comments have informed our inspection and their comments incorporated into the report. We have also been able to speak with parents of the present service user who are generally impressed with the knowledge and skills of the staff team supporting their son, with some minor reservations which we have touched upon within this report, and which are not always within the control of the service itself. During our site visit we also were shown bedroom and communal spaces and examined a range of documentation maintained by the service including a support plan, risk information, medication records, complaints and health and safety records. 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. Some important information is available to prospective residents in an accessible format suited to their needs, and this could be extended to other documentation.The service is to be commended for their robust assessment and admission process, that ensures the needs of prospective service users can be met and their transition into the home is managed smoothly with all parties involved in the process. Evidence: The service has always made information available to residents in a format suited to their needs. With the departure of the previous residents and the admission of new service users, there is the need for the service to redevelop information into more suitable formats. Some important user guide and complaints information has already been developed with the needs of the present service user in mind, however,the service acknowledges that this will need to be adapted and individualised for other service users who will be admitted; and will extend to other documentation to fully inform service users of their rights and responsibilities and the service they can expect to receive. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: The service is rightly proud of the extensive transition process undertaken with the present service user to help their move from children to adult services and to living in a different environment a supported by a different staff team. Examination of records provided evidence a robust assessment of need, and a transition programme from school to adult social care for the service user at a pace suited to their needs. Opportunities have been facilitated for a range of introductory visits to introduce the service user to staff, and for staff to observe the service user in a range of settings including their former placement, and these have formed a crucial part of the transition process. Compatibility issues will be a key consideration in the assessment and admission of other service users into the house. 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. The manager and staff demonstrate an exceptional understanding of autism and the specific needs of the service user concerned. They have developed strategies for working with the service user and managing behaviours that arise. They have a robust risk framework in place that does not seek to inhibit the experiences of the service users but takes a responsible approach to risk taking. Evidence: At present there is only one new service user resident in the house and we examined their file during our visit. We noted exceptionally detailed support plan, behaviour, and communication guidance information has been developed to inform staff and ensure they work in a consistent manner with the service user. In our discussion with the manager and another staff member, it is clear that the service user is a focal point and his needs and preferences dictate the way in which the service is adapting and responding to his needs.We found daily log entries about Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: the service user to be well maintained by staff, entries can be cross referenced to other information, relating to incidents or events and actions taken can be seen to ensure that staff are responding appropriately. The manager spoke of a recent positive review of the placement a view shared by a parent we spoke with. Opportunities are provided for the service user to be actively involved in the development of his support plan through 1-1 time with his key worker. Goals that the service user can work to are being developed and these include opportunities to develop independence through daily living skills, but, there is a need for behaviour to stabilise and routines to be fully established in order for these to be worked on effectively. When we spoke with parents of the service user they commented that they are very happy with the company and the staff there seem to be quite high standards I am genrally impressed with their response to difficulties and understanding of Autism The current service user has been living in the house since September 2009 following an extensive assessment and transition programme. The service has evolved and is developing in accordance with his needs and preferences. Parents of the service user have expressed a wish for him to be part of a community within the home, as a sole occupant at this time his family express concerns at his becoming isolated. We are assured by the manager that there is a clear intention to admit additional service users into the house but stress the importance of taking time with transitions to ensure that the service user group are compatible with each other. There is a comprehensive assessment of the potential risks and their safety implications for the everyday routines and activities the service user may experience,some of these were developed prior to admission and now need revision, the service is able to demonstrate how they have amended and responded to some risks which have arisen without limiting the experience or enjoyment of the service user. The understanding of risk in relation to the service user is continuing to evolve as staff become more familiar with him and initial behaviours begin to stabilise and and in some instances diminish. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service user has a tailored programme of activities that is in the early stages of development, this would benefit from increased opportunities to access the community. The service is supportive of service users maintaining contact with important people in their lives and facilitates visits where possible. The Home has responded to the predictable nature of the service users choice of menu, which reflects some health eating choices. Evidence: The current service user has a flexible activity programme that is evolving to incorporate activities that he enjoys. He currently makes use of a music gym, has use of a trampoline at another service, enjoys aromatherapy,and likes to access the garden at the home. Staff are involving the service user more in household domestic routines and he is supported to undertake his own laundry, tidy his bedroom and help with household shopping, staff are also introducing opportunities to develop cooking Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: skills. The service user has currently been assessed as requiring 2:1 staffing when in the community, and is funded for up to 2 hours each day. The activities programme ensures that he does have an opportunity to go out each day but relatives are concerned that funding limits around staffing may restrict the opportunities he has to access the community and the real benefits external activities have for him. A parent we spoke with commented: I sometimes wonder if he has got enough to do Currently the service user continues to return home for a good part of the week leaving on Friday pm and returning on Monday a.m.This is facilitated by the home. A communication book is maintained to ensure that the home and family keep each other informed. The service users parents expressed mixed views as to whether the amount of information they receive from the home is adequate and this is a minor concern at least during the settling in period to the home for their son.There is also some suggestion by one parent that the completion of the book by different staff can sometimes mean that communication is a little disjointed, and has suggested that consideration should be given as to whether the key worker should have responsibility for completing the communication book to aid consistency. The service is aware of the desire parents have to know about the service users day but have to balance this with their responsibility to the service user to treat him as an adult and for some things to be confidential to him. The service user has consented to allow staff to help him with managing his mail. Initially when the service user came to live at the home a four week menu plan was established, he found this unacceptable and made clear his own demands for a more predictable menu made up of personal favourites, that is repetitive and familiar, and which he enjoys. He has an awareness of healthy eating and spoke of this briefly to us when we visited and this is reflected in the household rules he has developed with staff. However, the scope for changing the menu weekly to incorporate new an different foods is limited at present; the staff team acknowledge that this will need to be adapted to also accommodate the preferences of other residents as they are admitted to the service. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: 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. staff demonstrate an excellent understanding of the personal care needs and routines of the service user, the service has been proactive in developing partnerships with health care professionals to ensure effective health care support is provided to the service user. Arrangements for the management of medication have improved and are conducted satisfactorily. Evidence: Examination of service user records indicated that the home has developed very detailed personal care routines for the service user, he needs support in only a few areas of his personal care routine. The home has responded to his expressed preference for having male staff support, and try to ensure a male staff member will provide support on a minimum of one shift each day. Health action plans have been started and these provided us with information about health professionals who are involved with the service user in supporting routine health care support. The service has established a good working relationship with the local hospital and set Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: the groundwork in place to ensure that any potential difficulties that the service user may experience by admission for routine appointments or inpatient care will be overcome. The manager acknowledged this had taken a lot of work but is worthwhile in ensuring hospital staff have a fuller understanding of the service user and their needs. Since admission to the home a medication review has been conducted, a risk assessment has also been developed in the event of refusals of medication. The service user currently has only a few prescribed medications, these are administered by staff who are trained to do so and whose competency is routinely assessed, capacity judgements are in place to support administration by staff, and the service user has consented to staff administering medication to him. Consideration should be given to enabling the service user to have a more active role in the administration of his medication whilst under the supervision of staff, once behaviour has stabilised and if capacity judgements indicate this to be appropriate. When we examined medication records we found these to be completed satisfactorily with no gaps in recording. A register of the initials of administering staff is not currently kept and we consider this good practise to do so to inform medication audits. Care Homes for Adults (18-65 years) Page 19 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place that provide service users with opportunities to express their views and be listened to, and ensure they are safeguarded from harm. Evidence: The AQAA informs us that no complaints or safeguarding alerts have been made since the last key inspection. A more accessible format of the complaints procedure has been developed suited to the needs of the current service user. The home manager and staff have listened to comments we have made in regard to other services within the organisation about how staff interpret service user concerns however minor. As a consequence, the home has established a complaints and concerns record, this captures feedback from the service user which may reflect a negative view or experience and the record details how the issue has been addressed. Whilst these do not constitute issues of complaint that require formal investigation, they do reflect the day to day irritations that the service user is sometimes annoyed or upset by and can evidence these are are appropriately dealt with in a timely manner at local level, and not overlooked. The present service users money is managed by a parent and funds are made available for weekly expenditure, a running total of the balance is maintained and Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: checked at every shift change, receipts are obtained of all expenditure Discussion with staff and observations of interactions between staff and the service user highlighted staff have an excellent level of awareness and understanding of the service users needs and behaviours. Detailed guidance is in place to inform the support they provide. All behaviours are recorded and whilst the home was initially unprepared for the range of behaviours experienced, records indicate that there is already a significant reduction in the numbers of incidents as a consequence of the strategies developed to help minimise these. Some restrictions have been implemented as a result of observed and experienced behaviours, these are open to review as the service user becomes more settled and behaviour stabilises and are recorded in the service users file. All staff receive SCIP training and all staff are undertaking either diploma or certificate training in positive behavioural support. A record of the service users personal possessions is maintained. The organisation has a good understanding of the adult safeguarding protocols and the process to be followed, staff are provided with annual training updates in regard to adult safeguarding. Care Homes for Adults (18-65 years) Page 21 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience 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 a comfortable and safe environment within ordinary community housing, this has adapted to suit the current needs of the service user and would be enhanced by the suggested improvements. The environment is maintained to a good standard by a continuous programme of maintenance. However, there is a need for the service to promote good hand washing habits and provide the facilities to enable service users to dry their hands. Evidence: The home is clean, tidy and furnishings are generally to a good standard. Staff report that repairs and maintenance arrangements are satisfactory. The communal environment appears somewhat spartan as a result of needing to safeguard the service user and others from harm, this has adapted to suit his current needs. As the service user becomes settled some of the restrictions in place may be able to be relaxed, and this will be kept under review. A record of the restrictions implemented is maintained within the service users file. Rather enthusiastic bathing by the resident has resulted in some flood damage to the dining room ceiling below, whilst there are plans for remedial works to be conducted, this will be delayed until staff are confident the possibility of flooding during bathing routines has been minimised. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: We noted some dampness on an external wall in a downstairs bathroom, the manager reported this to have been recently repainted and thought the dampness may be as a result of the excessive rainfall experienced in recent weeks, this has been reported to the provider and we are assured action is to be taken to address this. We are advised that kitchen work surfaces currently showing some signs of wear and tear are due for replacement in the near future. Checks of fire alarm and emergency lighting are routinely conducted and fire drills held regularly. The service user has participated in fire alarm and drill arrangements and has been awarded a certificate to reflect his positive involvement, which he is very proud of. Owing to concerns that the service user may block toilets if paper towels and toilet paper are freely available in the bathroom a limited supply is made available each day for his personal use, paper towels are not and we found no means for hand drying within the bathroom at the time of our visit, the service should be promoting good hand washing habits and we would urge that consideration be given to the provision of an alternative means of hand drying to be made available. We have drawn to the attention of the manager that the provision of a blind on the frosted bathroom window upstairs will add to the privacy and dignity enjoyed by the service user and we would urge this be implemented. Unused bedrooms are in varying stages of upgrading in preparation for new residents being admitted. 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. Staffing levels are responsive to the needs of the resident. Systems are in place to ensure a robust recruitment of new staff is maintained. Staff are provided with mandatory and specific autism training, and demonstrate an excellent knowledge and skill base in regard to the needs of people with autism. New staff receive specific and nationally approved induction to underpin their knowledge and understanding. All staff receive opportunities to meet with their colleagues regularly and to receive an appraisal and assessment of their performance and development routinely through scheduled formal supervision Evidence: There are enough staff on duty to support the present service user. When out in the community the service user is currently supported by two staff, funding limitations mean that this additional staffing is funded for two hours each day. The service users parents feel this unfairly restricts him from activities and stimulation he enjoys by being out in the community and benefits from; they would like to see this arrangement reviewed. The staff team are provided with regular opportunities to meet together and often share team meetings with staff at Canute road, and are given dedicated time to Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: discuss issues related to the Collier road service. The company operates a robust recruitment procedure that aims to recruit good quality staff and ensures that all necessary vetting and checks have been undertaken prior to their working within the service. The Manager maintains a training matrix and this informs us that all staff have completed or have mandatory training booked. A rolling programme of training is organised for staff to keep them updated. There are several new staff who have completed initial company induction that ensures they have the necessary underpinning autism specific awareness to help with their support of service users, once completed new staff also undertake the nationally approved common induction standards. Once induction is completed staff have access to wider training and there is an expectation that they will undertake NVQ level 2 or 3. The service has been proactive in identifying autism specific training and also providing staff with the opportunity to undertake a certificate or diploma in positive behavioural support. When we spoke with relatives of the present service user they commented that they are: Extremely happy with staff, very high calibre, they have a knowledge and skill base to a very high level A previous requirement regarding the induction and supervision of relief staff has been resolved although we did not assess any individual relief staff files we are advised that relief staff used are supervised by the registered manager of Canute road who also oversees the management of Collier road, she also oversees the induction of these staff who primarily work within either Canute road or Collier road. There is a regular supervision programme schedule in place and examination of individual staff files highlighted that supervisions are being maintained. We surveyed staff earlier in the year, staff who returned surveys indicated that they always or usually had the right support, experience and knowledge to meet the different needs of people using the service. On the day we met two other staff one of whom commented positively on the organisation of the company and the professionalism of staff through the availability and belief in the training of staff to a high standard. 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. The service is very well managed, systems are in place that safeguard the health and safety of service users and staff. The service demonstrates the ability to monitor service delivery and is proactive in implementing changes and improvements. Evidence: The manager post is currently vacant and has been for some time, oversight and management of the home is provided from the registered manager of Canute road another home in the organisation which is located a short distance away. The present management arrangements have worked well and an application to registration to make this arrangement permanent we are advised is currently underway. The manager overseeing the home is able to demonstrate through formal qualification and professional experience that they are highly competent in a number of areas and provide good leadership and role model to other employees. They are able to demonstrate that they continue to update their own professional development. In survey feedback when asked what the service does well a staff member Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: commented:It is a well organised company that runs smoothly, everyone is very helpful The AQAA has been completed to a high standard and provides us with most of the information we need. The home implements a comprehensive quality assurance programme seeking the views of all stakeholders in regard to service quality, a survey has not been used with the present service users and the home staff seek to gain feedback through 1-1 sessions and utilise the complaints procedure to record feedback. The service has established systems to self review and this informs the production of quarterly quality assurance reports, although stakeholders are routinely consulted, quality reports would benefit from inclusion of their feedback and how their views have been acted upon and influence service development and delivery. An annual quality report should be published and available for inspection and we have discussed this with the manager to implement. Staff annually have the opportunity to express their views about service quality. The provider visits weekly and completes monthly visit reports, these would benefit from additional detail and do not make clear any actions taken as a result of visits, discussions with staff and service users or examination of records. we have discussed this with the manager who will take this up with the Responsible individual.There is a five year development plan in place for the service. Records are well maintained accessible and kept updated. A current certificate of insurance is displayed. The AQAA informs us that all health and safety servicing has been undertaken. The home has been proactive in ensuring that working practises are safe and preventable accidents are minimised,without inhibiting the promotion of independence and skills development in service users. There are no recorded accidents since the new service user was admitted. Health and safety systems are reviewed regularly based on the experiences of service users and staff in their daily routines and activities both inside and outside the home environment. 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 1 27 The privacy and dignity of a service user would be enhanced by the addition of blinds to an upstairs bathroom window The service should promote good handwashing habits and ensure service users are provided with a means to dry their hands. Regulation 26 provider visit reports would benefit from additional detail to inform us what issues the responsible individual may have identified and what actions have been taken. An annual quality assurance report should be published and made avaialble for inspection. 2 30 3 39 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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