Inspection on 10/06/09 for Ashclyst

This is the latest available inspection report for this service, carried out on 10th June 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

Ashclyst 23/06/08

Ashclyst 25/06/07

Ashclyst 03/05/06

Ashclyst 16/11/05

Ashclyst 04/05/05

Ashclyst 25/10/04

Ashclyst 22/04/04

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 12/10/2009.

Key inspection report Care homes for adults (18-65 years) Name: Address: Ashclyst 23 Park Lane Winterbourne South Glos BS36 1AT     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: Wendy Kirby     Date: 1 0 0 6 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: Ashclyst 23 Park Lane Winterbourne South Glos BS36 1AT 01454250946 01179709301 samrv2003@yahoo.co.uk admin@aspectsandmilestones.org.uk Aspects and Milestones Trust care home 4 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) : Number of places (if applicable): Under 65 learning disability Additional conditions: May accommodate up to 4 residents aged 19 - 64 years Date of last inspection Brief description of the care home Ashclyst is a extended semi detached bungalow which provides accommodation for 4 people with learning disabilities and mental health. The house has domestic style facilities such as kitchen diner, lounge, bathroom and toilets and a large garden. The home is situated on the borders of Winterbourne and Frampton Cotterell in the district of South Gloucestershire. The nearest surrounding areas are Thornbury, Iron Acton, Winterbourne where local shops and pubs can be found, Chipping Sodbury where a small shopping village exisit and Yate which has a number of shops pubs, libraries, churches and other social facilities. The home has its own minibus which provides transport to the neighbouring areas and the local community. Each placement cost £1200 per week. The home is staffed with 24 hour care. The Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 4 Brief description of the care home house is maintained by John Dean who is repsonsible for all maintainance and decoration of the home and the registered providers are Aspects and Milestones Trust. 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: 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 announced Key Inspection which included a visit to the home. The visit was completed by one inspector over one day and lasted approximately nine hours. Prior to the inspection we (The Commission) looked at various pieces of information to gather evidence in preparation for our visit, which included the following: The homes inspection record, which gives us an account of any information we have received about the home since the last inspection. The Annual Quality Assurance Assessment, known as an AQAA. The home is requested annually to complete and return this assessment to us by a specified time. We received the AQAA on time, which contained information about what the home considers it does well and what plans they have for further improvements in the coming year. During our visit we spoke with some of the people who live in the home, the area Care Homes for Adults (18-65 years) Page 6 of 30 manager, acting manager and other staff members who were on duty. Comments received will be referred to throughout this report. We also looked at how effectively staff engage with people in the home and how they were interacting and communicating with each other. We looked at four individual care files, which included pre-admission assessments, care plans and risk assessments. We also looked at a number of records and files relating to the day-to-day running and management of the home. We spent time in all communal areas of the home and some of the bedrooms. The acting manager and area manager received feedback about the visit throughout the day who both demonstrated a very caring, committed attitude to their roles and responsibilities in ensuring they provide quality of care to the people who use the service. 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: The home is clean and comfortable. With the exception of some areas identified in the report it provides a safe, peaceful and well maintained environment for the people living there. This will be further enhanced when the planned work on one bathroom and the gardens have been completed. We believe the home has made good progress in the last six months and that it will Care Homes for Adults (18-65 years) Page 8 of 30 continue to work in developing its aims and objectives in order that the National Minimum Care Standards are fully achieved and maintained. No requirements have been made as a result of this inspection. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed to ensure the home is suitable to meet individual requirements. Evidence: The acting manager was able to describe the process that is undertaken to ensure that a full assessment is conducted for people wishing to live in the home. We looked at the pre-admission assessments, which were comprehensive covering all activities of daily living, a full health screen and personal history background. The information gathered pre-admission should provide a sound benchmark of each persons ability, state of health prior to admission and subsequent needs when they move into the home. We were told that people wishing to live in the home, family and carers are involved in the pre admission assessment wherever possible and all information is used to determine the suitability of the placement. Where possible the home also obtains Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: comprehensive assessments and care plans from other health and social care professionals involved, for example, social workers and hospital staff. We were told that people who were considering moving into the home have an opportunity to meet with people already living in the home and staff. Visits, sleepovers and outings are tailored to the individual. This transitional period can take up to two months before admission to the home. There is a policy to guide staff on the admission process. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures that the service provided to each individual takes into account their personal preferences, supported by both written information in care plans and risk assessments which are subject to ongoing review. Staff have a good awareness of individual needs and treat people in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. People living in the home are consulted on, and given opportunities to participate in, all aspects of life in the home. People are supported to take risks in their daily lives within their home and out in the community. Evidence: From the initial pre admission assessments staff had identified needs enabling them to Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: form written care plans. The plans that we looked at were detailed and person centered, including personal preferences and like and dislikes. Plans told us that people had specific requests and routines, this is good practice and helps demonstrate that people are involved in deciding how they wish to receive care. Each person has a portfolio with person centered assessments, which means that staff put the views, wishes, likes and dislikes of each person at the center of all care provided. The information was informative and useful enabling staff members to provide the appropriate care to support health and social needs. The plans showed consistency in assessing, planning and evaluating care as required. Regular care reviews take place for people living in the home, which can include family members and Key Workers wherever possible. This allows the opportunity to discuss and evaluate care and any issues or concerns people might have. Staff demonstrated a clear understanding of peoples individual needs. Through observation and discussions with the staff we saw skills of sensitivity and warmth when communicating and delivering care to people living in the home. Some people have complex needs with varying impairments and learning disabilities. We were told about individual communication requirements and through patience and time the staff had identified effective methods of communication with individuals. Risk assessments were examined and showed us that staff were mindful of keeping people safe within their home and out in the community. Individual risk assessments detailed for example, how much supervision was required when visiting the GP, what risks were involved with regards to road safety and preparing meals and drinks in the kitchen. The acting manager told us that the staff were empowering people to promote as much independence as possible but at the same time making sure that they do this as safely as possible. 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. People enjoy a range of activities and are supported to live a fulfilling life in and out of the home. People are supported and encouraged to maintain firm connections with families and friends. People take an active role in promoting and maintaining a healthy well balanced diet. Evidence: Care plans and discussions with staff demonstrated that the home was providing people with opportunities to develop social, emotional, communication and independent living skills. There was information on levels of independence and the level of support that was required by staff to support the people both in and outside of the home. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: Weekly activities and plans are reviewed with people, staff and families to ensure that they remain relevant to the individual. All individual tastes and preferences are taken into account. One family invited staff to their home to see where a prospective admission had lived and the assessment was completed with various family members including siblings. The information shared is produced in a Lifestyle Plan and provides staff with extremely useful information including, peoples personalities, essential things that are important to individuals, how people express emotions, things that people enjoy and how to support people successfully and keep them safe. Daily routines and activity plans were discussed, which included attending various day centers and clubs in the local community. People regularly go out and enjoy the local community amenities by visiting pubs, restaurants, leisure center, shops, and cinemas. Some people attend college to develop skills and some are involved in voluntary or paid work. Useful information is shared by having several notice boards throughout the home notifying people of any news, current events, dates for your diary and an activity programme. Lounges in the home provide good entertainment systems including televisions, videos, DVD players and musical systems. The home operates an open door policy for visitors and people are able to see visitors in the privacy of their own rooms or they can use the communal areas and garden when weather permits. People living in the home often visit friends and family and communicate by writing letters, sending cards on special occasions and by using the telephone. Friends and families are invited to the home for coffee mornings, parties and other special events. The size and layout of the dining room makes it possible for everyone to enjoy the social advantages of dining together, however people can choose to receive their meals in their rooms if they prefer. People make their own choices at mealtimes with the support from staff. The menus, which they have produced, offer a varied healthy diet plan. Alternatives were also made available and flexibility in meals was evident. People are encouraged to help prepare the meals. Staff in the home are mindful of educating and assisting people in maintaining a healthy balanced diet and peoples weight is monitored on a monthly basis. The kitchen was clean, tidy and well equipped. The stores, fridge and freezer had a good supply of food. People living in the home are involved in the shopping and use local amenities for their food supplies. 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 service had good systems for meeting and monitoring individuals physical, emotional and health care needs. People are supported to live the lives they choose. There are safe systems of practice in receiving, storing, administering, and disposing of drugs. Evidence: There does not appear to be any unnecessary rules in the home and it was clear that the acting manager and staff are working towards empowering people and encouraging them to maintain independence, autonomy and choice. Daily routines are flexible within the home, people can get up and go to bed when they like, have their meals in their bedrooms, they can go out when they wish and participate in activities they have a particular interest in. This was confirmed through documentation in care files, in discussion with individuals and through observation during our visit. Staff support and encourage people to express their preferences when purchasing Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: clothes, toiletries and having their hair done. Plans also tell staff whether people prefer male or female carers when receiving personal care and what they like to be called. All personal care is provided in private and bedrooms and bathrooms can be locked form the inside. The home promotes privacy and dignity to all people who use the home. Staff attend training on induction, which covers aspects such as closing doors and pulling curtains when delivering personal care and knocking on doors and waiting for an invitation to enter before going in to their bedrooms. We saw staff knocking on peoples doors before entering, members of staff spoke respectfully about individuals needs and referred to them in the term of address that they preferred. The care plans we looked at gave clear information about individual needs both physically and emotionally. Health Care needs are detailed in the Care Files. Records of visits to the General Practitioner and the outcomes are recorded. Specialist referrals and visits to other health professionals including, Consultants, Chiropractors and Dentists were seen; to help ensure that peoples identified needs are being monitored and met. The acting manager explained that peoples healthcare needs are closely monitored in consultation with primary health care services and that access to health screening is undertaken. Visiting health and social care professionals gave positive accounts in a recent survey conducted by the home and stated, I find the team are interested and want to make things work, Staff provide a high quality of care, The home is very proactive and take on board my comments and The overall quality of the service has improved. The home has various recording methods so that they have a quick reference guide and background history for individuals. Information can include a daily account, fluid and nutritional intake and a record of any seizures. Short term care is also documented for example when a person is on antibiotics for a chest infection. All staff have had first aid training. Policies and procedures for receiving, storing, administering and disposing of medications are in place. There were photographs of each person on their medication charts to help ensure that medication was dispensed to the correct person. Medication fact sheets are available and tell staff how people like to take their medicine and why they need the medication. The administration charts were legible and continuity of administration was shown Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: with a signature from the person dispensing. Up to date records evidenced that medication received in the home and medication being returned to the local pharmacy was being followed correctly. Staff training records evidenced that staff had received competency training, which is updated annually. 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. There are policies and procedures in place to manage complaints and people should be confident that their concerns will be listened to and acted upon. There are good arrangements in place for staff training and awareness of protecting vulnerable adults so that people living in the home are further protected from abuse. Evidence: Staff knowledge on the complaints policy and procedures and adult protection procedures has improved in recent months. A recent protection issue in the home has now been resolved. Although procedures were not carried out effectively in the first instance the home has welcomed the support of the adult protection team and other health and social care professionals. We believe through conversations held with the acting manager and the area manager that the home has learned from this experience and that people living in the home are protected by the policies and procedures in place. People living in the home and families have information provided in the Service User Guide on how to make a complaint and voice concerns this information is also on display throughout the home in various formats. We receive details from the home about any internal complaints investigations and Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: safeguarding referrals, the outcomes have shown us that these have been dealt with openly and effectively. The acting manager told us that she is committed to encourage an open culture within the home so that people feel comfortable and are able to make a complaint or a suggestion without fear of reprisal. Any concerns raised by people living in the home and visitors are dealt with immediately, information of the outcome is cascaded down to the staff, through handover and are recorded. Staff demonstrated an awareness of individuals and that they would be able to recognise if a person was sad or concerned about something, either through facial and vocal expression or changes in their behaviour. People are also able to express any concerns they may have in the meetings held in the home and on a one to one basis during their monthly care plan reviews. One person living in the home has been supported by People First, a national advocacy service. We were told that the home actively promotes staff training and education in the protection of vulnerable adults on induction and on an annual basis the staff receive an update. A number of staff are also enrolled on the National Vocational Qualification (NVQ) in care award and a component of the award addresses issues around the topic of the protection of vulnerable adults from abuse. There are policies and procedures in respect of whistle blowing as well as a range of guidance information on the topic of protection of vulnerable adults from abuse. The availability of this information should increase staff awareness and understanding of their role in protecting the people in their care. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and comfortable. With the exception of some areas identified below it provides a safe, peaceful and well maintained environment for the people living there. The bedrooms, communal rooms and facilities are suitable for their purpose and meet the peoples needs. Evidence: The home is located on the borders of Winterbourne and Frampton Cottrell where local shops can be found. The other neighbouring area is Yate which has a number of shops and other social facilities including pubs, a sports centre, swimming pool, restaurants, coffee shops and a library. The home has its own transport available, which enables a degree of independence. The home provides accommodation for up to four people and in general is in fairly good repair. One of the communal bathrooms was very poor on inspection, however we were told that this was due to be refurbished and redecorated in the coming week. A further bathroom has been completed to a good standard but still requires appropriate screening up at the window. Other areas which will require attention this year is the hallway, landing and stairs, which will need redecorating and carpets Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: replaced. We walked around the inside and outside of the home and viewed the bedrooms and the communal areas including the dining room and lounge. Room sizes are fairly spacious for their stated purpose. All areas of the home were decorated to peoples taste, clean and well maintained. Some attention has been given to ensure that areas are homely, including photographs of the people living there. People had been supported to personalise their bedrooms with pictures and ornaments and they are able to bring items of furniture should they wish. Rooms are lockable so that they can maintain their privacy and keep their personal possessions secure. The lounge area allows for people to be seated together enjoying the entertainment systems on offer. The laundry room and sluice is well equipped but need to be redecorated and additional storage supplied. The AQAA tells us that this has been targeted over the next twelve months. Supplies of gloves and aprons were seen throughout the home. COSSH (Control of Substances Hazardous to Helath) substances are kept in a locked cupboard and risk assessments and safe systems of work are in place to protect people living, working and visiting the home. All staff are aware of the infection control policies in the home. The home has an extensive garden which at present is not being put to good use. The acting manager and area manager told us about future plans to landscape the area, design and develop a sensory garden and plant vegetables and fruit for peoples use. The people living in the home will be involved in this project and we look forward to seeing its progress during future visits. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The relationships between staff and people living in the home are good and create a warm positive environment to live in. People are supported and protected by the homes recruitment policy. The people are cared for by skilled staff that are trained, supported and supervised by management. Evidence: There is a new acting manager in place. During our visit and in discussions we saw that staff are developing and growing into a stable team that are dedicated to caring for the people living in the home. The home currently has four full time employees who have an NVQ 3 in care. The home is currently looking at recruiting more staff members and having its own bank staff. Agency staff are used occasionally when needed and the home tries to ensure consistency for people living in the home by having the same staff to cover any shifts. We know that the homes staffing levels are dictated by need. Recently two people living in the home required one to one support on a short term basis, funding was applied for through the local authority and the staff provision was put in place. The Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: acting manager told us that she will be working on the duty rota two shifts each week. She believes that this will help her get to know the people living in the home, visitors and staff more effectively and will enable her to identify strengths and weaknesses in the home. We spent time throughout the day observing staff carrying out their duties and assisting individuals. Staff were respectful, warm in manner, good humoured and sensitive towards the people within a relaxed homely environment. Morale in the home appeared good with the staff working well together. The home follows a good recruitment procedure. This will help ensure that the right people are employed to work at the home, and people living in the home will be further protected. Records contain completed application forms with a full employment history, two written references and Criminal Records Bureau (CRB) disclosures. Staff receive a job description, terms and conditions of employment, and GSCC (General Social Care Council) code of conduct. There is an induction programme, which covers all mandatory training, including Fire, Manual Handling, Health and Safety and the Protection of Vulnerable Adults. The home has a mentor system where all new staff are linked with and shadow a senior staff member during each shift to enable continuity and continued training throughout the induction process. The home provides the staff at the home with training and development opportunities tailored to individual needs. The manager and staff are conscientious in attending training relevant to the needs of the people they are caring for. Courses are relevant to the roles they perform in order to understand the needs of individuals and to keep them up to date with current practice. To date, the team has focused on training in Autism Awareness, Managing Epilepsy and Non Violent Crisis Intervention. The AQAA tells us that the staff have an annual development plan in order to identify any training needs. In addition to this staff have a minimum of eight one to one supervisions each year. The management have established a formal recorded supervision procedure for all staff. A plan is devised for discussion relating to the people living in the home, work issues, staff issues, personal development and training. Senior staff have received training in how to give effective supervision to help ensure that the sessions are valued. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and best interests are central to the management approach in the home. People benefit from a well managed and safe environment. There are good systems in place to protect and safeguard the people living in the home. Evidence: Since the last inspection the home has appointed a new acting manager. She was previously the deputy manager in another home within the same organisation and subsequently has a good knowledge of the organisation and its policies and procedures. Her career has been predominately looking after younger people and she has attained NVQ Level 4, the Registered Managers Award. The acting manager told us that she also undertakes additional periodic training to maintain her knowledge and update her skills and level of competence and is currently Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: at university on a years course studying Empowering Practice. The course focuses on person centered planning and nurturing relationships. The ethos of the service is person centered with the views of service users actively being sought as part of this process, this is through one to one sessions and house meetings. Feedback from the deputy manager, senior team and all remaining staff is that they are establishing a stable workforce that supports a commitment to providing quality care for the benefit of the people living in the home. The management encourages innovation within staff teams and ideas that are generated are respected and actioned, which demonstrates an open and inclusive atmosphere. The home continues to monitor and assess the quality of services provided, by giving people questionnaires to complete and holding meetings for people living in the home and their relatives, families and friends. Regular audits are also carried out in the home with regards to care documentation, environment, activities, medication, and other procedures in the home. We looked at some of the comments received from recent questionnaires. Comments included, The home is welcoming with a calm friendly atmosphere, We are very impressed by all the services that our relative receives, and I am very pleased with the way my relative is cared for, communication is very good and informative. The organisation has comprehensive policies and procedures to support the home, which are designed to ensure it complies with the law and remains aware of good practice guidelines. Details of the policies were provided by the acting manager as part of the AQAA. The policy and procedure for holding peoples personal money was looked at. We looked at the statements of four individual accounts and saw that good accounting methods are maintained and receipts for sundries were available. Documentation showed that relevant checks were maintained correctly and at the required intervals including all fire alarms and equipment and emergency lighting. The homes records showed all necessary service contracts were up to date including, gas and electrical services. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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