Inspection on 06/10/09 for Chescombe Lodge

This is the latest available inspection report for this service, carried out on 6th October 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

Chescombe Lodge 24/11/06

Chescombe Lodge 09/02/06

Chescombe Lodge 23/05/05

Chescombe Lodge 15/02/05

Chescombe Lodge 31/08/04

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 25/11/2009.

Key inspection report Care homes for adults (18-65 years) Name: Address: Chescombe Lodge Westbury Park Bristol BS6 7JE     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: Melanie Edwards     Date: 0 6 1 0 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 29 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 29 Information about the care home Name of care home: Address: Chescombe Lodge Westbury Park Bristol BS6 7JE 01179735197 01179706903 chescombe@johnson1.demon.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Chescombe Trust care home 13 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: May accommodate up to 13 persons aged 18 - 65 years Date of last inspection Brief description of the care home Chescombe Lodge is operated by the Chescombe Trust and is registered to provide accommodation and personal care for up to 13 persons, aged 18-65 years, in the learning disability category. The home accommodates people with a variety of complex needs, some of whom display challenging behaviour. The aim is to provide a comfortable and homely environment in which individuals can be supported to participate in community living. The home itself is a large building that requires high maintenance and is not entirely suited to its stated purpose. It has spacious grounds and blends in well with the local area. It is close to local facilities and amenities, the Downs, and has ready access to public transport. The cost of placement at the home is between 610.00 pounds - 2067.00 pounds the amount being dependent upon each individual persons assessed needs. Additional Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 13 0 9 1 0 2 0 0 8 Brief description of the care home charges are made for a range of different items and these are detailed in the homes brochure. Information about the home can be obtained from the home manager. Care Homes for Adults (18-65 years) Page 5 of 29 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: We did the unannounced inspection over one day. We met two of the thirteen residents, to find out their views of the home and what daily life is like for them. We met the registered manager, Mr Kevin Johnson, the two deputy managers, the care manager and two support workers. We discussed with them their roles, responsibilities, training needs and what they do to assist and support residents. We saw residents being helped and supported by the staff who were on duty. We inspected a range of records to do with the running and managing of the home. The records we saw included a copy of the statement of purpose, the service user guide, six medication records, menus, the complaints record, the complaints Care Homes for Adults (18-65 years) Page 6 of 29 procedure, staff training records, the procedure for keeping people safe from abuse, the staff duty rota, three staff employment records, quality monitoring information and the fire book. We saw two residents care plans and assessment records. We read the homes annual self assessment document called the AQAA. We have quoted from the AQAA in this report. We saw most parts of the home. The only parts of the home we did not see were a small number of bedrooms. We found the home was operating within the required conditions of registration which we impose. The conditions of registration set out the type of care and the needs of residents as well as the numbers of residents who may stay at the home Care Homes for Adults (18-65 years) Page 7 of 29 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. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 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. There is up to date information for people to find out more about the home. The right sort of support and care for residents, is properly identified and planned with their involvement. Evidence: To find out more about what sort of information there is for people to learn more about the home, we read a copy of the service users guide and the statement of purpose. We saw written in the statement of purpose and the service users guide some up to date information about the service provided, the qualifications of the staff employed and the type of accommodation there is. The philosophy of care in the home and the way that the service supports and helps residents who have complex learning disabilities and mental health needs is explained really well. There is a copy of the complaints procedure in each service users guide so residents and those who represent their best interests, know how to complain if they need to. This is written in an easy to understand format. Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: We read two of the residents assessment records to see how well needs are identified and then assessed. The purpose of assessments are to work out what sort of help and support residents will need and how best to provide this for them. We found the assessment records were informative and they set out the residents health needs and social needs. We saw that residents had signed the assessment records. This is to show that residents have read and agreed with what had been identified as the care that they need. We also saw that the actions taken to support the person had been recorded in the assessment records. The assessment records we saw were being regularly reviewed and updated. The information is written in the first person style. This is done to help staff who read the records see the residents from a unique perspective. The care manager talked to us about how residents needs are assessed. They explained that the home has a key worker system. They told us a member of staff is allocated to take responsibility for building up a really good relationship with the resident. In the AQAA document there is some useful information about how people can make a choice of home and also how peoples needs are assessed. We have quoted this extract:We have a thorough initial assessment procedure in place.The statement of purpose and residents contracts are in place. Residents information pack available in a reasonably accessible format. Care needs are reviewed at least on a six monthly basis. These reviews are informed by the monthly key worker reports. Care Homes for Adults (18-65 years) Page 11 of 29 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. Residents individual needs and choices in their daily lives are respected and actively encouraged. Evidence: In the AQAA document there is some useful information about peoples individual needs and choices and we have quoted this extract :Each person has a very detailed individual service user plan. We use notes from resident meetings. Monitoring records for personal and health care needs. We refer to our completed risk assessments. Daily activity plans are designed to offer new experiences based upon choice and individual preferences. Residents have involvement with various colleges and other community projects. There is involvement with a local church in a voluntary role. There are a wide range of social activities responding to personal preferences. We have a user friendly complaints procedure. We read two care plans so that we could see how well residents are supported with their range of very complex and sometimes really challenging needs. The information Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: we read showed really well what the persons range of very complex needs are and what sort of help they need. We read some really helpful information in the care plans about the life history of the person and what matters to them including important family and significant others. Care plans had been written in a person centered way. This means that the information in them was really unique to each individual. We saw that care plans had been reviewed and updated regularly. This demonstrates the care that residents need and the support they get is clearly identified. The residents concerned had signed the care plans to show that they are in agreement with it. In our discussion with the staff they told us an aim of the home is to support residents to develop their independence in their daily lives. We saw one resident riding their bike on their own in the grounds. This is a really good example of residents being able to have independence in their lives. We saw some really helpful information in the care plans that we read about the potential risks the person may face and any risks from particular activities that they do. The care plans explained what to do to keep people safe and was helpful and informative. We saw residents go out with staff for a range of social and therapeutic activities. This is good evidence of how residents are well supported to take risks in their daily lives. Care Homes for Adults (18-65 years) Page 13 of 29 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. Residents are really well supported to live a varied and fulfilling life both in and out of the home. Residents are able to keep in contact with the people who matter to them in their lives. Residents are able to enjoy a well cooked diet. Evidence: In the AQAA document there is some useful information about peoples lifestyles, we have quoted this extract:Each person has a very detailed individual service user plan. There are key worker reports. We refer to notes from resident meetings. We also refer to monitoring records for personal and health care needs. All residents have completed risk assessments. Residents have a daily activity plan designed to offer new Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: experiences based upon choice and individual preferences. Involvement with various colleges and other community projects. There is involvement with a local Church in a voluntary role. There are a wide range of social activities responding to personal preferences. We have a user friendly complaints procedure. We saw residents going to different community based activities. Two people we met told us they go to college in the week. One person said they were learning the French language. One resident was away staying with their family on the day of the inspection. We were told by the staff that residents are well supported to keep in close contact with people who matter to them. We saw art works on display in the home. There is a dedicated art room and we saw arts and crafts projects involving residents and staff. These are really good examples of how residents are encouraged to take part in meaningful activities. The home has its own interactive WII computer games and residents use this regularly. The home now also has Internet acess and residents are being helped to use this. Residents who want to have been on holiday this year. One person we met told us they had gone to Tenby with the staff for the week. This is a really good example of therapeutic activities for residents to be part of if they want to. We looked at a copy of the current records of meals that residents have eaten over the last four weeks. We saw a choice of dishes recorded as available for each day. The residents are asked what meals they would like on a really regular basis. This is a really good way that residents make choices in their daily lives. We saw a varied choice of meal options available for the residents. Meal choices included a range of traditional, nutritional meals. The lunchtime meal choices of tuna pasta bake or lasagne looked healthy and appetising. Care Homes for Adults (18-65 years) Page 15 of 29 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. Residents health and personal care needs are well met. The residents are treated respectfully and their privacy is maintained. Evidence: There is some really useful information in the AQAA document about how residents health and personal care needs are met and we have quoted this extract:All residents are registered with local health care professionals including GPs, dentist, opticians, chiropodist and each person has regular check ups and any follow up action as required. A number of people are supported by the community leaning disabilities team The GP practice is currently undertaking a Well Man,or Well Woman review of all residents registered at their practise. The care manager does monthly reviews of residents health care needs. Health care action plans have been completed for each resident this includes an emergency data sheet in case of hospital admission. Administering medication via a thorough internal training pack for staff,delivered by the care manager. The staff have an accredited training qualification in safe handling of medicines. Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: To learn more about how residents are supported to meet their care needs we looked in detail at two care plans. We read some really helpful information in the care plans. The care plans showed how to give the support and care to the residents who have really complex learning disabilities that profoundly impact on their daily lives. We saw that care plans had been reviewed and amended regularly. This needs to be done to show us that the home continues to monitor residents needs, to make sure they can still give them the right level of support and care. We saw the staff on duty help and support the residents in a skilled and patient way. We also discussed with the staff we met the care needs of the residents. The staff conveyed a really good understanding of residents needs. We saw staff talking to residents in a polite and respectful way. We observed staff knock on bedroom doors before going into the rooms. This is to maintain privacy. We looked at the way that residents medication is given to them, stored and disposed of to see if this is done correctly. We looked at the medication administration charts of six residents. The medication administration charts were legible up to date and had the signature of the staff giving out the medications. This helps demonstrate medication is given to residents safely. We also saw extra information written by the staff at the home to explain the ways that people like to take their medication, as well as what they are for. This information should mean residents are given medication in the way that suits them best. The stock of medication we saw was satisfactorily organised. We did advise that when signing in medications the exact amount and quantity of medications must be recorded. This relates to us seeing in the record entries to show that medicines have arrived at the home from the pharmacy. However the records only said how many dispensing boxes of medication had been delivered. The records did not always state what medication had been signed in, the amount, or who for. This additional information needs to be recorded to keep residents medication supplies safe. Care Homes for Adults (18-65 years) Page 17 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents complaints are dealt with well in the home. The home makes a commendable effort to keep residents free from abuse. Evidence: We read in the AQAA document some really useful information about how complaints are dealt with and how residents are kept safe in the home, we have quoted this extract:Service users have a copy of the complaints procedures in their care plan in an accessible format. There is a supply of these forms in a central location in the ping pong room and everyone is informed of their availability. All new staff members are thoroughly informed about Safeguarding Adults and Deprivation of Liberty law (DOLS)during their induction. Existing staff have been trained in all aspects of Safeguarding Adults and DOLS. All staff are provided with an information pack which includes the Alerters Guide. Managers have involvement in the development and introduction and monitoring of DOLS within the Bristol area. We have done a current assessment for all residents against DOLS standard, these are completed and held on record. We checked the complaints records to see how complaints are dealt with by the home. There had been a number of complaints made by residents about other residents since before the last inspection. We could see from the information we read that residents are listened to and given a chance to make their views known, if they feel they have Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: been treated wrongly by another resident. We also saw that when needed action is always taken by the home. In our discussions with staff who we met they conveyed to us an understanding of the importance of supporting residents to make their views known if they are unhappy. The residents who we met said they could talk to the staff if they need to. We saw a copy of the complaints procedure kept in the home. This has been written in an easy to understand format. It has our contact information as well if people need to get in touch with us. We were told by the staff that there are occasional residents meetings. The meetings may be used as a way for residents to be helped by the staff to make known any complaints they may have. This is a way residents take control in their lives and to make complaints if they need to. The staff we met conveyed a really good understanding of the importances of representing the views of residents who due to their learning disabilities cannot verbalise them. We saw a copy of the policy to do with the topic of protection of vulnerable adults from abuse. The policy is to help to guide staff to take the correct course of action if they ever have to respond to an allegation of abuse. As mentioned in the section we have quoted from the AQAA document an assessment has been done for each resident. These have been done to find out what restrictions there may be being placed,on each persons freedom of movement and their liberty. These assessments were done to make sure that the home is caring for residents in accordance with the law, specifically the Deprivation of Liberty legislation. They are a really good example of aiming to ensure that each residents legal rights are protected. They also show how residents as much as is possible are kept safe and risks from abuse are minimised. The staff do training courses in understanding the principle of the protection of vulnerable adults from abuse. The staff we spoke demonstrated to us a really good understanding about the subject of abuse and how they protect residents in the home. The staff told us this is a really relevant and important matter in the home. Due to their learning disabilities some of the residents can sometimes be really verbally and physically aggressive. The staff explained what strategies they follow to keep residents and themselves safe and free from harm. Care Homes for Adults (18-65 years) Page 19 of 29 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. As much as is practical, based on the age and size of the building,residents live in a homely safe environment. Evidence: Chescombe Lodge is a large four storey building in the residential suburb of westburyon-trym in Bristol. The home is really near to bus routes into town. It is near to a really large open park area, a local church, pubs and a local shopping area. There is no lift however there are ground floor bedrooms for people who may not be able to walk up stairs. The original building is over one hundred years old. The rooms are all for single use. Two bedrooms have en-suite toilet and shower facilities. One resident kindly showed us their room. They said they like living there. There is a light and airy dining area, as well as two lounges. The residents we saw looked settled in their surroundings. Many bedrooms look personalised with personal possessions, photographs and pictures displayed in some rooms,to create a more homely feel to rooms. One resident we met told us they had been able to chose the colours of the paint for the walls of Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: their bedrooms. This is a really good way to give residents choices in their daily lives. We saw furniture and fittings provided including a wardrobe, comfortable chairs a bedside cabinet and a chest of drawers in each bedroom. We saw residents artworks on display in their rooms and throughout the home. This makes the environment look more homely. There are showers or bathrooms located close to bedrooms on each floor. We saw some residents being well supported to clean their bedrooms. We read some really useful information in the AQAA document about the plans for the home environment,we have quoted this extract:The Trust has worked hard to maintain a supportive attractive living environment even though there is a high degree of physical aggression shown to the property. There is of course a considerable level of commitment to ongoing maintenance and development of the Lodge. We will continue to address all such issues as and when they arise while we continue to live in Chescombe Lodge. However The Trust recognises that the Lodge has physical limitations that cannot be overcome and that the building will not be ideally suited to provide the appropriate living environment in the years ahead. We will continue to maintain the Lodge to the required standard.We have plans for the development of a purpose built property that will improve the living environment for everyone using the service. Care Homes for Adults (18-65 years) Page 21 of 29 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. Residents are being cared for and supported by enough well trained and suitable staff. Evidence: We read some really helpful information in the AQAA document about the staff team and we have quoted this extract: We have a well established, highly trained, staff team many of whom have been employed for over seventeen years who are well aware of the needs of the service users. They are highly qualified and have a well developed level of personal knowledge of how best to support the individual needs of the residents and an awareness of the need to support colleagues. We train and develop our staff to a high standard. We have currently achieved a ratio of nearly one hundred percent of the care staff team holding or registered and working towards completion of an appropriate National Vocational Qualification (NVQ). Four members of the management team have achieved NVQ in care level four and four hold the registered managers award in addition to numerous other management and care qualifications. One manager has completed a significant part of level four higher professional diploma in learning disability services. Last year two further members of staff achieved NVQ level four in health and social care. One staff member has recently achieved a NVQ level three and another a NVQ level two Seven new staff have recently started on their NVQ level two. Two people have achieved a, cooking and food processing qualification NVQ level two and one person has achieved competence Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: in cleaning and support services at NVQ level two. A substantial amount of training has taken place over the last year in mandatory topics as evidenced by the newly developed training matrix and personal records. We checked the staff employment files of three staff to make sure that safe recruitment procedures are followed. We saw two written professional references for each new member of staff before they start work at the home. The staff must undertake a criminal records bureau check before starting employment. These checks aim to make sure the home takes on only suitable people to work with residents. All of the staff who we met said that they feel very supported in their work. We were told by the staff that they have regular support meetings with a named supervisor. These meetings take place to guide and support staff in their work. We saw records that demonstrated staff have regular one to one support meetings, with an experienced fellow member of the staff team. Care Homes for Adults (18-65 years) Page 23 of 29 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 is well run and is run in residents best interests. There are effective methods being used to monitor the quality of the care and service in the home. The health and safety of people in the home is well protected. Evidence: There is some really useful information in the AQAA document about the management of the home and we have quoted this extract:We have a board of seven Trustees three of whom have a family member living in the Lodge and the remainder are professionals from a range of backgrounds. We have a well established team of five senior managers. Each manager has a long history of working and caring for people with learning disabilities in a variety of roles and settings. Five are highly qualified and four have achieved the registered managers qualification. Each member of the team shares their personal knowledge and skills in support of the delivery of care to a high standard. The management team are well structured and highly Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: supported by each other and the Trustees. This approach secures operational continuity for the Trust. We maintain a high profile in a variety of external forums such as Bristol Provider Forum and learning disabilities group South Gloustershire Provider Forum and effective relationships with all other Local authorities that we contract with. The registered manager sits on the steerage committee of, care and support west and acts as Treasurer for the association. Staff training and development is highly developed. We have an effective and very involved group of Trustees and they support and drive forward the development of the Trust. We met Mr Johnson the registered manager, the two deputy managers and the care manager in the home. All of the managers explained very clearly to us their roles and responsibilities. The managers are given different areas of responsibilities. The evidence we found from this inspection showed us that this allocation of different areas of responsibility in the home works really well. We saw information to show that the quality of care and the overall service is regularly checked in the home. Mr Johnson explained really clearly to us that overall standards of care and service for residents are looked at really closely. Good practice is identified and areas that may need improving are addressed. We found that residents records were satisfactorily maintained up to date and in good order. The records relating to the management of the home were also satisfactorily maintained up to date and in order. The records were kept secure in the home and available to staff when needed. We have mentioned other records elsewhere in the report. The environment looked safe and adequately maintained . We saw some really helpful health and safety audits carried out of the whole environment on a really frequent regular basis. These are done to address health and safety concerns and problems in the home. We saw evidence that confirmed that staff do regular training in health and safety matters including first aid, food hygiene training and moving and handling practices. This should help protect residents health and safety if staff are knowledgeable and well trained in health and safety matters. The fire logbook records showed fire alarm tests are being carried out. There are also fire drills carried out on a regular basis to help protect the health and safety of residents and staff. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: We saw that the kitchen was tidy and organised. The home won a five star food hygiene award. This award is given by environmental health inspectors, to show that really safe and well organised food safety practices are in operation. We saw records to demonstrate that high risk foods are temperature probed before serving to ensure the food has reached above minimum required temperature. We saw staff who are directly involved in care duties were serving food to residents and going into the kitchen wearing suitable protective aprons to minimise the risks of cross infection from their uniforms onto food or surfaces in the kitchen. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 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 1 20 13 An accurate record medication must be kept of all medication in the home. Health and safety. 07/10/2009 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 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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