Inspection on 26/02/09 for Deafway

This is the latest available inspection report for this service, carried out on 26th February 2009.

CSCI 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

Deafway 19/01/06

Deafway 01/02/05

Deafway 22/07/04

Similar services:

SignHealth

Mere Hall View

Beechfield Lodge

Christopher Grange (Rhona House)

Sense

Auden House

Sign, 100 Bowfell Road

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Deafway Brockholes Brow Preston Lancashire PR2 5AL     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Vivienne Morris     Date: 0 9 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Deafway Preston Brockholes Brow Lancashire PR2 5AL 01772796461 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): stuart.richardson@deafway.org.uk Deafway Name of registered manager (if applicable) Stuart Richardson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 sensory impairment Additional conditions: The registered person may provide the following category of service only: Care Home only - Code PC To Service Users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Sensory Impairment - Code SI The maximum number of Service Users who can be accommodated is: 34 Date of last inspection Brief description of the care home Deafway is a care home for adults, registered to provide residential accommodation for thirty-four people who have a sensory impairment. The accommodation consists of four residential units amidst extensive garden areas. There are local shops and public amenities within walking distance of the home. A regular bus service to Preston city centre is close at hand. All residential areas within the home are equipped with environmental aids and adaptations to meet the needs of people who are deaf. These include visual fire alarm systems, flashing doorbells and text phones. There is a cafeteria on site that offers a wide range of meals to suit all dietary needs Care Homes for Adults (18-65 years) Page 4 of 31 34 Over 65 0 care home 34 Brief description of the care home and tastes. The majority of staff can communicate in British Sign Language, which is the primary mode of communication within the home. At the time of this visit to the service fees ranged from £730 to £1260 with various extra costs for personal toiletries, hairdressing and some activities. Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: The last key inpection to this service took place on 26th February 2007. The quality rating for this service is three star. This means that people who use this service experience excellent quality outcomes. The site visit to Deafway formed part of the inspection process and was commenced one day during February 2009 and completed one day in March 2009. It was unannounced, which means that the managers, staff and people living at the home did not know it was going to take place. During the course of the site visit we spoke with two people living at the home who were able to lip read and who could communicate with us verbally. We spoke with Care Homes for Adults (18-65 years) Page 6 of 31 another five people through a British Sign Language (BSL) interpreter. We also had a discussion through the BSL interpreter with a Deaf member of staff and we also spoke with other people working at the home. Comments from these people are reflected throughout this report. Relevant records and documents were examined and a tour of the premises took place, when a random selection of private accommodation was viewed and all communal areas were seen. Comment cards were received from one person who was living at the home and seven staff members and their feedback is reflected throughout this report. Every year the provider completes a self-assessment, known as an AQAA, which gives information to the Commission about how the service is meeting outcomes for the people living at the home and how the quality of service provided is monitored. We observed the activity within the home and tracked the care of three people during the site visit, not to the exclusion of other people living at Deafway. The total key inspection process focused on the outcomes for people living at the home and involved gathering information about the service over a period of time. The Commission for Social Care Inspection had not received any complaints about this service since the last inspection but four alleged incidents had been reported resulting in safeguarding procedures being invoked. What the care home does well: Good information was gathered before people were admitted to the home so that staff were provided with a clear picture of individual needs to ensure that they were confident that the care and support required could be delivered. The admission process incorporated equality and diversity needs so that everyone assessed for admission were given the same opportunities. The plans of care had been generated from the information gathered before people were admitted to the home so that all assessed needs were recorded and from this expected outcomes had been developed so that staff knew what goals and aspirations those living at the home wanted to achieve. A variety of external professionals had been involved in the care of people living at Deafway to ensure that their health care needs were being appropriately met. The routines of the home were very flexible with a wide range of activities being organised both in the home and within the local and wider communities for those who wished to participate. People living at the home were supported to find work and enrol on college courses if they wanted to do so. They were also helped to access an advocate to act on their behalf should they so require and they were able to have some control over their lives by managing their own finances and medication, should they so wish. People living at the home were provided with nutritious, well balanced meals so that their dietary intake was sufficient and meal times were flexible with a wide range of menu choices available so that people could choose what they wanted to eat. The complaints procedure was freely available within the home and it was also included within the service users guide so that people were given enough information about how they could make a complaint should they so wish. All relevant checks for prospective employees had been conducted before employment so that people living at the home were protected. The policies and procedures in relation to safeguarding vulnerable adults were easily accessible and staff spoken to knew the procedure to take should an allegation of abuse be received by the home. The home was tastefully furnished and pleasantly decorated to a high standard and the premises, both internally and externally were well maintained providing those living at Deafway with a safe, clean, comfortable and homely environment. Effective infection control measures were in place to ensure that the health and safety of people was adequately protected. Records showed that a lot of training was provided for staff so that their knowledge, skills and personal develpment was constantly improved. The home was managed well and the health, safety and welfare of people was protected by the policies, procedures and practices of the home to ensure that any Care Homes for Adults (18-65 years) Page 8 of 31 hazards, which could pose a potential risk, were minimised or eliminated. The quality of service provided was well monitored so that any strengths or areas for development could be identified and issues addressed as necessary. When asked what the home does well one staff member wrote on the comment card, it makes sure that peoples medical needs are met and another commented, Deafway provides a deaf friendly environment for the people living there with special regard for the deaf culture. It encourages people not to regard their deafness as a barrier to achieving their ambitions. When asked if there was anything else staff would like to tell us one staff member wrote on the comment card, I feel that the residents are very happy living here and one person living at the home who we spoke with told us, I am happy living here. It is a good home. The food is nice and we have a brilliant cook. She gives us different things and another told us, I please myself when I get up in the morning and when I go to bed at night. It is my choice. 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 set out on page 4. Care Homes for Adults (18-65 years) Page 9 of 31 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 10 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 11 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs were thoroughly assessed before they were admitted to the home to ensure that the staff team could provide the appropriate support and care. Evidence: At the time of our visit to this service there were 25 people living at the home. We tracked the care of three of these people but had discussions with others as well. The home had gathered a lot of detailed information from a variety of sources about the needs of people before they were admitted to the home to ensure that the staff team could meet their assessed needs. Deafway information pack supported equality and diversity guidelines in that, all referrals are considered on an individual basis regardless of age, gender, ethnic origin, sexual orientation or background history. We received a comment card from one person who uses the service who said that they Care Homes for Adults (18-65 years) Page 12 of 31 Evidence: were asked if they wanted to move in to this home and had received enough information about Deafway so that they could decide if it was the right place for them to live. When asked what the service does well, the registered manager told us, prior to admission, any prospective service user is visited and assessed in their own home environment and a full description with pictures of Deafway is given to them along with a comprehensive information pack. They are then invited to visit Deafway and stay for the day or overnight as required to ensure that they are involved in the decision making of their move. On occasions we have challenged the decision of care managers if we think that the removal of service users from or to Deafway has been for reasons other than the service users best interests. Care Homes for Adults (18-65 years) Page 13 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home were supported to make decisions and choices about what they wanted to do, within a risk management framework. However, the care planning process could have been better. Evidence: The three plans of care examined covered peoples assessed needs, but they could have been more detailed and explained how peoples needs were to be met. Some non- specific terms were used, such as as necessary and as required, which did not provide staff with enough clear guidance about the support individual people needed. This was discussed with the registered manager of the service who was aware that some improvements were needed to the care planning process. The plans of care had been developed with the people living at the home so that they had some say in the planning of their own care. Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: Records seen showed that a variety of external professionals were involved with the care of people living at Deafway to ensure that their health care needs were being appropriately met. Detailed assessments had been conducted so that any potential risks to people living at the home were identified and strategies implemented in order to eliminate or minimise the risk factor. Records seen showed that people were able to take controlled risks within a risk management framework. We noted that people living at the home were offered a wide range of choices throughout the day so that they were able to make informed decisions about what they wanted to do. Those wishing to use an independent person to act on their behalf were assisted to access an advocate so that they could be supported in making decisions. When asked what they do well the registered manager wrote on the self-assessment, every service user has an individual plan of care and we actively encourage service users to be involved in the planning of their care package. We hold regular group meetings and individual meetings to ensure that their needs and choices are being met and that care packages are a fluid document which can be updated and adapted to match the changing needs of the individual. Our service is based on a rehabilitation process and residents are encouraged to make decisions with as much or little support from staff as is necessary. The risks involved in any activity are fully assessed and recorded and these are discussed with the service users prior to the activity taking place. Comment cards were received from seven members of staff who felt that, in general, they had the right support, experience and knowledge to meet the differing needs of people who use the service. When asked what the service does well, one member of staff wrote on the comment card, it meets all service users individual needs. The person who submitted a comment card and who lived at the home said that they received the care and support that they required so that their individual needs were being met. Care Homes for Adults (18-65 years) Page 15 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home were supported in maintaining relationships and accessing social, leisure and educational opportunities. Evidence: At the time of our visit to this service an activities organiser was not appointed. We noted that interviews were being held whilst we were at the home to fill this position. However, we were pleased to see that those living at the home were provided with plenty of opportunities to fulfill their chosen lifestyle. One person living at the home told us, I am happy living at the home. I do a variety of activities and I attend college, which I enjoy. I clean my own room and do my washing. I do some work here too, like putting the bins out for collection. I never get bored. Its good here. I keep fit and healthy and the food is nice. We get different food Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: which is good. I have no complaints because it is good here. The staff are good. They are all very nice. One care plan examined told us that the person often visited the family home and that they were supported to maintain family links. Another plan of care showed that the person was supported to write to his mum every week in order to maintain contact. Care plans seen showed that people were offered support to attend a range of social skills and diverse activities. Some people living at the home were excitedly planning a trip to Paris this year. Two plans of care showed that one to one activity sessions were provided as required so that people less able were given the same opportunities as other people living at the home. People living at the home and staff worked together to promote practical skills such as cooking, washing, shopping and household chores so that independence was maintained as much as possible and it was clear that peoples choice was positively promoted. One person living at the home told us that he had a job washing cars and that he enjoyed doing this. There was a good risk assessment in place on this persons care records in relation to his job. We were told that some people living at Deafway were involved in a British Sign Language theatre group, which involved a playwright and research team. The play when completed would be interpreted so that hearing people could enjoy it too. One person living at the home told us, I go out to the pub at night to meet my hearing friends. Care plans showed that people maintained contact with the community through a wide range of activities and some went to the leisure centre regularly to maintain fitness. Two activities for each person living at the home were provided each day and these were arranged on an individual basis or in small groups. Representatives from the local college visited Deafway regularly to support people with specific courses and other people went to college and other community based groups to receive training of their choice. A sports hall was available on site so that people could play games if they wanted to do so and a range of extreme activities were organised, such as scuba diving, quad biking, visits to Royal Navy destroyers and helicopter flights to allow those living at the Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: home the same opportunities as people living in the community. An outdoor facility in the Lake District was regularly visited by the people living at Deafway. It was noted that daily routines were flexible and that people were able to live their lives how they chose to do so by spending time in any area of the home visiting friends and joining in different activities. The Service Users Guide told readers that people ready for discharge from Deafway often opted to remain in the Preston area as they had built up a number of close relationships during their stay at Deafway. The management of meals was good. A canteen was available on site where both staff and those living at Deafway went to eat. A wide range of nutritious food was on offer, including a vegetarian option although alternatives could be requested if required. People collected their chosen meal from the servery and then were able to dine anywhere in the canteen they wished with friends and staff. Meals were served over two hours during which period people could eat at a time which was most suitable for them, which showed flexibility and choice of mealtimes. Care Homes for Adults (18-65 years) Page 18 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs were fully met and the management of medications was good. Evidence: The care records seen showed that peoples health care needs were being met by the involvement of a wide range of external professionals. It was pleasing to see that information about peoples medical conditions was available within the care records. so that staff were able to extend their knowledge about specific medical disorders. The plans of care included what personal care people living at the home needed so that staff could support them appropriately. Relevant risk assessments were in place to ensure that people living at the home were kept safe when personal care was being delivered. The management of medications was, in general satisfactory and records showed that safe administration was evident. However, risk assessments had not been conducted for people who administered their own medications to ensure that safe practices were Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: being followed and that people were not at risk. Hand written entries on the Medication Administration Records had not been signed, witnessed and countersigned in order to reduce the possibility of any transcription errors. Staff had received training in the administration of medications and had been assessed as being competent to give out medications so that people living at the home were protected from medication errors or drug misuse. Care Homes for Adults (18-65 years) Page 20 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints were managed well and people living at Deafway were safeguarded by the robust policies and procedures adopted by the home. Evidence: A clear complaints procedure was in place at the home which told people how they could make a complaint if they wished to do so. A system was in place so that complaints received by the home could be appropriately recorded to ensure that complaints could be monitored and audited. Policies and procedures were in place to safeguard people living at the home and staff spoken to were fully aware of what they needed to do should they feel that someone at the home was being mistreated. Records showed that staff had received appropriate training in the Protection Of Vulnerable Adults, so that people living at Deafway were protected. Staff spoken to were aware of what they needed to do if someone living at Deafway was unhappy and wanted to make a complaint. Care Homes for Adults (18-65 years) Page 21 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provided a safe and comfortable environment for the people living there. Evidence: When asked what had improved in the last twelve months the registered manager told us, extensive upgrading of the environment has taken place which has included upgrading of the bathrooms, lounges and kitchens. Many bedrooms have been refurbished. During our inspection we toured the premises and found that the environment was well maintained and fit for purpose. People living at the home gave us permission to view their bedrooms. Those seen were comfortable and personalised, creating a homely environment for the people living in them, who told us that they were happy with their rooms and were quite proud to show us their private accommodation and their possessions. The communal areas around the home were comfortable and the catering facilities were clean and hygienic. There were clear policies and procedures in place in relation to the control of infection and the Control Of Substances Hazardous to Health Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: (COSHH), so that the risk of cross infection was minimised and so that any domestic products were used safely. The person who submitted a comment card and who lived at Deafway told us that the home is usually fresh and clean. When asked what the service does well one staff member wrote on the comment card, it ensures that people live in a safe and comfortable environment. Care Homes for Adults (18-65 years) Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The number and skill mix of staff on duty met peoples needs and the recruitment practices protected those living at the home. Evidence: The staff duty rotas were examined which identified staff on duty at any time of the day or night. A recognised tool was used to calculate the staffing levels in accordance with the assessed needs of people living at the home. One person was receiving one to one support and records showed that additional staff were deployed to give appropriate care for this individual so that their needs were being met. At the time of our visit to this service there were 29 support workers employed at Deafway, of which 37 had completed a recognised qualification in care. The home was striving to achieve the recommended level of 50 of care workers with an appropriate qualification, so that the workforce would be well qualified to support people in their care. We examined the personnel records of four staff members, which showed that all relevant checks had been obtained before people were employed to work at Deafway to ensure that people living there were consistently protected. Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: Staff spoken to told us that they received enough training to ensure that they could support people in their care and so that they were kept up to date with new ways of working. Records showed that a range of mandatory training was provided and that training relevant to people living at the home was also provided. When asked what the service does well the registered manager wrote on the homes self-assessment, We hold regular staff meetings and team meetings and staff have regular supervision sessions and annual appraisal. We have return to work interviews following staff illness to ensure that they are well enough to return to work and to find out if any support is needed. We also have regular welfare visits in the case of long term absence. Those staff members who returned comment cards told us that their employer carried out checks, such as CRB and references before they started work and that their induction covered most of the things they needed to know to do the job properly. One of these people wrote, further information was given during my early years of employment with Deafway. All seven staff members said that they were being given training relevant to their roles and which kept them up to date with new ways of working. Five of these people felt that the training provided helped them to understand and meet individual needs of the people they looked after. One of these people wrote, as a team leader I keep everything up to date. Two staff members felt that the training received did not help them to understand and meet individual needs of people they supported. Staff members who sent in comment cards said that there were usually enough staff on duty to meet peoples needs. One person wrote, problems are sometimes caused by last minute sickness or by emergencies such as hospitalisation of a resident. Care Homes for Adults (18-65 years) Page 25 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was managed well so that the health, welfare and safety of the people living and working there was protected. Evidence: The registered manager of deafway is qualified and experienced in managing residential care services for adults, and there are clear lines of accountability within the home and wider organisation. People living at the home were aware of who the manager was and told us that they felt able to approach him with any concerns they may have. One person said, he works very hard. Surveys for those living at the home had been conducted in a suitable format so that their views about what life is like at Deafway could be obtained. Surveys had also been conducted for relatives so that their views about how goals for people living at the home were being achieved. We were told that surveys for stakeholders were going to Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: be reviewed because the response is always poor with little feedback being provided. A representative from the organisation conducted unannounced monthly visits, following which a report was written and kept on site. Also a range of audit trails had been introduced so that any stengths or areas for development were identified and issues addressed as needed. A variety of meetings were held with minutes retained so that any relevant information could be passed on to those concerned and so that people involved could discuss various issues and topics. A wide range of assessments were in place so that any risks were identified and strategies implemented to eliminate or minimise the element of risk. The homes self-assessment told us that systems and equipment were serviced as was required to ensure that they were safe for use. This was confirmed by examination of a random selection of service certificates which were up to date, showing that the safety of people living at the home and those working there was protected. A wide range of policies and procedures were in place, which had been appropriately reviewed and updated so that staff were kept informed of any changes implemented and were aware of new ways of working. A health and safety handbook was given to new staff outlining the policies and procedures of the home and relevant mandatory training was provided at the induction stage so that staff were aware of their responsibilities to report anything that had the potential to cause harm. Accident records had been completed approriately and were retained at the home so that a clear audit of accidents and incidents could be conducted in order to identify any recurring patterns. When asked what the service does well the registered manager wrote on the homes self assessment, the registered manager holds qualifications in management and care (Diploma in management, Registered Managers Award). We are putting our senior staff through the National Vocational Qualification level 4 Registered Managers Award. All of our management and senior staff are well trained and have many years experience and skills. We send out annual questionnaires to stakeholders, staff and service users to ask for suggestions on how our service can be improved and to assess how well we are achieving our goals. The home has a mission statement and the organisation has long and short term action plans. We have a strict health & safety Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: policy and regular checks are made and recorded. Care Homes for Adults (18-65 years) Page 28 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 29 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 It is recommended that the plans of care be more detailed, explaining how the assessed needs of people living at the home are to be met and that none specific terms are avoided so that person centered planning is further developed. Hand written enteries on the Medication Administration Records should be signed, witnessed and countersigned to avoid any transcription errors. Risk assessments should be conducted for those people who are responsible for taking their own medication so that safe practices are maintained. 2 20 3 32 The home should continue to work towards 50 of care staff achieving a recognised qualification in care so that the staff team is collectively well qualified to support people living at the home. Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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