Inspection on 23/03/09 for Elmridge Nursing Home

This is the latest available inspection report for this service, carried out on 23rd March 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

Elmridge Nursing Home 12/12/05

Elmridge Nursing Home 01/08/05

Elmridge Nursing Home 11/11/04

Elmridge Nursing Home 21/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Elmridge Nursing Home The Pastures Coulby Newham Middlesbrough TS8 0UJ 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: Stephen Ellis Date: 2 3 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 28 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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 28 Information about the care home Name of care home: Address: Elmridge Nursing Home The Pastures Coulby Newham Middlesbrough TS8 0UJ 01642590028 01642576384 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) : BUPA Care Homes (GL) Ltd care home 42 Number of places (if applicable): Under 65 Over 65 42 0 learning disability Additional conditions: The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Learning disability - Code LD, maximum number of places: 42 The maximum number of service users who can be accommodated is: 42 Date of last inspection 1 5 0 3 2 0 0 7 A bit about the care home Elmridge Nursing Home is a 42-bedded care home with nursing, registered under the Care Standards Act 2000 to provide care for 42 adults with learning disabilities. The home has conditions of Care Homes for Adults (18-65 years) Page 4 of 28 registration in place to enable it to provide care for 22 people with learning disabilities aged between 18 and 65 and no more than 20 people with learning disabilities aged over 65. People without nursing needs may be accommodated, although primarily the home provides for people who require nursing care. The home was first registered under the Registered Homes Act 1984 in 1993. The registered provider is BUPA (Goldsborough) Ltd. The registered manager is Mrs Helen Saunders. The home aims to provide high quality, person-centred care and support for all of the people who use its service, enabling them to lead fulfilling lives, recognising their needs, wishes, hopes and aspirations. Elmridge is a single storey building divided in 4 units. Each unit is well equipped, including lounge and dining areas, single, en suite bedrooms, plus assisted bathrooms and shower rooms. The home is well provided with facilities and equipment suitable for the needs of the people who use its services, both internally and externally. Weekly fees vary between £525 and £982, but the actual amount payable depends on peoples individual circumstances. Care Homes for Adults (18-65 years) Page 5 of 28 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 Care Homes for Adults (18-65 years) Page 6 of 28 How we did our inspection: This is what the inspector did when they were at the care home This key unannounced inspection was carried out on 23rd March 2009. The last key inspection of this service was on 15th March 2007. The current key inspection was informed by the homes self assessment of its performance, called an Annual Quality Assurance Assessment (AQAA) completed on 31st December 2008. At the time of the inspection, there were 41 people who use the service living at Elmridge, including 32 people in receipt of nursing care. Several people who use the service from each unit participated in the inspection, plus one relative. The fieldwork part of the inspection included a tour of the building, direct observation of a number of activities, lunch with people who use the service on one unit, plus discussions with 8 people who use the service and 8 members of staff. There were only limited comments received from a good number of people who use the service, due to comparatively high levels of disability and complex communication needs, although members of staff were able to assist in the process. A sample of key records was examined, including support care plans, audits and staff files. The weekly fees vary between £525 and £982, but the actual amount people pay depends on their individual circumstances. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well The needs and aspirations of people who are considering using the service are thoroughly assessed and acted on wherever possible. Peoples individual needs and choices are very well assessed and acted on, so that people who use the service are supported in their daily lives and decision making and encouraged to take responsible risks to maximise opportunities for fulfilment. The service promotes person centred lifestyles that provide numerous opportunities for independence, choice, social inclusion and fulfilment. The health and personal care of people who use the service is based on their individual needs and wishes, and achieves high standards. The principles of respect, dignity and privacy are put into practice. People who use the service have access to a robust, effective complaints procedure and are protected from abuse. The physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment, which encourages independence. Staff members are trained, skilled and in sufficient numbers to fulfil the aims of the home and the changing needs of people who use the service. The management and administration of the home is based on openness and respect, with very good quality assurance systems developed and implemented by an experienced registered manager and wider management team. Page 8 of 28 Care Homes for Adults (18-65 years) What has got better from the last inspection The home has redecorated many bedrooms and upgraded the premises, on a rolling programme, including the refitting of 2 shower rooms. It has developed its quality assurance procedures, including use of audits, surveys and consultations, so that it can readily obtain feedback from people who use the service and their representatives, and use that information to improve the service wherever possible. It has reviewed and improved its policies and procedures concerning staff recruitment. It has developed the Personal Best policy whereby members of staff are encouraged to give of their best at all times and promote positive outcomes for people who use the service. It has adopted a personcentred approach to the delivery of care, with the person who uses the service (their needs, wishes, hopes and aspirations) at the centre of care and support. It has introduced the Nite Bite service whereby people who use the service can have access to healthy snacks and drinks throughout the evening and night as they wish. It was awarded 4 stars for food hygiene by the local Environmental Health Authority in 2008. Care Homes for Adults (18-65 years) Page 9 of 28 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Stephen Ellis If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get 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 28 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 28 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 . The needs and aspirations of people who are about to use the service are thoroughly assessed and acted on wherever possible. Evidence: The plans of care of 4 people who use the service (one from each unit) were impressive in their detail and breadth of coverage concerning peoples assessed needs and aspirations, plus detailed risk assessments. They showed that a person-centred approach was followed wherever possible in supporting the people who use the service. Each person had the assistance of a key worker at the home and there was much written evidence to show that each persons views and feelings were taken into consideration by the service, including the meetings held regularly with the people who use the service by the support staff. The plans of care showed that people were only admitted to the service after a full assessment of their needs, wishes and aspirations had taken place. The service supports introductory visits and trial stays and provides full information to people who are thinking of using the service, plus their relatives and representatives. Each person who uses the service has a contract and service users guide, including pictorial information to aid communication. Care Homes for Adults (18-65 years) Page 12 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Peoples individual needs and choices are very well assessed and acted on, so that people who use the service are supported in their daily lives and decision making and encouraged to take responsible risks to maximise opportunities for their fulfilment. Evidence: Comments were received from 8 people who use the service plus one relative. The plans of care of 4 people who use the service were examined. Eight members of staff were spoken with. Staff members confirmed that people who use the service were closely involved with the development and maintenance of their support plans of care and were encouraged to take responsible risks that were appropriate for the individual and their circumstances. Typical comments included: The staff help me do the things I want to. The staff are very supportive. I visit my son every day. The staff have taught me to allow my son to speak for himself. This is a very good home; both of us are happy now. All people who use the service have had the involvement of health and social care professionals from the Local Authority and/or Primary Care Trusts, which commission the service. The care home provides a named key worker for each Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: person who uses the service, plus a named nurse for each person receiving nursing care. There was much evidence of people being involved in personal decision making and in decisions affecting the life of the home. For example, all are engaged in regular meetings of people who use the service and key worker meetings, where choices of activities and menus are discussed. There are regular reviews and evaluations of the plans of care, involving each person who uses the service, including monthly update reports by key workers and named nurses where appropriate. Plans of care were impressive in their thoroughness and attention to detail and used pictorial representations well as an aid to communication. Issues covered included: personal details; key worker; named associate person; photograph; the providers QUEST individual, detailed assessment of needs, based on activities of daily living; essential lifestyle plan, including my life, covering morning, afternoon, evening and night, describing typical patterns of daily living and preferences for the individual person; evidence of involvement of the person using the service, plus relatives where appropriate; professional visits from health and social care personnel; personal plan, including risk management; map of life, including activities and interests; skin integrity risk assessment; weight; continence; bathing; dietician and nutritional assessment; moving and handling risk assessment, including the use of bedrails where appropriate; relatives expectations and end of life plan where appropriate. Peoples wishes, aspirations and preferences were clearly recorded. A person centred approach is followed in supporting people. Care Homes for Adults (18-65 years) Page 14 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The service promotes person centred lifestyles that provide numerous opportunities for independence, choice, social inclusion and fulfilment. Evidence: Comments received from 6 people who use the service, plus some direct observation of activities, confirmed that people enjoyed lifestyles that were individual and suitable for their wishes and needs. These observations were reinforced by information supplied by the full time activities coordinator (there are 2 other activity coordinators plus volunteers involved). Activities and personal interests included music; frequent outings to places of local interest, often in small groups using the homes minibus; visiting entertainers (fortnightly); television and DVDs; craft and art work; community events, such as community teas and competitions (e.g. making the largest tea cosy); seasonal events, such as St Patricks Day; theatre trips;participation in day service centre activities; summer fete; lunch outings; visits from Zoo Lab; dog therapy visits; Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: cinema trips; karaoke; hairdressing visits at the home; visits from members of local churches; visits from Motivation; plus visits to and from relatives and friends; and individual and small group holidays in this country and abroad. People who use the service keep in touch with their relatives where possible and were encouraged to develop and maintain friendships with others where appropriate. The care home staff were interested in their views and opinions about their daily lives and lifestyle choices. For example, clothing, meals and personal activities are all discussed and people who use the service are supported to make choices and assist in the achievement of personal goals. Comments received from staff supported documented records in care plans of consultation and support with each person who used the service. Varied and appetizing menus are provided each day, reflecting peoples preferences and healthy eating options, providing a good choice of meals, snacks and drinks. A nite bite service provides snacks and drinks throughout the night, based on healthy eating options. Care Homes for Adults (18-65 years) Page 16 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The health and personal care of people who use the service is based on their individual needs and wishes. The principles of respect, dignity and privacy are put into practice. Evidence: People who use the service were well supported in their personal care needs and lifestyle choices involving assistance or support, as evidenced in 4 plans of care, direct observation and comments received from 7 members of staff, 2 people who use the service and one visitor. As one relative said: I can trust the staff in here with my son. If hes down in the dumps, the staff can make him laugh. The health care is absolutely fantastic; theyre starting to withdraw his tablets gradually...hes getting stronger every day. Over 60 percent of permanent care staff have achieved National Vocational Qualifications in care at level 2 or above, and all have completed in-house training, including very good induction and foundation training, as confirmed by 6 staff members and personnel records. Such training helps to ensure good personal care, based on sound caring values and principles. Each person who uses the service participates in the compilation and review of an essential lifestyle plan, which is person centred and individual to the person concerned. It is based on a detailed assessment of health and personal care needs, using the homes QUEST tool, based on all of the activities of daily living, plus Personal Best system that encourages staff to Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: aim for excellence in the delivery of individual, fulfilling outcomes for each person using the service. The service uses key operating guides to ensure best practice in particular aspects of care, which is reflected in the homes policies and procedures. Clinical forums involving various disciplines engaged in promoting the health and wellbeing of people with learning disabilities, meet regularly at Elmridge for discussions and sharing of best practice guidance. The health care arrangements for people who use the service were well documented in their plans of care and showed that all health and social care professionals were engaged in constructive ways. These included local doctors, community nurses, community learning disability team, speech and language therapists, occupational therapists, chiropodists, dentists, hospital medical specialists, physiotherapists and wheelchair services where appropriate. Comments from people who use the service confirmed that there are many ways in which the service is actively trying to promote their health and wellbeing, including healthy eating and exercise. Peoples health history, needs and aspirations were very well documented in plans of care that were person centred. These plans of care for both personal and health care needs were frequently reviewed and updated with the full participation of each person who used the service, involving named nurses and key workers (staff from the service assigned to each person who uses the service, who develop a special relationship with the person who uses the service so that their needs and wishes are better understood and facilitated). The plans of care were impressive in their detail and were person centred in their focus on the needs and wishes of the individual person who uses the service, including pictorial representations where appropriate. End of life care planning is carried out where appropriate and involves all clinical specialists, including external nursing staff with special expertise. There were examples given where this approach had been very effective in helping people who use the service towards the end of their lives. The medication charts for the people who use the service were examined and found to be well maintained. A photograph of each person who uses the service is maintained on the record sheet to aid identification of the individual person. The service uses a monitored dosage system supplied by a local Pharmacist. All members of staff who administer medication have completed Safe Handling of Medicines training or equivalent. Medication audits are carried out at regular intervals by the manager or designated nursing staff member. Staff members responsible for medication undergo periodic competency assessment and refresher training in medication. Care Homes for Adults (18-65 years) Page 18 of 28 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 . People who use the service have access to a robust, effective complaints procedure and are protected from abuse. Evidence: People who use the service are encouraged to approach staff with any concern they might have. Typical comments included: I know who to speak to if I am not happy. Staff members confirmed that they had had training in the protection of vulnerable adults and safeguarding procedures. The service has a full, written policy within the home available for staff members to read and follow. Complaints and concerns are carefully recorded by the service and regularly checked by management. Any issues of concern are regularly discussed with people who use the service in group meetings and/or individually. An external manager visits the home each month and talks to people who use the service about their experiences and any concerns or complaints, and these are recorded. Staff members are only appointed after extensive checks have been completed, including enhanced criminal record bureau checks, protection of vulnerable adults checks and the taking up of at least two references per applicant. People who use the service are consulted about the suitability of prospective members of staff, at various stages of the selection process, including during the 3 months probationary period. The home welcomes the involvement of relatives of people who use the service, volunteers and independent advocates wherever appropriate, and there were several example of parents being closely involved. Care Homes for Adults (18-65 years) Page 19 of 28 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 physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment, which encourages independence. Evidence: A tour of the four units that make up the home, and examination of service and maintenance records, showed that the premises are spacious, well maintained, comfortable and clean. People who use the service said that the premises were comfortable and clean. They confirmed that they are actively consulted about decor, furnishings and refurbishment. For example, each person chooses the decor and furnishing of their bedroom. Bedrooms are individual, of good size, personalised and well equipped, including an en suite toilet and wash hand basin. Lounges and dining areas on each unit are impressive in their good size and level of equipment and furnishing. Similarly, there is a spacious and well equipped reception area, with hairdressing room and sensory room adjoining. The reception area is often used for larger group events, such as visiting entertainment. An assisted bathroom and separate, assisted shower room are provided on each unit. There is a a patio and garden area of good size, which is accessible, private and enclosed, with good equipment and facilities for people who use the service. Also, there are written environmental risk assessments and personal risk assessments concerning the use of the premises. Since the last key inspection, there has been on-going redecoration and Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: refurnishing of parts of the premises as required, including several bedrooms and the re-fitting of 2 shower rooms. There are good fire safety and evacuation procedures, with clear instructions and regular checks being carried out, plus regular fire training and drills involving staff and people who use the service. All staff members have undergone training in health and safety issues, including food safety and infection control. Liquid soap and paper towels are provided in communal toilets, shower rooms and bathrooms to minimize the risk of cross-infection. These are spacious, well adapted facilities to meet the needs of people who use the service. The Laundry is of good size, accessible and well equipped with washing and tumble drying facilities. Care Homes for Adults (18-65 years) Page 21 of 28 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 . Staff members are trained, skilled and in sufficient numbers to fulfil the aims of the home and the changing needs of people who use the service. Evidence: Good procedures were evident in the recruitment and selection of new staff, including some limited involvement of people who use the service, in helping to select suitable candidates for employment (due to the high level of disability in many cases). Careful checks are carried out on prospective employees, including enhanced criminal record bureau checks, protection of vulnerable adults checks and the taking up of at least two references. New staff members undergo a thorough induction programme and probationary period of at least 3 months, which includes training in health and safety, moving and handling, first aid, fire safety and food hygiene. Such training is focused on working with people with learning disability. Service-specific training is provided, involving clinical specialists such as community nurses with special responsibility for epilepsy. Staff members confirmed the quality of training and support provided. Most staff training is accredited with the Learning Disability Award Framework and Skills for Care sector standards, or equivalent. Staff files were found to be well organised and detailed in relation to personnel information, qualifications, training needs analysis, induction and foundation training, plus specialist training to meet the particular needs of people who use the service. Over 60 percent of permanent members of care staff Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: had achieved National Vocational Qualifications (NVQ) in care at level 2 or above, and the remaining members were working towards such qualifications. All care staff members are required to register for NVQ awards in care, or health and social care, within 6 months of commencing employment, unless they already have achieved these qualifications. Additional training and the pursuit of further, relevant professional qualifications is promoted by Bupa through staff training needs analysis, supervision and annual appraisal processes. Nursing staff members are well qualified and involved in continuous prfessional development. Good staff supervision and support procedures are in place, with each member of staff typically receiving 1 to 1 supervision at least six times per year. There are regular team meetings. Staffing levels were appropriate, with typically 2 members of care staff on duty on each unit during the day between 8 am and 8 pm, and one awake member on duty on each unit at night. There is always at least one registered nurse and one senior member of care staff on duty at any time (often 2 registered nurses during the day) and the full time registered managers hours are not included in the care hours provided. Each member of care staff has a key worker role and a named nurse is assigned to each person in receipt of nursing care. Extra staff members and volunteers are deployed when necessary, such as when people require support to engage in personal community activities. Catering and domestic staff members are deployed in sufficient numbers to ensure the smooth running of the home. There is a full time activities coordinator plus 2 part time assistants engaged in organising and delivering activities and social events. There is also a full time administrator and separate maintenance staff who are all actively involved in the day to day running of the home. Care Homes for Adults (18-65 years) Page 23 of 28 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 management and administration of the home is based on openness and respect, with effective quality assurance systems developed and implemented by an experienced manager and wider management team. Evidence: The manager is very well experienced and qualified, being a registered nurse with the Registered Managers Award (RMA) at National Vocational Qualification (NVQ) level 4. Staff members and one visiting relative were very positive and complimentary about the management culture and ethos within the service, and the positive impact that had on outcomes for people who use the service. The home is well run, with strong emphasis placed on quality assurance. For example, the service has achieved the Investor in People (IIP) Award, which is an important, nationally recognised indicator of good quality assurance. Also, the home operates the Personal Best system that encourages members of staff to give of their best at all times in aiming to achieve excellent outcomes for people who use the service. The home is supported by a national team of Quality and Compliance Officers within Bupa, providing advice and guidance on health and safety, policies and procedures, and helping with quality standards, including auditing. A multi-disciplinary health and safety committee holds Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: regular meetings at the home. Senior staff at the home complete regular health and safety audits, frequent meetings with people who use the service and with their key workers, bi-monthly staff supervision sessions, and monthly team meetings. Each unit holds a weekly meeting involving people who use the service and staff. The homes maintenance officer makes regular reports to the team meetings and health and safety issues are fully addressed. Records and minutes are kept of all formal meetings. Line managers visit the home frequently, to monitor progress, offer support and guidance and to report on key issues such as performance and recommendations for improvement. A monthly report is made under regulation 26 of the Care Homes Regulations. Feedback from people who use the service is regularly obtained, including the use of annual satisfaction surveys involving relatives, and all their views and opinions are summarised and reflected in the homes action plan. External agencies are also consulted about a range of issues, including fire safety, and their recommendations are implemented wherever appropriate. There is much evidence of safe working practices carried on at the home, including regular moving and handling refresher training, infection control training, plus fire training and drills. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes  No  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 26 of 28 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 Description 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 Description 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 27 of 28 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. 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