Inspection on 29/09/09 for Innova House Care Home

This is the latest available inspection report for this service, carried out on 29th September 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

Innova House Care Home 18/01/06

Innova House Care Home 29/09/05

Innova House Care Home 09/02/05

Innova House Care Home 20/07/04

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Innova House Care Home Forest Avenue Forest Road Mansfield Nottinghamshire NG18 4BX     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: Rebecca Shewan     Date: 2 9 0 9 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 31 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 31 Information about the care home Name of care home: Address: Innova House Care Home Forest Avenue Forest Road Mansfield Nottinghamshire NG18 4BX 01623626252 01623650099 enquiries@innovahouse.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Dr Chandran,Dr Sudaram Rai,Dr M Cheedella care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: All residents will be in need of care and accommodation as a result of brain injury Date of last inspection Brief description of the care home Innova House is a care home registered to provide personal care and accommodation for up to 15 younger adults who fall within the categories MH and PD with have an acquired brain injury. The home accommodates people for short or long term care, respite care or emergency admissions and can provide day care. The home is located on the outskirts of Mansfield town centre close to shops, pubs, the post office and other amenities. The home was opened in August 2000 and consists of a converted and extended domestic dwelling. All of the homes bedrooms are single, six of the bedrooms have en-suite facilities. Bedrooms are located on two floors and there is a passenger lift. Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 15 Brief description of the care home The home has a small paved garden and use of a nearby allotment. There is ample car parking available. Indivdiuals fees are either health or social care assessed and are based on level of need of the individual. Therefore fees paid vary according to the individual and include a base rate fee of £895, with additional charges made for any one to one care required. People who use the service contribute individually towards transport. Additional fees are required for chiropody (£6 per session) and for holidays (Varied fee). People can find out about the service from CQC reports, by contacting them directly by email (enquiries@innova-house.com), through their web address (www.innovahouse.com), through placing Authorities and through other Healthcare Professionals. 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: This unannounced inspection took place during the morning and afternoon of the 29th September 2009. Incident reports and the homes Annual Quality Assurance Assessment (AQAA), held by the Care Quality Commission, were read before the inspection. The AQAA that was sent to us by the service is a self-assessment, which focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. The inspection of the home took six and a half hours. A tour of the home was undertaken and the Appointed Manager, four staff, and one person who uses the service were spoken with. The main method of inspection we use is called case tracking, which involves us choosing three people who live at the service and looking at the quality of the care they receive by speaking to them, observation, reading their Care Homes for Adults (18-65 years) Page 6 of 31 records and asking staff about their needs. Records such as care plans, staff files and medication records were also viewed. Thirteen people were accommodated at the home at the time of the inspection. The Care Quality Commission (CQC) referred to as we throughout this report, also conducted surveys of staff and people who use the service. The responses received were generally positive in many of the aspects of care and provisions provided. Comments from surveys have been incorporated into the body of this report. Care Homes for Adults (18-65 years) Page 7 of 31 What the care home does well: What has improved since the last inspection? What they could do better: In order to ensure that the people who use the service are receiving all prescribed medications and that medication records provide evidence that medication has been administered. Urgent action is required to ensure that all prescribed medications are signed for after they have been administered. Good practise recommendations have been made in that: the staff signatory list, in the Medication Administration file, should be updated to include staff initials and consideration should be given to the comments made by people who use the service and staff, throughout the report. NB: Since the inspection was conducted the Responsible Individual has written to the Care Homes for Adults (18-65 years) Page 8 of 31 CQC, confirming that Immediate Requirements have been addressed and appropriate actions have been taken to safeguard staff and people who use the service.. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 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 10 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are effective and efficient processes in place for assessing potential new people who may use the service. Pre admission procedures are designed to allow the prospective person, to have as much information about the service provided as possible, prior to being admitted to the service. Evidence: From records viewed we observed that significant time and effort is spent planning to make admission to the home personal and well managed. The Appointed Manager reported that prospective people and their families are treated as individuals and with dignity and respect for the life-changing decisions they need to make. We observed that there is a high value on responding to individual needs for information, reassurance and support prior to and during admissions processes. We observed that all new people who use the service, receive a comprehensive needs assessment before admission. From records viewed we noted that the service is highly efficient in obtaining a summary of any assessment undertaken through care management arrangements. Records viewed also provided us with evidence that Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: individuals are supported and encouraged to be involved in the assessment process and that information is gathered from a range of sources including other relevant professionals. Care Homes for Adults (18-65 years) Page 12 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individual Support Plans are comprehensive in detail and are suitable for informing staff as to how to meet the individuals specific needs. People who use the service are positively encouraged to have control over their lives, to exercise choice and to be independent in their decision-making. Risk assessments are comprehensive in detail and positively encourage the individuals independence, within their limits and any agreed restrictions. Evidence: We observed that staff are fully committed in supporting individuals to lead purposeful and fulfilling lives as independently as possible and in accordance with their specialist needs following an Acquired Brain Injury. From Support Plans viewed we observed that they are based on a full and up to date holistic assessment. Support Plans were noted to have been recorded in a person Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: centred manner and focus on the individuals strengths and personal preferences. We observed that Support Plans are written with the individual, or their representative, and include a range of information that is important to them, including information about their health and specialist needs. We observed from records viewed that key workers actively provide one to one support, keep the Support Plan up to date and make sure that other staff always know the persons current needs. The preferred communication style of each individual, is clearly documented in Support Plans and we observed staff using the individuals preferred method. We observed from the Support Plans sampled that they can be easily used by people who are not familiar with the individual to deliver a personalised and consistent person centred service. We observed that Support Plans are reviewed regularly and as the individuals needs change. We observed that people who use the service are encouraged to participate in the day to day running of the home. Each individual is aware of their responsibility to maintain their home environment and staff assist individuals, where necessary, to conduct their activities/chores/rest periods/skills learning at an agreed time. The Appointed Manager reported that the she does not take any responsibility for any of the finances for the people accommodated at the home and that most individuals have family, friends or representatives who protect their financial affairs. We were informed by the Appointed Manager that one of the current individuals accommodated is supported to maintain their own finances. We observed that clear and concise records of personal allowance accounts, known as Residents Monies are maintained by the service. The Support Plans sampled included comprehensive risk assessments, which are also regularly reviewed. We observed that any limitations on freedom or choice are always in the persons best interests and that limitations are agreed by all; they are fully documented and also reviewed regularly. Staff and people who use the service responded in their surveys that: The home looks after the service users with their needs, Give 100 care and well being, The home meets the individual needs of clients, The home does provide a good service and considers service users needs and It could take more consideration of staff input concerning service users because at the end of the day it is support staff who are hands on with the service user. Care Homes for Adults (18-65 years) Page 14 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 excellent 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 participate in a full activities programme that is both rewarding and stimulating. The home provides excellent social, cultural and recreational facilities. The choice and wishes of the people who use the service are respected. Meals and menus are varied and are provided in accordance with individuals requests. Evidence: From records viewed and discussions with staff we observed that the home understands the importance of enabling the people who use the service to achieve their goals, follow their interests and be integrated into community life and leisure activities, in a way that is directed by the individual. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: The Appointed Manager confirmed that the views of the individuals accommodated and their varied interests are considered, when planning the routines of daily living and arranging activities both in the home and the community. We observed that activities are designed to keep individuals active through the day, whilst providing ample leisure time in the evenings and weekends. The Appointed Manager confirmed that individuals are encouraged to attend college courses of their choosing. We observed that one person accommodated currently attends college and that no individuals are in active employment. From discussions with staff and records viewed we observed that the home has its own allotment, where individuals are encouraged to attend to plants and vegetables. The Appointed Manager reported that individuals religious wishes are respected and that current people using the service have not expressed a wish to practise their religious beliefs. Discussions with the Appointed Manager highlighted that although the current people accommodated fell into a specific age group and had similar religious beliefs, the home would welcome any potential new person who has special cultural/religious/spiritual beliefs and would make provision to accommodate their needs. We were informed by staff that contact with family and friends is positively encouraged, with visitors being able to attend the home at any time and in accordance with the individuals wishes. Documented records of assessments and consents for personal relationships between people who use the service, were noted. We observed that staff treat the issue of personal relations between people, in a sensitive and dignified manner. We observed that the people who use the service have access to all areas of the home to ensure that they have freedom of movement, though some areas are currently restricted due to the renovation works. The Appointed Manager and staff spoken with informed us that any restrictions are agreed and all renovation work, which would have a detrimental impact on the running of the service and the individuals accommodated, is very well organised in order to ensure that the impact is minimal. We observed that individuals who use the service, with or without assistance, conduct household chores/tasks. We observed that such tasks are appropriately assessed and agreed in the individuals Support Plan. The promotion of independence is an essential element of the homes ethos, therefore responsibility for housekeeping tasks is positively encouraged where individuals are able. Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: From menus viewed and discussions with the Appointed Manager we observed that the homes menus are devised with individuals input and are produced on a weekly basis. We observed that medical, therapeutic or religious diets are provided as needed. People who use the service reported that drinks and snacks are available at all times. We observed that individuals, where able, are also encouraged to have facilities in their own room for making drinks. Mealtimes were observed to be unhurried and a time for social interaction amongst staff and people who use the service. We observed that for those individuals who need support during mealtimes, including those who have difficulty swallowing or chewing, staff give assistance. We noted that staff are discrete and sensitive to the feelings of both the person they are helping and also to others present. Survey comments made in relation to lifestyle included: Get a pool table in, I really enjoy the meals, I enjoy the company and some of the staff, I would like to get out a little bit more to different places. To go the cinema more regularly with my family, Helps me with personal care, activities and shopping, Staff help us with everything, I do not get enough interaction with my support worker, The home is clean and I am fed well and Good trips out and food. Care Homes for Adults (18-65 years) Page 17 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. People who use the service are offered an excellent provision of health care and personal support by the service. Medication procedures ensure that all necessary precautions are taken to ensure that medications are stored safely and effectively. Evidence: We observed that people who use the service receive effective personal and healthcare support using a person centred approach. Individual Support Plans viewed provided evidence that peoples personal and healthcare needs are clearly recorded and detail how they will be delivered. We observed that staff respect peoples preferences and have expert knowledge about individual personal needs when providing support, including intimate care. Discussions with staff and observations made confirmed that staff respond appropriately and sensitively in all situations involving personal care, ensuring that it is conducted in private and at a time and pace directed by the person receiving the care. Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: From observations made we observed that all aids and equipment are provided to encourage maximum independence for people using services. Records viewed confirmed that specialist advice is sought by the home to ensure effective use of equipment. Support Plans and other records viewed provided evidence that people who use the service, have good access to healthcare including visual, hearing, oral and continence care. The Appointed Manager reported that they have the opportunity to choose their own GP and have access to all NHS healthcare facilities in the local community. We evidenced that good multi disciplinary working takes place in this service. The Appointed Manager reported that the home has access to a Psychiatrist, Psychologist and Physio Therapist, who are privately employed by the service Provider. We observed that staff are trained and competent in health care matters particularly in the care of individuals who have experienced an Acquired Brain Injury and associated physical immobility. Staff training records provided us with evidence that the home arranges training on health care topics that relate to the health care needs of the people who are accommodated. We observed that the home has robust procedures in place for the monitoring and recording of all drugs entering and leaving the home. Records viewed provided evidence that a staff signatory list in place, though this does not include staff initials which are used to record on Medication Administration record (MAR) sheets. Medication systems do not always follow good practise or safe practise guidelines and has required action, in that MAR sheets were viewed and it was evidenced that there were a number of missed entries present. The blister pack system was reviewed by a Team Leader and the Appointed Manager and it was concluded that the medication had been administered. Staff spoken with stated that missed entries was a recognised problem and that it was an issue being addressed, however the Appointed Manager was not aware of this issue. Due to the medications being unsigned for and the fact that some were anti psychotic or strong pain relief medications, an immediate requirement relating to missed entries was made. We observed that there were a number of handwritten entries made onto MAR sheets, which were undated and unexplained. An immediate Requirement was made and the Appointed Manager has resolved the issue prior to the conclusion of the inspection. The stores for medication were viewed and these were found to be maintained in a clean and orderly manner. We observed that there were no Controlled Drugs being Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: held by the home at the time of the inspection. We observed that there is a comprehensive medication policy in place and staff records confirmed that annual refresher training in Medication is provided to staff. Staff confirmed that administration of insulin training is provided for them by the District Nurse. 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 excellent 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 benefit from a robust and efficient complaints procedure, whilst the homes procedures, processes and staff training should protect individuals in the event of an allegation of abuse. Evidence: We observed that the home has a comprehensive complaints procedure in place. Records viewed provided evidence that the home has received seven complaints in the last twelve months. We observed that there was a clear audit trail of the actions taken by the Appointed Manager and staff to resolve the issues raised. We were informed that a review of the number and nature of complaints made is used as part of the quality assurance procedures in use at the service and that the management and staff of the home learn from complaints, in order to improve its service. Staff records viewed confirmed that both Criminal record Bureau (CRB) and Protection of Vulnerable Adult (POVA) checks are carried out on all new staff. Staff reported that they have attended training in the Safeguarding of Vulnerable adults. This was also evident from the staff files that were viewed. We observed that the home has obtained a copy of the Nottingham City and County Council Safeguarding Adults procedures.The Appointed Manager reported that there Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: have been no Safeguarding Alerts raised in the last twelve months and that staff are very clear about when an incident needs to be referred to the Local Authority as part of the local safeguarding procedures. Discussions with the Appointed Manager confirmed that she is aware of the POVA register referral system. Staff spoken with confirmed that they would know how and when to report any Safeguarding issues raised. Care Homes for Adults (18-65 years) Page 22 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 provides accommodation for individuals that is appropriate, well equipped, safe, hygienic and odour free, whilst infection control procedures are adhered to at all times. Evidence: We observed that the location and layout of the home are suitable for their stated purpose. There is an ongoing refurbishment plan in place, which has resulted in a major renovation of the premises being undertaken. As previously mentioned any works which will have an impact on the running of the service or the people accommodated are well co ordinated to ensure that the impact is minimal. We observed that the home has a friendly, relaxed atmosphere. We observed that there is an infection control policy in place and staff are trained in infection control procedures, this was confirmed by staff training records. Staff were observed adhering to infection control procedures. The house was clean and odour free throughout. There is a robust daily cleaning schedule in place, with audits being conducted of all aspects of the home being cleaned and maintained. Eight of the ten surveys received from people who use the service replied Always to the question, Is the home fresh and clean?. Appropriate Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: laundry facilities were also noted. Facilities of a Training Kitchen were also observed, this is an area where individuals are supported to attend to there own laundry. Care Homes for Adults (18-65 years) Page 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a flexible working staff team, that have the necessary skills and experience to the meet the needs of the people who use the service. Staff are well trained in matters associated to social care and Acquired Brain Injury. Evidence: We observed that a competent staff team meets the needs of the people who use the service. We saw that there is a clear staff rota in place, which details staff hours of working and staff job designations. Two staff are currently finalists in The Great East Midlands Care Awards 2009. Following the inspection we have received confirmation that at the awards evening the Innova House finalists won both categories entered, Best Newcomer and The Ancillary Workers Award. The home has a permanent staff team the Appointed Manager, two Assistant Managers, three Team Leaders, ten Rehabilitation Support Workers, three Activity Support Workers, a Cook, a Cleaner and a Premises Manager. The AQAA provided us with evidence that twelve care staff are trained in National Vocational Qualification (NVQ) level 2 or 3 in care, whilst a further seven care staff are undertaking NVQ training. This was also confirmed in the staff training records viewed. Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: Staff recruitment files were viewed and it was evidenced that these files contain all items required under the Care Homes Regulations 2001. We noted that the service has a highly developed recruitment procedure, that has the needs of people who use the service at its core. The recruitment of good quality carers is seen as integral to the delivery of an excellent service. We observed that the home has an Equal Opportunities policy in place and is an equal opportunities employer. We observed that the service ensures that all staff within its organisation receives relevant training, that is targeted and focused on improving outcomes for people with Acquired Brain Injuries. Individual staff training files were viewed and it was evident that staff have received training in Induction, Health & Safety, Food Hygiene, First Aid, Safeguarding Vulnerable Adults, Infection Control, Fire Safety, Moving and Handling and Medication. The staff induction-training package was viewed and this was found to be comprehensive in content. We observed staff supervision record dates and noted that the service is on target for the required six sessions per year. Staff commented in the surveys that Training is good and that It (the service) could make more time to discuss staff problems and concerns on a personal level, such as regular appraisals. Responses to how the management of the home support staff were also divided in opinion, with two people saying that they are supported Regularly or often, whilst two replied sometimes. Care Homes for Adults (18-65 years) Page 26 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 good 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 good, with evidence of consideration being given to the choice and opinions of the people who use the service. The health, safety and welfare of individuals accommodated and staff is protected at all times. Evidence: The Appointed Manager has many years experience of working with younger adults. She is also the Registered Manager of a Younger Adults care home also registered with the commission. Staff spoken with said that the Manager is always friendly, approachable and pro active. We observed that the home has a Quality Assurance Procedure in place and that effective quality audits have been conducted in the last twelve months. Records viewed confirmed that Regulation 26 visits are carried out by the Registered Providers. Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: We were informed by the Responsible Individual that the service is currently in the process of completing the ISO 9001 2008 Quality Management System (ISO 9001:2008 specifies requirements for a quality management system where an organisation needs to demonstrate its ability to consistently provide services that meets customer and applicable statutory and regulatory requirements). Quality review audits of medication procedures are to be implemented following the immediate Requirements made at the time of the inspection. From the AQAA provided by the home and from records viewed it was evident that fire drills, fire alarm testing and fire equipment checks, water checks and Portable Appliance Testing (where applicable) had been carried out within the last twelve months. We observed that current refurbishment works are carried out in a well orchestrated manner and it a way in which the safety and welfare of the people using the service and staff, is paramount. 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 1 20 13 That all prescribed medications are signed for after they have been administered. In order to ensure that the people who use the service are receiving all prescribed medications and that medication records provide evidence that medication has been administered. 29/09/2009 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 1 2 20 39 That the staff signatory list, in the Medication Administration file, is updated to include staff initials. That consideration is given to the comments made by people who use the service and staff, throughout the report. Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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