Inspection on 23/11/09 for Kitchener Road 83

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

Kitchener Road 83 07/02/06

Kitchener Road 83 26/07/05

Kitchener Road 83 08/11/04

Kitchener Road 83 19/07/04

Kitchener Road 83 23/02/04

Similar services:

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Edenvale

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Chatsworth Care - Dawson House

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Chatsworth Care - Tudor Lodge

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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: Kitchener Road 83 Kitchener Road 83 London N17 6DU     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: Margaret Flaws     Date: 2 3 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Kitchener Road 83 Kitchener Road 83 London N17 6DU 02088086931 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Edward William Marcus care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 3 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: Learning Disability - Code LD Date of last inspection Brief description of the care home 83 Kitchener Road is a privately run home for adults (aged 18-65) who have a learning disability. The home is an ordinary house, similar to its neighbours in a residential area of Tottenham north London. The stated aims of the home is to provide care to people who have a learning disability (usually mild to moderate) or service users with an autistic spectrum disorder including some users who may have complex behavioural problems. Priority is given to maintaining privacy, dignity, independence, security, civil rights, choice and fulfilment. Accommodation in the home is provided in three single rooms, one on the ground floor (with an en-suite shower and toilet facility) and two on the first floor (each equipped with a hand basin and sharing a bathroom and two toilets nearby). A sleeping in room and office are also provided on the first floor. Service users also have access to a lounge area, diner/conservatory, and rear garden area. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 3 Brief description of the care home Service users resident in the home are supported to use nearby community facilities to meet education and recreational needs including local transport networks, leisure facilities and shops in close proximity to the home. The fees are around #1,400 to #1,500 for each placement per week, and service users are expected to pay separately for items such as toiletries, hairdressing and clothes. Following Inspecting for Better Lives the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unnannounced inspection was part of the routine schedule of inspections for the home. The Registered Manager and a senior staff member on duty assisted us throughout and we discussed the running of the home in detail with them. We spoke to the other staff member on duty and to two residents. We also observed interactions between the residents and staff. We toured the home with the Registered Manager. We looked at the records and procedures kept in the home, including resident, staff and general home records. What the service does well Residents benefit from living in a home with excellant, systematic and innovative management that is focussed on meeting their needs. They benefit from a very well trained and committed staff team who are matched to their backgrounds. Care Homes for Adults (18-65 years) Page 6 of 29 They are supported to live their lives as freely as possible in a professional, non judgemental and kind way. Additional professional input and advice is regularly sought when needed. The home is very comfortable and welcoming. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Current and prospective residents know that their needs will be assessed and that they will be given information about what the home offers. Evidence: One new resident has been admitted to the home since the last key inspection and we saw his files and one other residents files. The files included comprehensive multidisciplinary assessments, discharge summaries and evidence of pre-admission meetings and plans. Assessments also covered the residents preferences, likes and dislikes. One resident transferred from another home run by the organisation and there was good information from his previous placement and evidence of several trial visits made to the home before his admission. There is clear information available for prospective residents and their families. All residents had had reviews completed by their placing authorities and by learning disability specialists. Information from these reviews was used to update the residents support plans and risk assessments. Along with information from the homes own reviews, these reviews enabled staff to keep up to date with the views of external Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: professionals and continue to meet the residents identified and changing needs. Throughout the inspection, the Registered Manager and staff demonstrated an excellant understanding of the residents needs. The home has contracts in place for all residents. These are kept on each persons file, along with signed permissions by the residents or families, acknowledging their rights and responsibilities. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to make their own choices and live the lives they wish to. Their needs and possible risks are assessed and regularly reviewed. Evidence: We saw the files of two residents and discussed their content with the Registered Manager and a senior staff member. Residents had comprehensive care plans and risk assessments in place. These meet previous requirements. The care plans (individual support plans) were clearly arranged to cover the main areas of each persons needs. One file contained assessments, reviews, information on appointments and correspondence. Regular reviews had been completed by social workers, care managers and learning disability psychatrists. The other file contained the persons detailed individual support plan and risk assessments. The Registered Manager showed us the system for reviewing the care plans. He has created simple reminders and cross check audits to ensure that the Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: files are reviewed and updated monthly. The individual support plans included visual communication tools, such as photographs, which are used liberally by staff, all of whom can use the homes digital camera. The Registered Manager showed us a more advanced visual format for the support plans that he is developing. It included photographs and simple mind maps and flow charts for staff staff and residents to follow. Each person has detailed risk assessment, which were regularly reviewed and updated to reflect any new risks to their wellbeing. These assessments demonstrated how the risks were managed without making life constrained for the resident. They gave good guidance to staff, with details of behavioural early warning signs and ways to support the residents. Throughout the inspection, we observed positive, kind and warm day to day interactions between the staff and the residents. The residents appeared very comfortable and confident with the staff and able to express their wishes and needs. Staff were observed to be sensitive and responsive. The daily life of the home appeared relaxed and residents were clearly spending time as they wished. To meet the communication needs of one resident, there are three Greek speaking staff and other staff have knowledge of basic Greek. One resident is mainly non verbal and the ways that staff communicate with him was clearly recorded. Residents wishes in case of death have been assessed and their preferences documented in their files. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to develop their daily living skills and follow their own routines.This includes supporting them with their preferred degree of family and social contact. The home enables residents to use their time as they wish and provides them with excellant choices of food. Evidence: Throughout the inspection, we saw good evidence that the residents are encouraged to develop as individuals and improve their independence and wellbeing. One resident went out for a ride to Enfield with a staff member, which he said he enjoyed. One resident got up in the afternoon and said he enjoyed being able to choose how he arranged his day. One other resident was asleep as he preferred to stay up late at night. The staff told us that this was his pattern and how he enjoyed spending his Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: time. Activities are clearly recorded in the residents records. Examples of activities in the home included games, painting and drawing the home, going out into the community and visiting London attractions and off the beaten track activities. Other activities included swimming, going out for walks, and going to the cinema. These activities were also documented with photographs. The home has Sky TV and the Registered Manager told us that the range of programmes is well liked by the resident. One residents watches sport and Asian programmes and another likes the music channels. The Greek resident has Greek television in his room. Residents are supported and encouraged to develop independent living skills. They have delegated tasks and responsibilities. Staff work with them to develop their abilities in cooking, cleaning and maintaining the household, and going out into the community. A staff member showed us a video of two residents learning kitchen skills with assistance from staff. In one case, a Greek resident was shown how to make a cup of tea by a Greek speaking staff member using pictorial guidelines. The Registered Manager told us that the residents enjoyed seeing the videos of themselves and that seeing themselves on film helped them to progress in learning daily living skills. The home places a strong emphasis on supporting residents to have holidays. There was extensive photographic evidence of residents and staff on holiday abroad and in Britain. Residents have had holidays in different parts of Asia and Europe. One resident prefers to go and visit relatives regularly in Europe. Another resident does not like overseas holidays and has had his first holiday in Kent. The Registered Manager told us that residents have monthly holiday planning and research meetings with the staff. The home has a vehicle and two staff members (who work at different times) are able to drive. They take the residents on day trips around London. The Registered Manager told us that the residents maintain the level of family contact they wish to. Their choices are clearly documented in the care plans. Other choices are supported by the home, for example, their preferences around food, music, religeous observance and day to day activities. Food choices appeared to be flexible, to meet the residents wishes. A previous requirement is met. There was a four week cyclical menu displayed in the kitchen. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: Staff described how they work with the residents preferences, which are identified at formal meetings and informally day to day. A record is kept of what people eat is kept. The Registered Manager and staff told us that the home offers a wide range of dishes from around the world. The residents are of Afro Caribbean, Indian and Greek descent and the staff are multicultural. This has given the home a wide selection of food options and residents clearly enjoyed a varied diet. There was a considerable supply of very good quality food in the home. This included a range of dry goods stored in an outside shed, frozen meat and fish and fresh fruit and vegetables. It was clear from the food stocks that meals are cooked from scratch and do not include processed or convenience foods. The Registered Manager told us that they do a big shop once a month and buy fresh foods as required. During the inspection, one resident got up late and had a late lunch prepared. The staff also told us that the meals are varied so that there are light and heavier options offered each day. During the summer, staff told us that the home had at least weekly barbeques outside and that the residents loved this way of eating. The home has a photograph album of local restaurants and cafes so the residents can select where they would like to go and eat out. The home is close to a wide range of shops in Tottenham. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have their dignity and privacy respected. They are provided with excellant support with their healthcare needs and their wellbeing is protected. Residents are protected by safe systems for the storage and administration of medication and staff trained to use these systems safely. Evidence: The care plans indicated that staff supported residents according to their needs with personal care. Appropriate permissions were agreed and signed off.Staff were observed interacting sensitively with the residents, ensuring that their privacy and dignity were protected. We checked two residents healthcare records on file. They had had regular health checkups, including input from opticians, dentists,learning disability specialists and their doctors. Healthcare records were kept up to date. The residents have had their learning disability and mental health needs regularly reviewed by appropriate professionals. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Staff told us that the home has a very good working relationship with a local GP, who sees all residents regularly, knows them well and does home visits if necessary. All residents have had their weight monitored regularly. One resident with high blood pressure has this regularly checked by the staff who know how to use a simple blood pressure machine. Staff could describe what they would do if there were significant changes. The senior staff member showed us the medication arrangements. The home uses a blister pack system and has a contract with Boots. Medication is stored in a locked cupboard in the office. The medication administration records we saw were accurate and reflected good practice in the home. They were appropriately signed by trained staff. The Registered Manager showed us how medication is delivered to the home and returned to the pharmacy, with a clear and systematic audit trail. Medication administration records were signed appropriately by staff. There is clear written guidance for staff on PRN (as required) administration. The training records showed that staff are trained to safely administer medication. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to raise their concerns and know how to do so. They are protected by staff trained in safeguarding and who know how to follow the homes safeguarding policies and procedures. Evidence: We saw an example of how the complaints procedure is presented to the residents. On the wall of one residents room, there were the photos and names of the staff and photos of the Registered Manager and Registered Provider, with simple information about who to talk to if they were unhappy. We observed that the residents appeared comfortable to express their wishes and concerns to staff as they arose. One resident told us that he knew how to express any concerns he had. We saw the complaints records, which showed that complaints received had been appropriately responded to and addressed. The home has a specific folder of information on safeguarding. This folder includes copies of the local authoritys safeguarding procedures, alerters forms, the homes clear policy and procedure and records of training done and staff assessments in this area. Staff have been trained regularly in safeguarding adults and were able to describe Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: what they would do if they had a safeguarding concern. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a very comfortable, homely environment, which is regularly maintained and improved to meet their needs. The home is kept safe, well maintained, clean and hygienic. Evidence: The home is in a terraced house in Tottenham. It appeared safe, clean and very comfortable. There are local shops close by and good access to public transport. The home has three single bedrooms, with one ensuite bedroom on the ground floor for a resident with mobility difficulties. The bedrooms have been refurbished. We saw one residents bedroom, which was highly personalised and decorated and comfortably furnished and laid out. The organisation has done considerable work on the house since the last inspection. Recent work has included new wooden floors throughout and safety tread on the stairs,new kitchen floors and cupboards and a new fridge. The lounge has been refurbished and is bright, colourful and spacious. It is nicely decorated with large pictures of the residents and other photos of their activities and Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: holidays. The built on conservatory area has been creatively redeveloped into a light space for games and socialising. There is table football, pool and art materials available. The back garden has been made into a full length patio area with a garden swing, storage shed, basketball hoop and barbeque. This barbeque and outdoor area was used regularly in the summer. The Registered Manager told us that since the back garden has been levelled in this way, the resident with mobility needs has felt confident to spend time outside.The patio space is completed with flower boarders. The side fence to the next door property has fallen down and needs replacing. The Registered Manager said that the organisation has tried unnsuccessfully to get the neighbours to repair it and is continuing to try and get a response. In the meantime, it is recommended that the home make a temporary fence to protect the residents. Residents and staff keep the home clean and there is a good quality washing machine. There was evidence of a good practice in infection control, for example, colour coded chopping boards, different tea towels for dishes and hand drying and guidelines for infection control arund the home. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected and enabled by a safely recruited staff team who are comprehensively inducted, trained and supported. Evidence: We looked at the files of two staff and all the training and supervision records. All staff have been safely recruited, with thorough preemployment checks carried out. These included obtaining two written references and a current Criminal Records Bureau and POVA check before they commence work. The staff members we spoke to had been recruited since the last inspection and were able to confirm that these checks had been properly undertaken before they started working in the home. A section has been added to the application form for prospective employees to explain gaps in their employment history. All staff now have a recent photograph on their files. These improvements meet requirements made at the last inspection. All had staff had contracts, health checks, job descriptions, evidence of the right to work in the UK and had signed out of the European Working Time Convention. The induction process is very comprehensive and well documented. Staff undertake an induction over several weeks and sign off when they have familiarised themselves with Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: specific policies and procedures. The Registered Manager and staff described the shadowing process, in which new staff work alongside existing staff to get to know the residents and ways of working with them. The Registered Manager and staff confirmed that new staff can ask for additional shadowing time to get to know residents until they feel confident to work on ordinary shifts. Staff training certificates are kept on file. The Registered Manager told us about the training programme followed by the home. This is divided into internal and external training and covered all mandatory training in a rolling programme. The home has good access to Haringey Councils free training programme and there were certificates on files for the courses that the staff have attended. Internal training is a mix of video training (with tests for understanding completed after watching the training and follow up supervision and staff meeting discussions) and training provided by the Registered Manager in areas in which he is a qualified trainer. Staff are progressing through NVQ achievement. During the day there are two staff on duty, along with the Registered Manager and, at night, one sleeping staff member. We saw the staff rota which reflected this. We saw the supervision records. There is a clear supervision schedule posted in advance in the office. All staff had received individual supervision from the manager at least six times per year and the supervision notes indicated that there is a focus on meeting the residents needs and professional development. Regular staff and management meetings are held and the minutes clearly demonstrated that residents needs and interests were discussed, along with the running of the home. Both supervision and management meeting notes had detailed action plans with responsiblities and timescales outlined and worked to. Staff have had regular appraisals and action plans developed from them. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a well run home with excellant management. They are protected by the organisations and homes quality assurance and health and safety policies and procedures. Evidence: The Registered Manager has worked in the home for twelve years and been registered for several years. This meets a previous requirement. He has a Registered Managers Award and an NVQ4 in Care. He told us he is also registered to undertake the new LMC qualification. He demonstrated an excellant understanding of the residents needs and worked sensitively with them. Residents appeared comfortable and confident with him. He worked openly, closely and transparently with the staff on duty and staff said they were comfortable with his management style. The home has a 360 degree appraisal system for the manager. This means that staff and residents contribute feedback to his performance appraisal. This appeared to work well and staff said they enjoyed contributing to this and the Registered Manager said that this helped in his management development. He told us that he has daily contact with the Registered Provider and monthly formal supervision. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: The organisation surveys residents, their relatives and care professionals on annual basis to maintain quality standards in the home. The Registered Manager described the additional quality assurance mechanisms he has put in place and how he acts on the feedback received to improve services. He gave clear examples of how this has been done. The Registered Manager has put in place compliance ystems for auditing complaints, medication, training and supervision,risk assessments and care plan reviews. These systems appeared to work well and were clear for staff to follow. Health and safety checks had been completed and we looked at the certificates kept at the home. These were all up to date and in order. The home has up to date Public Liability Insurance. Fire safety checks are done regularly. The home has a fire risk assessment and the Registered Manager showed us how this is regularly reviewed by staff. We saw records of quarterly fire drills, weekly alarms tests and the maintenance checks on the fire safety equipment. The fire drills are documented but we noted that they have only been carried out during the daytime. It is recommended that at least one drill per year be carried out Staff had recently received updated fire safety training by the fire service. Staff are trained in health and safety,food hygiene, first aid and infection control. Incidents are clearly recorded in the accident and incident logs. Actions in response to incidents and accidents are taken by staff and each persons file, care plans and risk assessments are updated as necessary. The home reports serious incidents to the Care Quality Commission as required under Regulation Thirty Seven of the Care Standards Act 2000. One innovative way of working that the home has developed is to use photographs to document incidents, for example, damage done to the fabric of the building when residents experience times of frustration. These photographs are then used to think about devising solutions and ways of decreasing the frequency of incidents. There are health and safety checks on staff who drive and guidelines in place for the the use of the homes car. The car has safety glass fitted in between the driver and passengers. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 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 24 That the home updates the medication profiles of each resident. That the home make a temporary back fence to protect the residents. Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!