Inspection on 17/04/09 for Libury Hall

This is the latest available inspection report for this service, carried out on 17th April 2009.

CQC found this care home to be providing an Good 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

Libury Hall 31/07/06

Libury Hall 07/02/06

Libury Hall 03/05/05

Libury Hall 13/12/04

Libury Hall 29/06/04

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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: Libury Hall Gt. Munden Nr. Ware Hertfordshire SG11 1JD     The quality rating for this care home is:   two star good 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: Julia Bradshaw     Date: 1 7 0 4 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: Libury Hall Gt. Munden Nr. Ware Hertfordshire SG11 1JD 01920438224 01920438887 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs A Schorr,Mrs Annemarie Helene Hildegard Schorr care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Libury Hall comprises a large detached house and five cottages that are located to the rear of the main house. The main house has been adapted and converted to provide 17 single bedrooms and two double rooms. There are four other bedrooms on the ground floor, with adequate bathrooms and toilet facilities provided on both floors. The main kitchen, laundry and offices are located on the ground floor. There are several large communal areas located throughout the ground floor. The cottages each provide a sitting/dining room, kitchen, bathroom, toilets and two or three bedrooms. The home is located in a rural position surrounded by farmland, with the village of Great Munden approximately half a mile away. Transport is provided to support people to go shopping and engage in social trips in both Hertford and Ware. There is day centre situated within the grounds of Libury Hall where everyone has the opportunity to attend, on a daily basis. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 37 37 37 37 Brief description of the care home The weekly fees range from £520 to £575. The Statement of Purpose , Service User Guide and a copy of the most recent inspection report can be found within the main office of the home. 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: two star good 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 key inspection was carried out on the 17th April 2009 and took place over one day. The last key inspection was carried out on the 18th April 2007 and an Annual Service Review was carried out on the 29th April 2008 . The focus of the inspections undertaken by the Care Quality Commission is upon outcomes for the people who use the service and their views of the service provided. The primary method inspection used was case tracking which involved selecting four people and tracking the care they received through looking at their care records, discussion where possible with the people who use the service, the care staff and observation of care practices. The visit was unannounced and planning for the visit included assessment of the notifications of significant events, which had been received from the service to the Care Quality Commission. We looked at the last Inspection Report and information on safeguarding and complaints since the last inspection. We also looked at the Annual Quality Assurance Care Homes for Adults (18-65 years) Page 6 of 29 Assessment (AQAA) and reviewed what the service has improved in the last twelve months and its plans for the next twelve months. The AQAA is a self assessment tool that looks at how the service is meeting the needs of the people living within Libury Hall and also provides us with some numerical information. A selected tour of the building was conducted during which the inspector spoke with residents, staff and the registered manager was present throughout this inspection. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? The manager and staff have worked hard to improve the individual care plans by making these documents more person centered and the environment more homely using soft complimentary colours and creating more useful communal space for everyone. The manager and staff have worked hard to involve the service users in local community activities by supporting both a rural farm project and a team of volunteers from Tescos were coming in May to re-decorate one of the lounges, lift area and staff Care Homes for Adults (18-65 years) Page 8 of 29 area to assist in further improving the general environmental standards throughout the home. The home also achieved Investors in People award in January 2009. 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 9 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 10 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. Information about the service is kept up to date and provided for all prospective users of this service and everyone wishing to enter the home has a full assessment of need completed. This ensures that all parties can be sure the home can meet all individual needs. The terms and conditions of the home are agreed in writing so that people are clear about the roles and responsibilties. Evidence: The service has developed a statement of purpose, which sets out the aims and objectives of the service, and includes a guide, which provides information about the service and the specialist care the service offers. The guide details what the prospective and current individuals can expect and gives a clear account of the specialist services provided, quality of the accommodation, qualifications and experience of staff and how to make a complaint. All new service users are given a copy of the guide and the services makes one available for all to view as they wish. Admissions are not made to the service until a full needs assessment has been undertaken. A skilled and trained person always completes the assessment prior to Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: admission to the service. The assessment was detailed and appropriate to the policy and procedure in place. The assessment explored areas of diversity including preferences, religious and cultural needs, involvement from family, partners and advocates, race, gender, age and disability. It was evident that the service strives to seek the information and assessment through care management arrangements, prior to admission. The service has the capacity to support people who use the service and respond to diverse needs that may have been identified during the assessment process. One person who uses the service commented, I like it here, all the staff are really nice and helpful too. The assessment process is conducted annually to ensure that any changes in need are identified and associated support plans are then reviewed and or implemented. There are no privately funded placements. Each person had a statement of their individual terms and conditions and these are reviewed and adjustments made annually or as required. The AQQA states that We work very closely with the potential new resident during the assessment period. Day and night stays are arranged during this period. Advice is given from the bed placement team or the referral team with regard to the individual persons assessment. During this period full consideration is given to the indidvidual and their views. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans reflect a detailed and detailed record of peoples needs, which ensures that people using the service receive a service that meets their needs that is also reviewed regularly and safe from risk. Evidence: A total of four care plans were case tracked fully. It was established that people who use the service receive personal and healthcare support, which is suitable to meet their needs. Personal healthcare needs including specialist health and dietary requirements are recorded in each persons care plan. The care plan provides information and a guide for staff to know how to support the person. The care plan is generated from the pre admission assessment and includes guidelines, risk assessments for the management and control of a range of issues, including, where appropriate behavioural support guidelines. It was observed that the service reviews the needs assessment on an annual basis and this is linked with the care plans in place providing the required information in order for the staff to know Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: how to best meet the needs of the individual. The manager and the staff team should have worked hard since the last inspection was carried out to further improve and develop these care plans into a more effective working document. The AQAA states that The home operates a multi-disciplinary team recording system within the care planning process, as part of the revised recording process more emphasis has been put on identifying the individuals needs and choices. Support Plans are reviewed annually or when there is a recognised change in need. People using this service have access to their care plans and these are made available at all times. It was observed that personal support is responsive and created to meet the individual choices, needs and preferences. Generally Staff were observed to respect the privacy and dignity of everyone living within Libury Hall. However a service user addressed an issue with a member of staff who was adminstering ear drops to someone during the lunchtime meal. This was dealt with immediately and the inspector was reassured that this was an isolated occurrence and wholly inappropriate. The manager stated that the normal procedure for adminsistering all medication is within the designated medication room. People are supported and helped to maintain their independence and generally can take responsibility for their personal care needs. Risk assessment are in place for a number of issues where control measures may be required to be identified and implemented in order for the individual to take risks as required. Risk assessments held on the files case tracked included, fire safety, personal hygiene, transport, community access and a financial risk assessment. Other risk assessments are in pace as required. The AQAA states that Risk assessments are undertaken with a view to the needs and views of the resident. Staff training in relation to the Deprivation of Liberty Safeguarding is planned as part of the mandatory programme for the whole staff team. During the inspection it was directly observed that confidential records were being stored appropriately. Care Homes for Adults (18-65 years) Page 14 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. People who use the service are offered and receive appropriate opportunities for social/leisure which meets their needs, within the limitations of the remote and rural position of this service. Evidence: People who use the service have the opportunity to develop and maintain important personal and family relationships. On the day of the inspection the majority of people who use the service were attending their daycare placement which is located within a separate building opposite Libury Hall. I really like going to daycare with all my friends that I live with. We make things. Activities include woodwork, painting and gardening. There is a display of paintings in the main dining area of the home, which are exceptional. Service users are justifiably very proud of the work they produce. They can choose to come and go from the day centre although most prefer to stay and return to the house for their meals. They have access to drinks at the day centre Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: and spend time chatting and playing games for example darts, cards etc. A number of people who use the service were seen to be very relaxed and calm within their own environment and engaging with staff in an equal manner. The people using the service had a variety of communal and or personal spaces in which to relax. One person commented that we can do what we like, I like reading and listening to music in my room. Unfortunately the rural location of this service restricts people from accessing local community facilities easily and is dependent on staff transporting people. However the service has now increased its transport in the past year from two to three vehicles which has helped improve the opportunities for people to get out and about. The service has also started to produce a Newsletter, which is edited by one of the service users. Also the manager said there were plans to offer people the opportunity to take part in a rural farm project called rural care. The AQAA determines that the service Has supported residents in obtaining bus passes in order to promote and encourage peoples independence. The menu is varied with a range of choices .The meals are balanced and nutritious and cater for the varying cultural and dietary needs of individuals. The daily choice was on display within the main dining room. The food provided appeared appetising and well presented. Comments received included I really like the food and we get plenty. The people spoken to were happy with the food provided and there is always a choice of two hot meals plus a selection of different salad options for example ham, cheese or fish. There have been lengthy discussions in past inspections regarding how mealtimes are arranged, which involves people being served their meals rather than people being able to serve themselves. However the manager was able to provide ample evidence of endeavouring to change this slightly institutionalised arrangement but with the vast majority of people living within Libury Hall choosing to continue with the existing system . 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. People who use the service have their health and personal care needs carried out effectively and respectfully, ensuring that their wishes and choices are promoted. Evidence: Individuals files included information of individuals health needs and how these were to be met were contained within the daily records, the assessment and the care plan. The manager stated that a number of the people who use the service have complex mental health needs. The delivery of personal care was individual and flexible according to changing needs and preferences. Personal care and support is provided in private and by a person of the same gender where possible. Guidance and support is provided with personal hygiene tasks where required although where people are able to attend to their own personal hygiene needs they were encouraged to do so. External mental health support services are accessed through the community mental health services, based in East Herts. Evidence was held on the individuals file regarding outreach services. There is also an individual health action plan is in place . A local GP from the surgery in Puckeridge provides a weekly service to the home and there is also an on call service available. The chiropodist visits every three weeks. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Medications were stored appropriately in locked cabinets within the main medication room. Medication administration records were viewed at this visit and were satisfactorily maintained. The service operates a system of double checking the administration of medication to further protect the health and well being of the residents. Bottles and boxes were observed to have the date of opening added and where a homely remedy had been administered there was a running record maintained. The Medication Administration Record (MAR) had been double signed for all controlled medication that had been administered. To ensure the clinical effectiveness of the medication stored, the temperatures of the room were being recorded to ensure that medication was being stored in the correct environmental conditions. The service has reviewed the medication administration policy and procedures since the last inspection took place. The AQAA states The service maintains positive contact with outside health professionals. Staff support service users to attend appointments and respect confidentiality. During the inspection documents were seen of records where people had been supported to attend specialist clinics and relevant specialist support services, including community psychiatric nurses, psychiatrist and physiologists. A staff member commented that people who live here see it as their home and are very proactive in saying what they feel about things, including the staff. 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. People living in this service can be assured that they will be protected from abuse and that they will be listened to if they raise any concerns or make a complaint about any aspect of their care. Evidence: The service has an open culture, which allows people to express their views and concerns through a variety of methods. Feedback gained from one of the people who uses the service confirmed that they are aware of what to do if they are unhappy and wish or wish to make a complaint. The individual stated, If I was unhappy I would go to the office and talk to the staff, they would mostly always sort it out. During discussions with people living within Libury Hall it was clear that people have the ability and skills necessary to raise any issues or concerns they have and are a strong advocate for the service they expect to receive. Many people living within Libury Hall have been in the care system for many years and are fully aware of their rights to a service that meets their needs. Residents meetings are held regularly and are well attended. (Last meetings were held on the 12/02/09 and 5/03/09) The service has a clear complaints policy and procedure that was available within the main reception of the home. It was reported that the service had not received any complaints since the last inspection was carried out. The manager reported that any points raised by the people or their representatives were addressed immediately and therefore never appeared as complaints. The service understood the procedure for Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: safeguarding vulnerable adults. Training in the safeguarding and protection of vulnerable people is scheduled for 2009. The policies and procedures relating to recruitment promotes the safety of the people who use the service through the completion of an enhanced Criminal Records Bureau (CRB) disclosures and two written references before a new staff member starts work at the service. 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. The environment is maintained to a standard where people using the service can feel comfortable, safe and protected. Evidence: The manager and staff have worked extremely hard to improve the environment for the people living at Libury Hall as the main part of this home was built over a hundred years ago and appears quite institutional, with large communal areas and ageing outbuildings in need of constant repair and updating. However since the last inspection took place the following improvements have been made, one of the lounges has been upgraded with new furnishings and fittings, another room has been adapted to create a games room, the conservatory has been adapted to allow part of it to become a smoking area, which has created a larger communal area for the nonsmoking residents. The bathrooms have also been re-decorated and a new parker bath has been fitted to one of the first floor bathrooms. The manager stated that there are plans to create a new 40 bedded unit next to the original building and to move the existing residents from both the cottages and from the first floor all into the new building. All fire records were up to date, including the last fire drill carried out on the 25/10/08, the last fire alarm tests were carried out on the 9/04/09. The emergency lights were tested on the 20/03/09. The maintenance person also carries out the health and safety checks and these were all up to date. There are adequate bathrooms Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: and toilets throughout and although these appear large and unwelcoming, the manager and staff have endeavoured to create a more homely style by re-decorating these in soft and complimentary colours and by personalising them. The communal areas are now more modern in style and the colour schemes help create a more welcoming and homely environment. The dining area has been brightened up with a large collage at one end and was created by the residents at the day centre. The kitchen areas was clean and provided all the necessary equipment. Cleaning schedules were seen and all staff who manage food preparation have up to date food hygiene certificates. There are facilities available for people to make hot drinks and snacks. There is a plan to create a new daycare programme for people to further develop their life skills, with a particular focus on people doing their own washing and cooking. This is currently difficult to implement due to the existing industrial style kitchen and laundry rooms. The inspector was invited into several residents bedrooms and was able to see that people had been supported in creating very personalised and homely bedrooms. The manager stated that everyone has their own front door keys. 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. People who use this service are supported by staff who are well trained and competent to meet their needs. The procedures for recruiting staff are thorough and ensures that residents are protected from abuse. Evidence: There are enough qualified, competent and experienced staff to meet the health and welfare of people using the service. Staffing rotas take into account the needs and routines of the people using the service The service recognises the importance of training and delivers a programme that meets any statutory requirements and the National Minimum Standards. The AQAA states All senior staff have completed their NVQ level 4 in management and also level 2 in medication.. The staff training records were checked and confirmed that all staff have received their mandatory training. In addition to this training staff have also attended Mental Capacity Act training, Safeguarding Adults and Deprivation of Liberty Safeguards. Staff spoken to confirmed they receive regular supervision and several staff stated that they found it productive and supported. A variety of staff meetings are held on a regular basis and include senior staff meetings, night care meetings. All staff are clear regarding their role and what is expected of them. People using the service report that staff working with them know what they are meant to do and that they meet their Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: individual needs in a way that they are satisfied with. One person using the service commented that Staff look after me very well here. The Manager has the required qualifications and experience and is competent to run the home. The Manager and the staff team have a clear understanding of the key principles and focus of the service, based on organisational values and priorities. They work to continuously improve the service. Feedback received on the day of the inspection from staff and the people who use the service that they find the management team approachable. The manager stated that there were currently no staff vacancies. The whole staff team should be congratulated on achieving the award Investors in People in 2009. The staff induction is comprehensive and is linked to skills for Care. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users can be assured that they are protected by the Health & Safety procedures in place, that their have their views listened to and benefit from a well managed home. Evidence: There is regular monitoring system in place to ensure that procedures and policies are being followed and checks are made to ensure the health, safety and welfare of anyone who lives, works or visits the home is promoted and protected. Appropriate risk assessments are carried out with regular reviews taking place. There is a maintenance person on site who can deal with minor maintenance work that is necessary and is also responsible for carry out health and safety checks, and fire system testing. A spot check showed that incident and accidents have been reported appropriately to the Commission as required by the Commission. Staff and the people who use the service concurred that there is an open atmosphere in the home that it is well run and they confirmed that they are informed of any events that may affect them. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: The manager and staff worked hard to continue to improve and further develop the services to people with enduring mental health needs. This service enables and supports people to maintain a level of independence that would be unachievable within local communities due to peoples complex health needs. Due partly to the rural location, people are able to enjoy an element of freedom, that elsewhere would prove difficult. The service received Investors in People award in 2009. The manager and staff have worked hard in the last year to improve both the care planning system and environment standards, which were clearly appreciated by the people using this service. Several people spoken to stated that The staff are very kind and help support me when things are difficult. We are able to get out and about more now we have more transport. I like going to daycare as we make things for the house. 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 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. 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