Inspection on 29/01/09 for Magnolia Court

This is the latest available inspection report for this service, carried out on 29th January 2009.

CSCI 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

Magnolia Court 20/12/05

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Magnolia Court 62 Leigham Court Road The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lynne Field Date: 0 6 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 32 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 2 0 Magnolia Court Ltd care home 2 magnolia2@caretech-uk.com Magnolia Court 62 Leigham Court Road 02086966651 learning disability Additional conditions: The registered person may provide the following category of service only: Care Home Only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 2 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home 62 Leigham Court Road has been converted from an ordinary family home. It is semi-detached to the registered care home at 64 Leigham Court Road. 62 Leigham Court Road has been converted into two self-contained flats, each for one service user, with a common front door and hallway entrance. Apart from one of the selfcontained flats, the ground floor also has an office, a toilet and the laundry room. There is a medium sized back garden for the sole use of the occupant of the ground floor flat and access is only available via this flat. There are two steps to the front door so the home is not wheelchair accessible, but the ground floor flat has a mobility access shower/bathroom. The home is within walking distance of a large shopping area with full community facilities and rail and bus transport. The forecourt of the home has space for 2 cars to park and there is on street parking in nearby streets. The registered manager said the fees were between #2156-08 to #782600 per week. Potential service users would be given the Service User Guide and verbal information about the home. A copy of the most recent CSCI inspection report is available in the reception/hallway area of the home. The range of fees charged at the home is #2209.98 - #7667.83 per week and there are no additional charges. Care Homes for Adults (18-65 years) Page 5 of 32 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 Care Homes for Adults (18-65 years) Page 6 of 32 How we did our inspection: This is what the inspector did when they were at the care home The unannounced inspection was carried out over two days in January and February 2009. We checked a number of records, including care plans, staff records and building maintenance records. The registered manager had returned from maternity leave on the week of the inspection and the home had been managed by the deputy manager in her absence. We met both residents and spoke to two staff during the course of the inspection and all were very positive. We checked relevant policies and procedures as well as the residents files, the care plans which included detailed risk assessments as well as associated health and safety records. During the visit we were able to observe how staff interacted with residents and how residents responded to staff. We met both residents and spent time speaking to one resident and two members of staff, who were positive about the home and the service. On the second day of the inspection we were able to inspect the staff recruitment files and speak to the deputy manager who was gave us additional information relating to the recruitment of care staff to the home and the organisation. The deputy manager returned a standard form, the Annual Quality Assurance Assessment to CSCI. This was taken into Care Homes for Adults (18-65 years) Page 7 of 32 consideration and used as part of the inspection process. We found that the home offers a high level of care and support to the residents. The manager and staff continue to give a good service. Staff were observed to be competent and caring. Staff interaction with residents was observed to be knowledgeable and was conducted in a respectful manner. What the care home does well The home gives the residents choices and they are consulted on all issues in their lives and on how the home is run. The registered manager and staff make the home as comfortable and homely as possible. Residents are able to be individual and make daily choices about how their day will be. Care plans, risk assessments and goals are all reviewed and evaluated. These reflect the residents health and social care needs and give information about how the resident likes their care to be given. Staff help residents to make decisions and include relatives and other professionals when difficult decisions need to be made. Staff know what food residents like and support residents to choose and eat a balanced healthy diet. Care Homes for Adults (18-65 years) Page 8 of 32 What has got better from the last inspection What the care home could do better The medication policy and practice should be reviewed to ensure good practice is followed when medication is needed to be given to a resident when they will be absent from the home. Care Homes for Adults (18-65 years) Page 9 of 32 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Lynne Field 33 Greycoat Street London SW1P 2QF 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 10 of 32 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 11 of 32 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 . Service users have their needs assessed by senior staff before they move into the home and know that staff has decided that the home can meet their assessed needs before they move there. Prospective service users, their relatives and relevant professionals can come and look around the home and meet staff before they decide to move there. Evidence: We saw a copy of the service user guide which incorporates the statement of purpose. The registered manager said they were in the process of changing all the literature and policys and procedures to the new organisations paperwork. It is written in large clear font and simple language with pictorial images throughout. This makes it more suited to service users with cognitive disabilities. It covers all aspects of life at the home and is written with humour, making it a friendly and welcoming document. There is a separate service user complaints procedure available with the service user guide, which is also clearly and simply written with pictorial images throughout, and includes all of the information required by regulation. This is displayed in the entrance hall of Care Homes for Adults (18-65 years) Page 12 of 32 Evidence: the home to make it accessible to all. We checked both service user files and saw copies of the thorough assessments that had been undertaken prior to placement. There were guidelines and reports from the previous placements and initial risk assessments completed. The assessment that was taken by the home is comprehensive, covering areas such as psychological support and mental health needs, managing emotions, communication skills, daily living skills, relationships and sexual needs, community presence and participation, recreation and relaxation and cultural and spiritual needs. Prospective service users are given the opportunity to visit the home prior to placement, with the most recently admitted service user having visited the home with three carers. Their mother and brother as well as the care manager were also involved in the decision about them moving to the home and were able to visit too. Care Homes for Adults (18-65 years) Page 13 of 32 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 . Residents assessed and changing needs and personal goals are reflected in their individual care plan. Residents are supported and enabled to make as many decisions and choices about their daily life as possible. Thorough risk assessments and behavioral guidelines have been devised which support residents to be as independent as possible. Evidence: We checked both residents care files and noted the care plans gave a thorough description of the residents behaviors, reactions and preferences and how the resident was to be treated. We were told care plans are developed from the pre admission assessments and in consultation with the resident, their family, care manager and other professionals involved in the residents development. The risk assessments are developed from the initial assessment to suit the residents changing needs. The home assigns key workers to the resident and induction programme is organized. There will Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: be a thorough internal assessment of the resident during the first six weeks of the residents stay at the home. After six weeks there will be a review of how the resident is settling in. Residents are registered with a local general practitioner. All risk assessments are in place for both residents. The challenging behaviors of the residents are severe and so risk assessments and guidelines have been written for most aspects of residents behaviors. Risk assessments from previous placements were obtained before placement at the home and new risk assessments and guidelines have been written in conjunction with external experts such as the South London and Maudsley team. This team includes a general practitioner, consultant psychiatrist, behavioral support practitioner, care manager and community psychiatric nurse. All risk assessments and guidelines have been signed by staff as having been read, and risk assessments have been reviewed as necessary. We saw evidence that the care plans were reviewed regularly within the allotted time scale or sooner if things have changed or there have been developments in the residents behavior and life. There are also guidelines in place in regard to the behavioral characteristics of the each resident. Both care plans stated the residents individual strengths, needs and hopes. These related to the needs and hopes that had arisen from the assessment. All documents were signed and dated by the manager and key worker and the resident who cannot sign is indicated in the column provided that they refused. In some cases where the resident could sign these were also signed by the resident. The areas covered also included emotional needs, house skills, communications, aggression management, speech and language therapy, gradual community presence and hygiene. There were copies of goal plans that had immediate, medium term and long term goals and an action plan review record of each goal. Thorough guidelines were present, with a record of staff signatures to show that all staff had read and understood each guideline. Care plans had been regularly reviewed and these were signed and dated. The resident who is verbal makes his own choices and decisions, supported by staff and subject to any restrictions in his agreed behavioral guidelines. The resident who can communicate verbally, participates in the residents monthly meeting and in the monthly key work session. We met both residents during the inspection and one resident invited us to his flat to have a cup of tea he made for us. We were able to observe during the inspection he was able to choose where he spent his time in his flat and whether he wanted to go out or not. The resident who is non-verbal expresses her preferences via her behaviors. We were told this can be obvious such as pushing things away or throwing food to the ground, or less obvious and interpreted by staff who are now experienced with her moods and behaviors. Staff told us the resident has made a lot of progress over the time she had been at the home and can now make sounds that are recognizable as some staffs names and some foods and drink. When we spoke to her we noted she observed our face and appeared to listen to what we said. When we came to go she seemed to acknowledge us going with a friendly sound. Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: Care Homes for Adults (18-65 years) Page 16 of 32 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 encouraged to develop independent skills and interests as well as access the community with the support of staff when required. Families and friends are encouraged to keep in touch with the residents and participate in social activities. Residents engage in appropriate, enjoyable and fulfilling activities and mix with the general community. Residents rights and responsibilities are respected. A healthy diet is provided, which the residents enjoy. Evidence: Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: Neither resident because of their cognitive disabilities and challenging behaviors are able to work or attend educational classes. We found the residents daily routines are flexible if this suits the residents needs. Each resident has their own flat with their own staff so the service is very individual to each of them. One resident is autistic and because of this it is very important for staff to keep activities to a set routine. This is done and the routine can only be changed very occasionally as otherwise challenging behaviors are triggered. We were told the staff have been very successful with maintaining the necessary routine and support. Both residents have regular contact with their families and they are involved with any decisions that are being made about their care. One residents family attend review meetings and keep in telephone contact and the other resident visits their family monthly and stays for the weekend. When we met the resident on the second day of the inspection they were getting ready to visit their mother for the weekend. We also saw evidence of family contact in daily records and in the individual residents files. Since the resident has come to live at the home their behavior have improved to the extent that the resident is able to do things they were previously though never to have been able to do. Simple things such as going out in the community and shopping. This for them has been a big achievement. The second resident we met has a much more flexible daily routine and is supported to have as much independence as possible. They are encouraged to develop as many daily living and social skills as possible and to take some responsibility for their actions and their daily life. One resident enjoys doing word searches when they are at home but also have chosen additional activities such as visits to the snooker club, bowling, board games and cinema. We saw evidence of the support staff give to residents to help them access the local community. The support the staff give has enabled them to do ordinary things such as go out shopping, visit the park and enjoy drives out in the homes minibus. They also go out to cafes or the pub for meals. In the summer the home organised day trips out to the coast and one resident has recently been abroad on holiday, which they said they enjoyed. Because the residents live very separate lives they both have completely individual menus and completely different, reflecting the residents individual tastes, choices and ethnic backgrounds. These were seen and were varied and nutritious. The resident who was capable is supported by staff to make meals for themselves. Care Homes for Adults (18-65 years) Page 18 of 32 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 are given personal support in a way that ensures their privacy and dignity, and their physical and emotional health needs are met. Generally the homes medication policy and practice are good and protect the resident but policies and practices should be reviewed to ensure good practice is followed when medication is needed for a resident absent from the home. Evidence: We spoke to three staff about working with the residents and how they were able to support the residents. When we were invited by one resident to have a cup of tea in their flat, we were able to observe how staff interacted with them. We saw staff addressing residents appropriately. We found they sensitive and flexible in their approach to personal support in a way that promotes residents privacy, dignity and independence. Residents were well dressed with good personal grooming and hygiene. Residents have very challenging behaviours and the many detailed behavioural guidelines, which staff were familiar with and understood, had been reviewed at appropriate times. We were told these are reviewed when necessary. Staff seemed to understand the importance of consistent care and were observed to assisting the Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: residents by following the behavioural guidelines with humour, kindness and patience. Staff seemed to have a genuine fondness for the residents they were supporting and there appeared to be a mutual respect between them. Care files and daily records showed that staff ensure that residents access the full range of healthcare facilities, including the general practitioner, district nurse, chiropodist and optician. They are also supported to access a range of specialist health professionals as appropriate such as the psychologist, continence advisor, behavioural practitioner, psychiatrist and community psychiatric nurse. We were able to check the medication and found the storage, administration and recording of medication in very good order, including the controlled drugs. Staff told us two people sign when the medication is being dispensed. A tablet count is undertaken at each shift changeover and there are detailed guidelines for the administration of controlled drugs. The medication folder has full instructions and details of side effects for each of the medications administered, which is also good practice. The deputy manager said there were weekly spot checks and there was a monthly audit of all drugs in the home. The deputy manager said they ask the pharmacist to collect medication that has not been used. Records of returned controlled drugs, signed by the pharmacist, were seen. The pharmacist comes into the home once a year to check the medication and to speak to staff about the medication. This gives the staff an opportunity to ask any questions or address any concerns they may have about the residents medication. The new organisations medication policy is now in place. We were able to observe a member of staff getting the residents medication ready for them to take with them for their weekend away from the home to stay with their mother. It is the custom of the home to dispense this into a dosset box, for the resident to take with them for their stay away from the home, which is not good practice. We discussed this with the deputy manager and checked the new organisations medication policy, which states the medication must be prepared in a separate system and must be labeled appropriately. We discussed how this could be achieved by having the local pharmacist do this. The deputy manager was going to have this put into practice and have the appropriate amendment made to the medication policy to cover this as well as discussing this with staff. Care Homes for Adults (18-65 years) Page 20 of 32 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 . The residents are protected by the homes policies and procedures as well as the safeguards that are in place to protect them from abuse, neglect and self-harm. Evidence: The home has displayed the complaints policy in several places in the home and these give clear guidelines about how to complain. The complaints procedure and the abuse policy were reviewed and implemented in April 2007 and it reflects the actual practice at the home. It is written in accessible format. This makes it clear and accessible to residents and their relatives, as well as staff. We were shown the complaints book and there were two complaints. The deputy manager said she dealt with all complaints and treated them all with the same seriousness. These had been dealt with within the time scale of 28 days. We saw copies of the responses and outcomes. The registered manager, deputy and staff at the home are fully aware of the different types of abuse and how residents can be protected. All staff are trained on adult protection and are all aware of the procedure to take if any sort of abuse is suspected. The registered manager has obtained copies of the local authorities adult protection procedure and given a copy to each member of staff. Because of the residents known challenging behaviour the home has a restraints policy in place. There are strict guidelines of how and when this can be used. Records were seen of when and why it was used. There are records of the residents behaviours, what they were doing before and leading up to the behaviour as well as what was done to try to divert the Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: behaviour. Residents views are listened to at key worker meetings and they are protected from abuse, neglect and self-harm by the homes policies and procedures as well as by having risk assessments and restraining guidelines in place. We were told in the recent past the home has involved the police when there have been concerns about a residents money. This is still ongoing and needs to be resolved. We were told the home was waiting the police to get back to them with an outcome. Since the incident further safeguards and procedures have been put in place. Care Homes for Adults (18-65 years) Page 22 of 32 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 homely, comfortable and safe environment. Residents bedrooms suit their needs and disabilities and promote their independence. Toilets and bathrooms provide full privacy as well as meeting individual needs. The home is clean and hygienic throughout. Evidence: The home is a house that has been divided into two one bedroom flats with the side extension converted into a staff office. These are suitable for their stated purpose and are accessible and safe. Both flats have been designed, fitted and furnished to meet the needs of the resident who occupies them. They are personalised according to the individual residents needs and preferences. Both lounges have good quality furnishings, a television, video and music facilities. Because of one residents challenging behaviour they cannot have paintings or pictures on the walls. The home has arranged for attractive murals to be painted on the bedroom and lounge walls so they are attractive and homely. Bathroom, toilet and kitchen facilities are of good standard and the home is well decorated, clean and hygienic throughout. On the day of the inspection we noted there was damage to the walls in both flats caused by the residents and they were waiting for this to be repaired. They had problems with the Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: heating system and the maintenance men were at the home repairing this. Maintenance and repair has been an ongoing problem in the home but seems to be improving with the new organisation. Care Homes for Adults (18-65 years) Page 24 of 32 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 . Policy relating to the recruitment of staff is good and protects the residents by obtaining references, CRB checks, and obtains employment histories. There is an effective supervised staff team, who are experienced in supporting people with challenging behaviour. Staff training needs are identified and is formally planned so they have access to training that meets their needs and supports the residents. Evidence: The home operates a good recruitment process, following the organisations recruitment policy and procedures. This includes formal interview, taking up two references, CRB checks and POVA checks prior to appointment. A new member of staff goes through the Skills for Care workbook as part of their induction. We was told they make sure that during the induction programme, that new staff understand the principle of care and relates that to the experiences and in particular to the needs of the residents. Rotas were seen and evidenced that staffing ratios meet the assessed and agreed needs of residents. One resident has three to one staffing during the day and the other has one to one staffing. There are three waking staff at night who cover Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: both flats. The staff team is stable, with low rates of sickness and no agency staff use. The staff team is mixed in terms of race and gender. On the second day of the inspection we looked at two staff files. There were copies of training records and supervision records held on file. All the staff files had detailed records of recruitment with all the required checks having been made. Copies of signed contacts were on file. The home has a training matrix which is on the office wall. Fourteen of the fourteen permanent staff have already gained NVQ level 2 or above and one staff has started their training towards NVQ level 2. Staff have been inducted in Skills for Care Common Induction Standards. We saw staff have mandatory training as required and additional required training to support the residents effectively. This training is updated annually or when required. All staff has a training and development profile and this is reviewed at supervision and appraisal sessions. Staff records are kept in a locked cabinet in the staff room and are only accessible by the management of the home so confidentiality is not breached. We spoke to two staff during the inspection and both said they felt supported by the homes management and one said they were helped to look at how they could progress profesionally. Staff meetings are held monthly and we were shown copies of the minutes of the meetings. Care Homes for Adults (18-65 years) Page 26 of 32 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 home is being well managed by a manager of good character, long standing experience in care, who is open and supportive in her management approach. Working practices and associated records ensure that the health and safety of residents is promoted. Evidence: The registered manager has previous experience in managing a home for people with learning disabilities and challenging behaviour. She had just returned from maternity leave two days before the inspection and was in the process of taking over the management of the home again. She has obtained NVQ Level 4 and the Registered Managers Award. She demonstrated a thorough and sensitive knowledge of residents needs, characteristics and behaviours and a strong commitment to their rights, choice, dignity and independence. The home has been well managed by the deputy manager in the registered managers absence. We were able to speak to both the registered manager and the deputy manager during the inspection. The registered manager said they were in the process of changing all the documentation and policies and Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: procedures over to the new organisations. Both managers showed they were committed to running the home for the benefit of the residents. The home is well run and they make sure both residents are well looked after and are supported to develop as many skills as they are able to. The staff we spoke to during the inspection said they felt they are very supportive. There are written policies and arrangements for maintaining safe working practices in place, including appropriate risk assessments. The new organisation has just given a home a copy of their policies and procedures and the managers and staff are in the process of familiarizing themselves with these. The records we checked indicated that all fire and electrical systems and equipment in the home are serviced and inspected appropriately and that all internal checks are conducted at appropriate intervals. There are regular weekly health and safety checks are conducted in the home each week by a member of staff and these are recorded appropriately. We saw copies of returned quality monitoring surveys. The families of the residents were very positive about the service their relatives were receiving at the home and said they had developed in the time they had been at the home. Care Homes for Adults (18-65 years) Page 28 of 32 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 29 of 32 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 20 13 The registred person shall make arrangements for the safe administration of medication. Medication should only be dispensed from original containers and not into a dosset box. This ensure good practice is followed when medication is needed for a resident absent from the home. 03/04/2009 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 23 The registered person should contact the police to see if the police have finished the investigation of the incident regarding the residents money and draw the incident to a Care Homes for Adults (18-65 years) Page 30 of 32 conclusion. Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 03000 616161 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 32 of 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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