Inspection on 09/04/09 for Manchester Learning Disability Partnership
Also see our care home review for Manchester Learning Disability Partnership for more information
This is the latest available inspection report for this service, carried out on 9th April 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.
What follows are excerpts from this inspection report. For more information read the full report on the next tab.
Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.
Inspecting for better lives Key inspection report
Care homes for adults (18-65 years)
Name: Address: Manchester Learning Disability Partnership Short Breaks Service 37 West View Road Northenden Manchester M22 4LP The quality rating for this care home is: Three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Steve OConnor Date: 1 4 0 4 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: ï· Put the people who use social care first ï· Improve services and stamp out bad practice ï· Be an expert voice on social care ï· 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 39 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 39 Information about the care home
Name of care home: Address: Manchester Learning Disability Partnership Short Breaks Service 37 West View Road Northenden Manchester M22 4LP 01619457231 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) : Manchester Learning Disability Partnership care home 4 Number of places (if applicable): Under 65 Over 65 4 0 learning disability Additional conditions: The organisation must, at all times, employ a suitably qualified and experienced manager. The matters detailed in the attached schedule of requirements must be completed within the stated timescales. The home provides accommodation and care on a respite basis for a maximum of four adults aged between 18 and 65 years old whose primary need for care is by reason of learning disability. Date of last inspection 0 1 0 5 2 0 0 7 Care Homes for Adults (18-65 years) Page 4 of 39 A bit about the care home The service is based at a house registered with us as a Care Home for Younger People aged 18 to 65.
The house is at 37 West View, Northenden, Manchester, M22 4 We made an unannounced visit on the 9th April 2009 and to the office where the manager is on the 14th April 2009. Up to four people come to stay for a short break. The house is easy to get into and around for people who find it difficult to walk or use wheelchairs. The house is on an ordinary street in Northenden near to shops and bus stops and is easy to get around to local
Care Homes for Adults (18-65 years) Page 5 of 39 places like the town centre. Everybody who lives at the home has their own bedroom. Bedrooms have televisions and radios for people to use. They can bring some of their favourite things from home to make the room more personal. There are staff on duty all the time and they help people with things like shopping and cooking, looking after their money, taking their tablets, going out for a nice time and keeping clean and healthy. Care Homes for Adults (18-65 years) Page 6 of 39 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 39 How we did our inspection: This is what the inspector Steve O’Connor did when they were at the care home. We asked the manager to send us information about the service. I go out for a meal, I like the garden and helping. We spent time sitting with people and asking them about their stay and what they enjoyed doing. Care Homes for Adults (18-65 years) Page 8 of 39 We visited the house and talked to the manager and some of the staff about what they do and how they help people. We looked at some of the policies and procedures in the office. Policies are rules about how to do things. Procedures tell people how to follow the rules. We also looked at some care plans as well. We sent questionnaires to people who use the service, to some carers to find out what they feel about the short break service. We also sent some to staff so they could tell us what it was like working there.
Care Homes for Adults (18-65 years) Page 9 of 39 What the care home does well People and their carers were given lots of information and the chance to visit the house before deciding if they wanted to come and stay for a shortbreak. The staff worked with people and carers to find out all about the person and how they wanted and needed to be helped. Each person had a Support Plan that had lots of information about the person that told staff the best way to help people and what they can do themselves.
Care Homes for Adults (18-65 years) Page 10 of 39 One person’s plan said, I like to put my sock on my left foot first and I can put on my own trainers.’ The plans also explained to staff what was really important for the person. These are called Golden rules and for one person this was to ‘talking to him and explain what’s happening at all times.’ The plans also told staff lots of personal information about people so that they can try to make sure people are happy during their stay. One person’s plan told staff what makes them unhappy, ‘does not like the wind, noisy places, lifts and crowds.’ Another person’s plan tells the staff how they like their drinks. Care Homes for Adults (18-65 years) Page 11 of 39 ‘I like tea with no sugar in a mug and the tea needs to be cooled down.’ The support plans told staff what people liked and did not like to do for fun. One person’s plan told us that they liked going to the cinema, meals, colouring books, watching comedies programmes, looking at the garden, helping in the garden, watching DVD, singing, going to shops and buying favourite magazines. One carer said the ‘everyone gets a choice and chance to do something they like, they always come home having had a good time.’ Care Homes for Adults (18-65 years) Page 12 of 39 Staff understood how people expressed themselves to make choices and to tell people how they feel. The support plans told staff the best way to give people choices and one person’s plan explained that they Understands better if you show me the objects that go with the subject and better if use actions and mimes and I use gestures. People and their carers knew that they could speak to staff if they were unhappy about anything. All the people who contacted us said that they knew who to talk to if they were worried about anything. One person said, ‘I know that I can speak to staff if I am
Page 13 of 39 Care Homes for Adults (18-65 years) unhappy.’ During the visit to the house we saw people and staff talking to each other, joking, smiling and laughing together. Staff spent time with people and not with other staff. One carers said, ‘All staff are very friendly and easy to approach. All have a genuine attitude to care both with my son and myself, an excellent holistic approach.’ Carers felt comfortable and confident that people would be looked after and have a good time on their short break. One carer said, ‘Since my son has been attending Westview he has improved his behaviour, he always looks forward to his
Page 14 of 39 Care Homes for Adults (18-65 years) time there. I always feel confident in staff ability to care correctly for my son both physically and emotionally.’ Staff received training to help them do their job and to help people in the best and safest way. One member of staff said, ‘Training is always ongoing and I feel it relates well to the service we provide.’ The staff surveys showed that they felt that they were being supported by the manager and that they had the chance to meet with them at team meeting, job consultations and working with her on shifts. One staff member said, I can discuss anything with her at any time.’
Page 15 of 39 Care Homes for Adults (18-65 years) What has got better from the last inspection What the care home could do better Care Homes for Adults (18-65 years) Page 16 of 39 Several carers told us and had told the manager that they thought that if they had their own transport then people could go out on different outings and maybe go out more often. The manager knew this and they were trying to find out if it was possible to get their own transport. If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 17 of 39 If you want to speak to the inspector please contact Steve OConnor Care Quality Commission 3rd Floor, Unit 1 Tustin Court Port Way Preston PR2 2YQ Tel: 01772 730 100 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 18 of 39 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 19 of 39 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. Prospective users of the service are assessed to establish their support needs and whether the home can meet those needs. They and their families receive relevant information to help them make choices to use the service. Evidence: The service had a clear way to receive referrals from local authority care managers. A care management assessment of need and a detailed risk assessment check list was provided and used to decide whether the service can meet a persons needs. Experienced staff undertook an in-house assessment by visiting people and their carers and then they would come to visit the home for tea visit and overnight stays. In this way the staff were able to develop a relationship with the person and carers and for the manager to make a final decision as to whether the service can meet their needs and what further support, aids or equipment may be required. The manager maintained a detailed record of all the referrals and introductions including the visits to see people and their visits to the service. Records of a persons visits were made by the staff and this information was used to further develop the assessment and a support plan.
Care Homes for Adults (18-65 years) Page 20 of 39 Evidence: To help people and their carers make an informed choice whether to use the service they are provided with a Short Breaks Introduction Pack. This contained the Service Users Guide and other important information about the service. This was provided in different languages such as Urdu and Punjabi and could be changed to formats such as large print. This meant people and carers were informed about what they should expect to receive from the service, their rights and what they should do if they have any concerns. Care Homes for Adults (18-65 years) Page 21 of 39 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
. There was a clear system and practices for identifying the support to meet peoples needs and any risks they may experience. Risks were identified and acted upon so that people were supported correctly and safely. The staff encouraged people to make choices and decisions about their day-to-day experience and routines. Evidence: The manager was given a Care Management Care Plan by the local authority that described a persons needs. From this and the in-house assessment, further information was gathered to develop a personal care plan. The three support plans that we saw contained detailed and specific information that described in great detail what support a person needed to meet their individual needs and goals. Their likes, dislikes and choices in relation to daily routines were consistently recorded. The support plans focused on the person and what they wanted and felt was important. These person centred plans gave staff a clear understanding of the person and was considered an example of good practice. Care Homes for Adults (18-65 years) Page 22 of 39 Evidence: The amount and level of detailed information, in the support plans, reflected the complexity and range of peoples needs. Specialist guidance was also seen to support people in areas such as their mobility, nutrition and health. There may be long gaps in time between peoples stays. To make sure that the care plans were accurate they were regularly reviewed and carers were contacted so that the information and persons needs were still accurate, especially in relation to medication. Any changes in support needs were recorded in the support plans. The people using the service, at the time of the visit, communicated their needs and emotions through a range of verbal and non-verbal communication. The support plans did contain information about how they communicated their needs. However, through talking to and listening to how staff talked and understood people it was found that not all of this information was recorded in the support plans. It is recommended that the support plans contained clear and detailed information describing how a person communicated their needs, emotions and choices. The staff worked with the person, carers and other people to find out what they liked and did not like about their daily life such as meals, activities, places and people. By doing this staff try to offer people day-to-day choices and decisions that matched what they liked and enjoyed. Throughout the site visit, staff were observed to encourage people to make decisions and choices according to their preferences. Restrictions of choice were only made to safeguard the health and wellbeing of the person and only as a result of a full risk assessment. As part of the initial referral and assessment a detailed risk assessment was developed that looked at specific areas such as moving and handling, falls, personal care, communication and risks associated with the person being in the house and community. Those things that were identified as hazards were assessed further by the staff or relevant specialist providers and support guidance in reducing those hazards and risks were developed. Care Homes for Adults (18-65 years) Page 23 of 39 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 were offered the choice and support to take part in activities within the house and in the community that they enjoyed. Visitors were welcome and peoples routines were based on their own preferences and activities. Evidence: People used the service for a short time to give them and their carers a chance for a break. If a person already goes to a day service then they will continue to go during their stay. People had opportunities to visit local cafes, restaurants, pubs and other social activities, that they enjoyed, during their stay. People also had the opportunity to take part in domestic jobs such as shopping, preparing and cooking meals if they wanted. Comments from carers and the staff spoken to during the visit said that if they had their own transport then they could offer people more of a choice in leisure activities. This issue had already been identified by the service and was being looked at to see if
Care Homes for Adults (18-65 years) Page 24 of 39 Evidence: it was possible. It is recommended that peoples access to leisure activities and the use of the services own transport be considered. Peoples support plans contained information about what they liked and did not like to do for their leisure and included activities such as going out for meals, the cinema, walking and singing. One person said how much they liked helping in the garden, which was smashing and showed through their words and actions that they enjoyed staying for a short break. The staff kept to, as far as possible, the routines that people have developed in their own homes. These routines were clearly recorded in their support plans but there was also a high degree of flexibility, which meant that people could follow their normal routines or have a change if they wanted. Visitors were welcome to visit at any reasonable times but the service provided a short break away from peoples carers and so this would not happen often. As the service provided short breaks the choice of meals had to remain flexible and was dependent on what people liked and their dietary needs. Staff supported people to go shopping so they could make individual choices of foods that they enjoyed. Information on food likes and dislikes was used to decide the choice of meals and staff encouraged people to keep a healthy balanced diet with the availability of fresh fruit, vegetable and ingredients. Giving people the opportunity to eat out at cafes and restaurants was also seen as an important part of the stay. Care Homes for Adults (18-65 years) Page 25 of 39 Personal and healthcare support
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People were supported with their personal and healthcare needs in the way they wanted. People were given the medication they need at the right times to keep them well and healthy. Evidence: People had their own personal care checklist and staff used support guidance that described in detail how the person wanted to be helped. This set out clearly what the person could do themselves and what help they needed. It also included very person focused information such as the type of toiletries they liked to use and the order that they like to get dressed. It is recommended that the personal care guidance focuses more on what people can do themselves and then what help they may need. Peoples support plans recorded their morning and night-time routines and also included information about their preferences such as who they might want to provide personal care. Also, night-time preferences were recorded such as how they liked/needed their bed to be set up, the time the person liked to go to bed and get up in the morning. Peoples healthcare needs were found out before they came to stay. Health needs,
Care Homes for Adults (18-65 years) Page 26 of 39 Evidence: such as epilepsy, and the support needed, were clearly identified and guidance from the relevant healthcare service had been gained. Specific skills needed to support peoples healthcare needs were given to staff such as how to help a person with percutaneous endoscopic gastrostomy (PEG) feeding. Risk assessments showed if there was any behaviours that may affect the wellbeing of the person or others. Examples of guidance to staff in how to work with people safely were in place but it is recommended that any behavioural guidance is sufficiently detailed and related directly to the actions needed to be taken by staff to minimise the impact of such behaviour. Important health information was also kept that might be needed during the persons stay if they became ill and required emergency treatment or go to hospital. Any risks relating to how staff supported peoples personal and healthcare resulted in a risk assessment and, if needed, guidance from relevant health agencies. Those people who needed help with mobility had their needs identified through moving and handling assessments. Talking to the manager and staff highlighted that when supporting people in the community they would often link arms to support and give reassurance. It is recommended that any kind of physical support be fully risk assessed in terms of the safety of the person and the staff supporting them. Each person had a medication file that listed all current medication and an assessment of what help they needed. Changes in medication or they way it was given had to be told to staff before the persons stay. If the medication that arrived with the person was different from that listed then staff would contact the persons GP to confirm the changes. All the medication that comes with the person was recorded on a Medication Administration Record (MAR) sheet. The MAR sheets seen were accurate in recording the dosage of medication given. The quantity of medication was checked daily and MAR sheets were regularly checked by the manager. Care Homes for Adults (18-65 years) Page 27 of 39 Concerns, complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People and or their carers were encouraged and support to talk about their concerns and worries and to make a complaint if they were not happy with the service. The systems and procedures were in place for the protection of people from abuse. Evidence: The service was part of the Manchester Learning Disability Partnership (MLDP) Short Break service and linked into the formal Manchester Adult Social Care departments formal complaint policy and procedures. This was a clear and well-established way of making a complaint. Information about how to make a complaint had been given to people and their carers. The service provided an easy read pictorial booklet to help them understand that they can talk about their worries and concerns. All the carers who responded to the surveys we sent them recognised that they had the right to make a complaint, had been given information how to do so and were comfortable raising any concerns with the staff and manager. One carer stated, Comments, complaints and compliments has all been explained to us. We know that any issues or concerns would be dealt with in a professional way and we would be kept up-to-date. The manager kept a record of all formal and informal complaints and concerns where people and carers had contacted the staff or manager to discuss things that they were
Care Homes for Adults (18-65 years) Page 28 of 39 Evidence: not happy with or concerns that they have. The staff would try to put right any concerns raised at the time or may need the manager to deal with it. The log recorded the actions taken and the outcome for the person concerned. The service follows the Manchester Multi-Agency Adult Protection Procedures. The staff team had access to a rolling programme of adult protection training and those spoken to during the visit were able to explain what they would do if an allegation or incident happened. Comments from surveys returned by carers all confirmed that knew who to speak to if they had any concerns about peoples safety. The way that peoples monies and spending was recorded showed what monies came in, what had been spent on such things as personal shopping or social activities and how much returned home with the person. Examples of the recording sheets were seen and found to be accurate. Peoples finances were checked every day by the staff and also by the manager on a regular basis. All new staff recruited by the service needed to have a Criminal Records Bureau (CRB) check including being checked against the Protection of Vulnerable Adults (POVA) list to make sure they were safe to work with people before beginning work. Care Homes for Adults (18-65 years) Page 29 of 39 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People enjoyed staying in a clean, well maintained and modern decorated house that had the facilities and layout to meet their mobility needs and provided a safe and homely environment. Evidence: Since the last inspection visit the house had been decorated throughout with many new fixtures and fittings and carpets. The home was clean, well maintained and nicely decorated in a modern style throughout. All furniture, fixtures and fittings were of a good quality. All areas of the house had wide doors to allow easy use for wheelchair user. The layout of the house allowed people the chance to spend time together or in private in a relaxed and homely atmosphere. People were encouraged to bring in some possessions to make bedrooms more personal. The ground floor bedroom was specially adapted for people with high mobility needs with a tracking hoist and had its own shower room with the equipment and aids to help people with their movement and personal care. Staff used colour coded chopping boards when preparing food and were aware of the need for good food hygiene. It is recommended that the manager identified those staff who need to have their food hygiene safety certificate renewed. Care Homes for Adults (18-65 years) Page 30 of 39 Evidence: The washing machine and dryer was suitable for the demands made in keeping clothes clean. All areas of the house had alcohol gel for staff to wash their hands and equipment such as disposable gloves and aprons. It was found that gloves were being kept in the bathrooms and it is recommended that the guidance from the local Primary Care Trust (PCT) regarding storing such equipment in a separate area be adopted. Care Homes for Adults (18-65 years) Page 31 of 39 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People benefited by having their needs understood and met by a staff team who have the skills and knowledge required to support them safely. The necessary recruitment practices and checks were in place to make sure that peoples safety and wellbeing was as protected as possible. Evidence: The staff team was made up of an Assistant Network Manager (the registered manager) and 6 support workers. There was at least two staff on duty during the day but this would depend on whether the people staying at the home attended a day service or not. To cover staff days off, holidays and sickness, staff were used from either the Manchester Learning Disability Partnership (MLDP) own bank or private agency staff. The MLDP bank staff covered the majority of shifts and several of the staff team work for this bank and provided better consistency of staffing. The relationship between the people and staff was seen as very positive and friendly with a lot of jokes and banter between them. The staff on duty had the skills to communicate and understand people. This meant that they could be more involved in making choices about their daily activities. Members of staff were offered vocational training that was based on the Learning Disability Qualification (LDQ) and the National Vocation Qualification (NVQ) Level 2/3
Care Homes for Adults (18-65 years) Page 32 of 39 Evidence: Award. New and long-standing staff had access to these vocational courses and they had all achieved the NVQ Level 2 and/or Level 3. All new staff members took part in the Manchester Adult Social Care Induction Programme that was made up of training linked to the Skills for Care Common Induction Standards and LDQ. This also involved working alongside and shadowing an experienced member of staff who acted as a mentor. Over the course of the Induction, staff met with their manager and mentor for a four, eight and 12-week review to judge their progress and developed a training and development plan for the coming 12 months. Examples of these reviews and appraisals were seen. All the surveys that were sent to us by staff were very positive about the training they received. A typical comment made by one member of staff was, All the mandatory training is now ongoing, even after several years as it is important that I undertake refresher in these areas. Comments we received from carers about their experiences of the service were very positive in terms of the quality of support given by the staff team. A typical comment given by one carers was that, All staff have excellent skills and experience in dealing with my son. One carer commented on what the service does well, Everything, if ever we have emergency care the staff have gone out of their way to support us. The service also had a way for assessing staff competence in key areas of skills and knowledge such as giving medication safely. This was done through regular job consultations, observation of their practice and the mentoring system whereby experienced staff were given a role in developing and monitoring the competence of new staff. The manager was aware of the changing emphasis on how staff needed to show competence in the knowledge and skills that they have learned. An agenda item was in the staff Job Consultation to look at key areas of their work and was used as an opportunity to assess staff competence. Members of staff went on training given by the MLDP and Manchester Adult Social Care training programmes and from other training providers. Staff training needs were identified through the job consultations and appraisal where, in addition to the core training, specific training relating to peoples support needs were identified and provided. A member of staff spoken to during the visit described the range of training they had gone on over the past 12 months and that they discussed their training needs with the manager. This included Adult Protection, the Mental Capacity Act and Recording with Care. Each member of staff has their own training plan and log that set out what they
Care Homes for Adults (18-65 years) Page 33 of 39 Evidence: needed to achieve to undertake their role e.g. moving and handling, food hygiene, adult protection, recording, eating and swallowing. The plan also includes their training needs for the coming year. The Short Break service had an established way of recruiting staff that included getting the documentation and checks needed to make sure that staff were safe to work with people. This included face-to-face interviews of which one person who used the service would be invited to sit on the interview panel. Also, two written references and CRB/POVA checks were completed before an appointment was confirmed. The manager commented that if they were not on the selection panel then they might not see the application forms and references. It is recommended that the registered manager had access to the required checks prior to staff working at the care home. Care Homes for Adults (18-65 years) Page 34 of 39 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
. People had positive experiences whilst using the short break service that was helped through an effective manager and management structure. People and their carer’s views of the quality of the service were sought on an ongoing basis and actions were taken to improve the service further. Evidence: The manager had day-to-day responsibility for the running of this and another shortbreak service. In agreement with the commission they were the registered manager for the whole short-break service. They were responsible for supervising the staff team and to ensure that standards of care were being maintained. They do this through allocating a large proportion of their time working with people, staff and monitoring the recording and operational systems. The manager had many years experience of supervising and managing services. They have achieved the Registered Managers Award and had taken part in regular mandatory refresher training to maintain their hands-on skills. Through the evidence gathered during the inspection the manager showed that she had the skills and knowledge to manage the service effectively for the benefit of the people they support. Care Homes for Adults (18-65 years) Page 35 of 39 Evidence: The responses from staff surveys found that they all felt that they were being supported by the manager and that they had the opportunity to meet with them on a regular basis through team meetings, job consultations and working with her on shifts and can discuss anything with her at any time. The staff and manager gathered information about the quality of the service provided in several ways. The care management and in-house reviews looked at the support individuals received and staff and the manager hold regular meetings with people and their carers to discuss their experiences. A quality assurance exercise took place in March 2008 where carers were asked to express views on their experiences of the service and what they felt worked and what needed improving. From this a report was produced setting out the key points raised and an action plan had been developed on how these will address the issues. The surveys raised several issues that the service were acting on including the provision of dedicated transport, better access to 1st floor bedrooms and looking at alternative ways of providing a short-break away from the home. The manager carried out a regular audit of health and safety within the home to look at potential risks and hazards. Risk assessments for safe working practices within the home were completed and reviewed annually. The required certificates of insurance were in place. Records were being maintained of hot water sources, fridge and freezer temperatures. It was found that the fridge and freezer was below the required temperature for safe food storage. The records had shown this but staff had not taken any action to rectify it. It is recommended that staff were aware of the required temperatures for the safe storage of food and the actions needed to maintain them. A fire log was being maintained of regular checks of the fire safety system. Self-closing doors had been installed so that they did not have to be wedged open and the fire evacuation procedures took account of peoples mobility issues. A fire risk assessment was in place and being reviewed annually. A letter from the local Fire Authority that was positive in relation to the fire safety arrangements. It is, however, recommended that the manager checks with the fire authority in terms of the frequency of checks required for the integrated smoke alarm, which was being tested on an annual basis. Care Homes for Adults (18-65 years) Page 36 of 39 Are there any outstanding requirements from the last inspection? Yes No ï£ 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 37 of 39 Requirements and recommendations from this inspection
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set
No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 14 It is recommended that peoples access to leisure activities and the use of the services own transport be considered to offer people more flexibility and choice in their leisure activities. It is recommended that any kind of hands on physical support provided by staff was risk assessed in terms of the safety of the person and the staff supporting them to reduce the risk of potential injuries. It is recommended that the registered manager had access to the required checks prior to staff working at the care home to make sure that they were satisfied that staff were safe to work with vulnerable people. It is recommended that the manager seeks guidance from the local fire authority in terms of the frequency of checks required for the integrated smoke alarm, which was being tested on an annual basis, to make sure they were meeting the required fire safety regulations. 2 19 3 34 4 42 Care Homes for Adults (18-65 years) Page 38 of 39 Helpline: Telephone: 03000 616161 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website.
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