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Inspection on 08/09/09 for Mancroft Cottage

Also see our care home review for Mancroft Cottage for more information

This is the latest available inspection report for this service, carried out on 8th September 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Key inspection report Care homes for adults (18-65 years) Name: Address: Mancroft Cottage 2 Mancroft Road Wolverhampton W Midlands WV6 8RS 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: Jonathan Potts Date: 0 8 0 9 2 0 0 9 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. 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 Care Homes for Adults (18-65 years) Page 2 of 35 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 35 Information about the care home Name of care home: Address: Mancroft Cottage 2 Mancroft Road Wolverhampton W Midlands WV6 8RS 01902742428 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): mancroftcottage@btinternet.com Mr Scott Bird Name of registered manager (if applicable) Mrs Carol Austin Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 3 0 care home 3 learning disability Additional conditions: The maximum number of service users to be accommodated is 3. The registered person may provide the following category of service only: Care home with personal care only- to service users of either gender, whose primary care needs on admission to the home are within the following category: -Learning Disability (LD) (3) Date of last inspection 1st Key Inspection Care Homes for Adults (18-65 years) Page 4 of 35 A bit about the care home Mancroft Cottage is sited in a desirable suburb of Wolverhampton near public transport links to the City centre. The house, which is in an established residential area, is a large detached property that consists of a large lounge, dining room/office, kitchen, separate laundry downstairs with three single bedrooms upstairs. One of the bedrooms is ensuite and the other two bedrooms are serviced by a large bathroom with bath separate shower and toilet. This is also a toilet on the ground floor. A small but private garden area is available to the rear of the house. Care Homes for Adults (18-65 years) Page 5 of 35 STAFF AVAILABLE 24 HOURS The house offers accommodation for up to 3 physically able adults with a learning disability. People living at the home are supported by 24 hr on site staffing. The owner currently works as one of the staff team, and is supported by a registered and a deputy manager. Information about the home and the service is offered in the homes guide. Current fees range between 1150 - 1500 pounds per week. Additional charges may include toiletries, clothes, furniture (if in addition to those provided) electrical items, additional costs of meals outside the home, cost of activities outside the home not covered by Social Services funding, and any willful damage. Care Homes for Adults (18-65 years) Page 6 of 35 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 7 of 35 How we did our inspection: This is what the inspector did when they were at the care home We did not tell the home we were going to visit, and arrived at Mancroft Cottage at 9.30am on the 8th September 2009, leaving at 4.45pm. The visit was carried out by one inspector. Before we visited the home we reviewed all the information we had received about it since our last check of the home, this including information sent to us by the homes manager (this in a document called an Annual Quality Assurance Assessment - AQAA). We also considered all the information that we have received as a result of the homes recent registration with us. We also sent out Survey forms. We received 7 of these back, 2 from people living at the home and 5 from staff. Care Homes for Adults (18-65 years) Page 8 of 35 We spoke to the people living at the home, the registered manager, the deputy manager and the homes owner (who is also a member of staff) during our visit. We also looked at care and management records as well as having a look around the building. What the care home does well The home carries out robust checks and completes detailed support plans that include the people living the home and others. The home carries out robust checks on any risks and minimizes these as far as possible. Care Homes for Adults (18-65 years) Page 9 of 35 The staff promote individuals health care needs. The home asks people what they want to do and wherever possible facilitate involvement in day to day activities they enjoy. One person said that they does cooking well. The house people live in allows space for privacy, and is well maintained. People told us they like the staff and house. Staff are motivated and have an interest in providing the people living at the home with the best possible support they can. They told us that Having not been open long I feel that all management are doing all they can to make it homely , they deliver good personal attention to individuals care and support needs and puts the needs Care Homes for Adults (18-65 years) Page 10 of 35 and wishes of the service users first , a totally person centered approach. The management of the home are qualified, experienced and have the drive to work toward improve outcomes for people living at the home. Staff told us they are treated equally and with respect. We are supported, encouraged at all times. What has got better from the last inspection 1st Care Homes for Adults (18-65 years) This is the first main inspection of the home. Page 11 of 35 What the care home could do better The support plans people have would be better if supplemented by an easy read summary of their main points. To ask people that they do consent to the staff holding their medication on their behalf. To minimize the risks that may be presented from hot radiators so that the chance of people being burnt is minimized. There are some areas where staff need further training so as to improve their knowledge and skills, and allow them to improve outcomes for people. Care Homes for Adults (18-65 years) Page 12 of 35 If you want to read the full report of our inspection please ask the person in charge of the care home CAROL AUSTIN OR SCOTT BIRD If you want to speak to the inspector please contact Jonathan Potts 77 Paradise Circus Queensway Birmingham W Midlands B1 2DT 01216005300 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 13 of 35 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 14 of 35 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. People who are considering moving into Mancroft Cottage are given information and have ample opportunity to sample the service, this so they are able to decide if they wish to live there. Evidence: We looked at the information available within the home for people that live there, this in books about how the service works and for who it is provided (These called the statement of purpose and service users guide). We saw that these are detailed documents and contain much accurate information about how people are provided a service, the building, the staff and what people can expect from the management. The service users guide is easier to understand for people, this as it is shorter than the statement of purpose and is supplemented by pictorial images. We looked at the pre admission checks for two of the people living at the home and these showed us that the home takes great care in ensuring that Mancroft Cottage can provide a service to people that they want. One of the people living at the home told us that she had been given information about the home, although we saw from the assessments that Care Homes for Adults (18-65 years) Page 15 of 35 Evidence: we looked at that the home has used visits to the service, and discussion with people as a way of ensuring they know what Mancroft Cottage can offer them. Both of the detailed pre admission checks showed that people had visited the home on a number of occasions before deciding to move in, this initially for short visits then for overnight stays. We also saw that the staff at the home had involved others who knew the people moving in (such as their relatives, social workers and health professionals) to find out what was important for them, and what they would need to do to ensure they had the support they needed. We saw that the pre admission checking process was carried out over a period of time (over a month) to allow people to get to know the home, the staff and the service they would receive. This allowed people to make an informed choice about moving into the home. The homes checks allowed staff to draw up an initial support plan that was centered around peoples needs, and made clear reference to what they themselves saw as important in terms of long term goals and day to day life. We saw that checks have been carried out shortly after people have moved into the home to ensure they are happy with the service they receive, this with the involvement of any other significant people such as social workers and family. We saw that people are offered contracts, these available in two formats, one more concise and supported by pictorial images. We saw that people have agreed to the homes terms and conditions with time taken by staff to explain what they are. Care Homes for Adults (18-65 years) Page 16 of 35 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. Individuals are involved in the planning the support they receive, and are helped to identify their goals and aspirations. Evidence: We looked at the individual support plans for two people living at the home and found these to be comprehensive, drawing on checks carried out with individuals. They clearly set out goals for the individual, in relation to physical, health, behavioral and lifestyle needs with detail as to how these would be achieved with the support of staff. Discussion with the manager showed she had a very good understanding of individuals needs, these as detailed in the plans that we looked at. Staff also told us in surveys that they have access to information as to individuals care needs. Discussion with individuals showed us that those areas of their plans we spoke to them about are accurate and reflect their needs and aspirations. We found that communication plans reflected the way individuals communicated with us, and saw the way that staff spoke to individuals reflected their understanding of how individual’s best communicated with them. Whilst we saw that individuals have signed and agreed some of the information in the Care Homes for Adults (18-65 years) Page 17 of 35 Evidence: care plans, with on going progress discussed with them at monthly key worker meetings the support plans themselves are large and very detailed. We discussed with the manager as to how these could be presented in an easier to read format so that individuals can see a summary of the plan in a format that is understandable to them. This is an area that the manager was aware needed development and we saw suggested formats that she was considering using, this based around easy read and pictorial formats. We saw from recording, minutes of meetings as well as checks that individuals are involved in, that individuals are involved in making decisions as to their life, this supplemented by what we saw in support plans. We also saw that where individuals need support to express their views independent supporters such as advocates are employed. The support people need with their finances is outlined in their individual plans with support provided by the placing authority where needed. We saw that the support plans are supported by a range of detailed risk checks. These risk checks are in response to specific areas of the support plan and cover areas where there is potential risk to individuals, with detail as to how these can be minimized. We discussed some specific areas of risk that had been identified with the manager, and how an individuals capacity to make decisions would mean they are able to take responsibility to take risk. The manager identified where there was some need to look into some of these to reflect the individuals capacity to take risks. Care Homes for Adults (18-65 years) Page 18 of 35 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 living at the home are able to follow their chosen lifestyle and support from staff and community services is promoted to help development of their life skills. The home is continuing to find out what peoples social, educational, cultural and recreational expectations are and is striving to provide for these. Evidence: We saw from support plans, checks and meetings where people looked at the support provided that people are involved in deciding how they wish to live their life at the home. We spoke to people living at the home and one told us that they are happy there and told us about the things they liked to do. These activities we saw to be clearly reflected in the individuals support plan. Another individual told us that they supported the local football team and again this we saw reflected by their clothing and the decor in their bedroom. Discussion with the manager showed that she felt that the service was person centered although was clear that this would improve further as the home developed. It was clear Care Homes for Adults (18-65 years) Page 19 of 35 Evidence: to us that the staff had spent much time drawing out what was important for people as individuals during the transition from their previous home to Mancroft. We saw that staff called individuals by their chosen names (this as people told us and as noted in support plans) and we saw staff showed respect to people in the way they spoke to them. We also saw that staff knocked peoples bedroom doors and asked their permission before entry. People living at the home are able to have the front door key if they wish and their bedroom door key, although the later were to be distributed on the day of our visit as new locks had been fitted (ones that could be locked on the inside without a key). We saw that each individual living at the home has their own activity plan, these said to be a guide, although we did see that the activities they are involved with do reflect their chosen preferences. When we arrived at the home people were getting ready to go up to the town with staff. When we spoke to the individuals they were looking forward to this and when they returned to the home, they spoke of what they had done and how they had enjoyed it. It was noted that staff used the bus service (with a bus stop close to the home) rather than use a car, this promoting independence and offering the opportunity for exercise. As the home has only recently admitted people after opening the manager stated she is still trying to source some occupational activities from such as colleges, although one individual is attending an adult training centre and also does some voluntary work in a local shop. The manager is also trying to source free bus passes for people living at the home to assist with independent (a goal for some individuals), and cheaper travel. We heard from one individual living at the home that they enjoy ironing and cooking, this an activity that they told us they do regularly. We also saw that the staff have taken photos of the person with cakes they have baked to capture the moment. We saw that there are house meetings where all the people living at the home meet to discuss various issues relating to how the home is run such as what the staff can do (key working), decisions about the television (due to some disagreements as to which channel should be on), activities, trip out and at one changes to the homes information guides. These we saw are agreed with people living at the home through their signature. Peoples support with their relatives is clearly detailed in their support plans, with such as agreed times when they will visit and take a person out. The home we also saw supports individuals to maintain relationships with other people, also providing advice as needed to ensure that risks are reduced. The manager was clear though that they would not look to take away peoples responsibility, such as keeping their room tidy or maintaining relationships, although would encourage informed choices. If staff are unable to provide specialist advice they have, and will source other professionals who can better provide this. We did see that the staff have explored such issues through risk checks that complement support plans. Care Homes for Adults (18-65 years) Page 20 of 35 Evidence: The home does not yet have set menus although the manager told us how she is using tester menus to get an idea as to what foods people like. The manager was conscious of the need to balance peoples choices of unhealthy foods with an intake of healthier options, this as we saw recorded on a daily basis, meal by meal basis. The foods people have also broadly reflect their likes and dislikes as recorded in their pre admission checks, with what saw are healthier options to balance out those that are not so nutritional. None of the individuals living at the home currently have special dietary requirements. We saw during the course of the visit that people are able to access a homely kitchen area and have involvement in food preparation and making themselves drinks. The home also has a spacious and pleasant dining area. Care Homes for Adults (18-65 years) Page 21 of 35 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. The personal support, health and personal care that people receive is centered on their personal needs and also reflects their choices. Evidence: People at the home are independent and need little hands on support with personal care, but require more verbal prompting to complete tasks; this as clearly laid out in individual support plans. We saw that individuals were clean and well presented at the time of our visit, and also looked well. The staff did however comment that there are times where males living at the home may chose not to shave and this choice is respected. We saw that people have the choice as to whether they wish to bathe or shower, this confirmed by the one individual we spoke, to who stated they liked to use the shower. The manager did talk about the fact that the staff group is predominately female, and two of the individuals living at the home are male. It was stated that this would be a factor that she would consider with the recruitment of new staff. We saw that individuals have ready access to health care services as needed this including their G.P and others such as dentist, optician and such like. The records kept by the home in respect of this access are well documented showing that any health care needs result in prompt referral by the home. We saw from records that individuals are Care Homes for Adults (18-65 years) Page 22 of 35 Evidence: supported to visit health services, this as should be the case as it encourages community integration. We saw that the home has information available to assist staff to learn about individuals health care, an example of this epilepsy. Whilst staff are yet to have any formal guidance in this area the homes procedures are detailed and clear. The manager also told, and showed us how they have promoted the individuals awareness of their own health through such as an easy read guide to epilepsy. The manager also showed us and explained how they are developing stand alone health care action plans for individuals, these to assist with the monitoring of individuals health care. We saw that there are some areas where staff would benefit from input in specific health care issues such as epilepsy although the manager was clearly aware of this, and is prioritizing training for the staff team. In light of the short time the home has been open, having people living there for a matter of a few months only, we agreed that the specific training staff need to address areas of health care need may take time to source, and training needs do have to be prioritized. As stated the manager has in the meantime ensured that staff do have clear written guidance in respect of health care matters (as we saw). We looked at the homes medication procedures and found these to be detailed and accessible to staff. We also looked at individuals medication records and found that these are well maintained. The manager has implemented a number of checks to monitor the giving of medication, handling and storage, with none of the staff giving out medication until she has carried out a competency assessment. We looked at the storage of medication and found that this was acceptable, with the home not holding any controlled drugs. We saw that support plans identified goals that included individuals working toward self administration of their medication. We did advise the manager that the issue of consent to medication needs to be explored with individuals, with their choices clearly documented to show this is the case. The majority of staff have undertaking a distance learning course in the administration of medication, this one of the areas of health care training that the manager has given priority. Care Homes for Adults (18-65 years) Page 23 of 35 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 who live at the home have access to a robust complaints procedure. The homes practices protect people from harm and abuse through management of risk. Evidence: We saw that the home has a complaints procedure that is available to people living at the home, this in a format that is supported by pictorial images. The homes complaints procedure was seen to have clear timescales by which staff would respond to any concerns. This is accompanied by an I am worried cards that are kept in the front hallway, these stamped with the address for social services. One person living at the home told us in a survey form that they knew who to speak to if they were unhappy, knew how to make a complaint and said that staff usually listen and act upon what they say. We spoke to one other person living at the home during our visit and they too confirmed they knew who to speak to if unhappy, and felt safe at Mancroft. We discussed complaint handling with the manager who showed a clear understanding of what to do if concerns did arise, this including the need to notify relevant agencies and document all appropriate information. Staff also told us that they knew what action to take if any of the people living at the home had concerns or complaints. The manager told us that discussion with staff about Care Homes for Adults (18-65 years) Page 24 of 35 Evidence: possible areas of concern would form part of their on going formal supervision. The manager also has shown us that she has a good understanding of safeguarding, her responsibilities in this area and the fact that she puts a high priority on keeping people living at the home safe. We saw that the home also has procedures in place in respect of safeguarding people living at the home, this supplemented by copies of the local social services safeguarding procedures, these also available in the house in an easy read format. We saw that the home has other procedures relating to such as management of peoples monies that set out how these will be protected, as we saw within individual risk checks and through clear recording of valuables kept by the home on behalf of individuals. These records included those relating to money and property. We saw that the manager completes regular checks on valuables safe kept and that any monies/valuables safe kept are checked daily when staff handover between shifts. We also saw from records that individuals in some cases have advocacy or other named professionals that they have contact with as well as relatives whom they would be able to talk to if unhappy. Care Homes for Adults (18-65 years) Page 25 of 35 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. Mancroft Cottage offers people that live there a safe, well maintained and homely environment in keeping with their needs. Evidence: The house is sited in a residential street, and blends in with the neighborhood, with positively no indication of the fact that it is anything but a domestic property. The size of the home enables it to allow a more family/home like environment as opposed to a larger unit. The house is easy for a person to familiarize themselves with, and we saw that people found there way around with no problem, accessing their bedrooms as and when they wished. Access to public transport is easy from a bus stop close to the home. We saw that people could have privacy in their bedrooms when they wanted. The home has a small but private rear garden, the manager telling us she wants to develop so that it provides scope for recreational activities such as gardening. She said that the plan is to purchase raised planters so that people living at the home can grow their own plants if they wish. We saw that the building is decorated and furnished to a high standard and presented as very comfortable. The house is spacious and there is ample space available for the three people living at the home and the staff on duty. People living at the home have access to Care Homes for Adults (18-65 years) Page 26 of 35 Evidence: a spacious lounge, separate dining room, kitchen and laundry. All have single bedrooms one with an en suite. Two people living there have access to a large bathroom with separate shower, bath and toilet in the absence of en suite facilities, this sited close to their rooms. All bedrooms are fitted with turn bolt locks, with keys available to people should they wish to hold them, as are front door keys. We looked at two of the bedrooms with the permission of the occupants (who showed us them) and they told us that they like their rooms. The rooms we saw are decorated to reflect individual tastes and have double beds which have been requested by the room’s occupants. The people living at the home are all physically able, so there is little need for adaptation of the property to meet physical needs at present, although the provider did tell us that he plans to fit radiator covers in the near future to ensure that any risk from hot radiators is minimized. We did advise that a risk check is put in place until this work is done, this to highlight how any risks from hot surfaces are minimized with the absence of covers. Hot water, whilst not regulated at taps, is controlled from the main boiler. We saw that the staff carry out regular checks of the water temperatures to ensure they are safe. Certification by contractors that we saw in respect of checks on such as gas equipment have further verified the safety of the home. We are aware from the checks carried out before we recently registered the home, and from discussion with the manager, that the owner has spoken to the fire prevention and environmental health departments, taking their advice as appropriate. We have seen that the home has checklists in place to ensure that it is kept safe, these checks carried out monthly. We saw that all areas of the home smell fresh, this including toilets and the laundry. People have access to liquid soap and paper towels with guidance displayed in areas on safe hand washing. We also saw that staff have access to national guidance on infection control. Care Homes for Adults (18-65 years) Page 27 of 35 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are available in sufficient numbers to appropriately support the people living at the home and the home ensure they are safe to work with vulnerable people. Evidence: We looked at the homes staff rota and found that this reflected the staff we found on duty during the time we were at the home. From discussion with the manager and sight of staffing records we saw that all the staff are permanently employed by the provider, and agency staff are not used. This assists consistency for the people living at the home, as does the fact there is a small staff group. We judged there to be sufficient staff on duty to meet the support needs of people living at the home. We did see that the social services departments paying for the placements have allocated set hours for the people living at the home to have 1:1 with staff. We saw that there was very clear weekly recording to show exactly how this time was allocated to each individual, evidencing the support hours the home is paid for. We judged this to be good practice, and useful if there is a need to request additional 1:1 hours, this as commissioners can see how the hours are allocated. Five staff told us that there was usually or always enough staff available. We spoke to people living at the home, one saying they liked the staff. Care Homes for Adults (18-65 years) Page 28 of 35 Evidence: We looked at the homes recruitment procedures which we saw are appropriate. When we looked at staff recruitment records we saw that checks of prospective staff, to ensure they are safe to work with vulnerable adults are carried out, this including enhanced disclosures. These checks are carried out prior to their employment. We saw that staff have, or are in the process of completing a suitable induction programme. The manager told us that she had considered the personal qualities of people applying for positions at the home, and how this fitted in with the service that they were looking to provide. This as a result led to some staff, whilst having caring qualities and a good attitude, not always having formal qualification. This is not the case for night staff however as the manager evidenced that more experienced and trained staff have been recruited to these positions, this as they are lone workers. We looked at the homes training plan and discussed training with the manager. Whilst there are some gaps in training provision we considered that the staff group is a new team that has only been employed by the home for a short period. The manager showed us that she is prioritizing training so that areas of greater need are addressed first. This was demonstrated by the fact that the majority of staff have completed medication training with a number having some input in safe working practices. She has also told us that when staff have completed their induction she will be looking to enroll them on vocational training. Based on the training input the staff have received in the short space of time the home has been open it can be seen that the management value the importance of training and how this can improve outcomes for people living at the home. We saw from looking at supervision records that staff are offered regular (as 5 staff confirmed) and appropriate support by the manager, these sessions focusing on work performance, training as well as discussion of the key worker role and individuals support needs. Five staff told us that they always or usually have the right support to meet individual needs. Care Homes for Adults (18-65 years) Page 29 of 35 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home are committed to developing a quality service that provides good outcomes for people living at the home. Evidence: We saw that the homes certificate of registration was on clear display in the front hall of the home and is the most current certificate that we have issued. The categories of registration reflect the service the home says it will provide in its guide to the home. The homes owner and manager have recently undergone checks through their registration with us, this showing us that they are competent to run a care home such as Mancroft Cottage. Discussion with the manager and owner (who is also one of the staff) has not changed our view in respect of their competence, as they have shown us that they have a good understanding of the needs of the people that live at the home and fully understand their responsibilities. The manager also evidenced that she has the expected vocational management qualification, as well as suitable previous experience of working with people with a learning disability. Care Homes for Adults (18-65 years) Page 30 of 35 Evidence: We discussed the arrangements for management of the home in light of the owner also been one of the staff and the manager told us that this not present any issues, as channels of communication are clear with regular meetings between herself, the deputy and the owner to discuss all matters relating to the home. Both the owner and manager are also clear as to their specific areas of responsibility, with the manager telling us that the owner allows autonomy to manage within the responsibilities of her role. Discussion with management showed a clear awareness of where the service needed to develop, this supporting what the manager had stated in the information she sent us before our visit to the home. We saw that the home is developing robust systems for checking the quality of the service such as regular audits of medication, safety checks and such like. The regular checks and meetings with people living at the home also allow the staff to pick up on peoples views and respond quickly to them. We also saw that the home has satisfaction questionnaires that are to be used in future quality monitoring (one we saw had been completed by one of the people living at the home, this showing that they are pleased with the service they receive). We saw that the home has a detailed health and safety policy that the manager said she has discussed with Environmental Health. We saw that the safety of the people living at the home and the staff is promoted through robust risk checks, although we did suggest to the manager that she should check the level of first aid training needed (as per guidance on our website) and discuss the need to provide food hygiene training for staff with Environmental Health. Care Homes for Adults (18-65 years) Page 31 of 35 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 32 of 35 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 6 To develop supplementary support plans that are in an easy to understand format to assist individuals understanding of them. To explore the issue of individuals consent to medication and record their express choices in respect of this matter. To risk assess any hazards presented by uncovered radiators. To continue with the planned training input for staff in respect of vocational qualifications and other relevant areas of practice as identified by the homes training plan. To carry out a risk assessment in respect of what level of first aid training is needed for staff, this based on the needs of the people living at the home. To discuss with Environmental Health as to what food hygiene training they should provide staff. 2 3 4 20 24 35 5 42 6 42 Care Homes for Adults (18-65 years) Page 33 of 35 Care Homes for Adults (18-65 years) Page 34 of 35 Helpline: Telephone: 03000 616161 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) 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 35 of 35 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!