Inspection on 04/03/10 for Meadowsweet

This is the latest available inspection report for this service, carried out on 4th March 2010.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Meadowsweet 30/10/07

Meadowsweet 22/06/07

Meadowsweet 22/05/06

Meadowsweet 20/10/05

Meadowsweet 14/06/05

Meadowsweet 02/12/04

Meadowsweet 07/06/04

Meadowsweet 19/01/04

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Chatsworth Care - Tudor Lodge

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Extracts from inspection reports are licensed from CQC, this page was updated on 16/05/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Meadowsweet 14 Meadowsweet Close Raynes Park London SW20 9PB The quality rating for this care home is: three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Janet Pitt Date: 0 4 0 3 2 0 1 0 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 32 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 © (2010) 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 32 Information about the care home Name of care home: Address: Meadowsweet 14 Meadowsweet Close Raynes Park London SW20 9PB 02085449830 F/P02085449830 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) : www.merton.gov.uk/housingsupport London Borough of Merton care home 6 Number of places (if applicable): Under 65 Over 65 6 0 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home 14, Meadowsweet Close is a registered care home for up to six adults with learning disabilities. Six people are currently living there. Meadowsweet is owned by a Housing Association and staffed by the London Borough of Merton. The home is situated in a residential area of Raynes Park close to local shops, bus services and leisure facilities. Accommodation is provided over two floors. One bedroom, bathroom, lounge/dining room, kitchen, laundry room and an office are available on the ground floor. Five bedrooms, one bathroom with toilet and a staff room are available on the first floor. A lift services both floors. The home is staffed twenty-four hours a day. Three meals are provided each day and people who use the service are able to prepare drinks and snacks in between meals. The address of the CSCI is included in the Statement of Purpose and inspection reports are available at Meadowsweet. The fees are varied, depending on peoples income. Care Homes for Adults (18-65 years) Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 6 of 32 How we did our inspection: This is what the inspector did when they were at the care home The Quality Rating for this service is three star. This means that the people who use this service experience excellent quality outcomes. One inspector undertook this unannounced inspection. The home provided us with an Annual Quality Assurance Assessment [AQAA]. Information from this document has been used to inform the report. A site visit was made which lasted three hours. During the visit records relating to care, staffing and training were inspected. Surveys were received from people that live in the home, their relatives or friends and staff that work in the home. We were able to talk with individuals at Meadowsweet and some members of staff that support them. Two people kindly showed us around the home and their rooms. We also looked at information that we hold such as notifications. Care Homes for Adults (18-65 years) Page 7 of 32 What the care home does well What has got better from the last inspection No requirements were made at the previous inspection. Recommendations made at the last inspection were making sure that there was evidence of large purchases made by the people that live in the home, replacement of the flooring in the kitchen and people being involved in the annual development plan. These have been implemented. Care Homes for Adults (18-65 years) Page 8 of 32 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Janet Pitt 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 02072390330 Care Homes for Adults (18-65 years) Page 9 of 32 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. Care Homes for Adults (18-65 years) Page 10 of 32 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 11 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals can be confident that they can make a choice about living at Meadowsweet. Care is taken to make sure their needs are properly assessed to make sure that the home can meet their needs. People are involved in the admission and assessment process and their views are noted. Contracts details the service provision and what is provided in the fee. Evidence: People who chose to live at Meadowsweet are given enough information to help them make a choice about whether to live in the home. Surveys we received from the individuals who live at Meadowsweet confirmed that this was the case. During our site visit we were able to look at peoples records. We found that an assessment of need had been done before a person moved into the home. There was evidence of the individual being involved in this process. An assessment of need was also done when the person moved in. This covered areas such as: health and social care needs and how an individual is able to communicate. Page 12 of 32 Care Homes for Adults (18-65 years) Evidence: Each person is given a tenancy contract for supported housing and a contract of residence. These documents clearly set out the responsibilities of the home and what is expected of the person. Whenever possible people had signed their own contracts. We found that photographs or pictures were used to assist in an individuals understanding and to enable them to participate fully. Care Homes for Adults (18-65 years) Page 13 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are involved in planning the care they need. Care plans lead from the assessment of need and are reviewed regularly. People who live at Meadowsweet are supported to make decisions about how they live their lives. Evidence: The homes AQAA stated: We discuss with clients what activities they would like to do through their residents meetings, all clients have a PCP [Person Centred Plan] where they decide what they want to plan for their lives in the forthcoming year and staff assist them with their dreams, all have a care plan which is updated every six months or when necessary. When we looked at care plans we found evidence to support this. There was information on a persons likes and dislikes, such as doesnt like eating food with others. and likes staff to knock before entering. The care plans detailed individuals day to day living requirements and covered things like Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: waking up times and when a person wanted a bath or shower. The AQAA told us: All the clients use public transport and travel around with staff to do their own shopping and risk assessments are in place to support this. All the clients assist in cleaning their rooms and home and participate in preparing supper in the evening. When we were on the site visit we saw people that live in the home going to the shops with members of staff and helping to prepared lunch and other food in the kitchen. Risk assessments are completed with an appropriate balance between risk and allowing people to live full meaningful lives. Surveys received from people that live in the home confirmed that they were able to chose what they do with their time and are supported to make decisions. Care Homes for Adults (18-65 years) Page 15 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home can be confident that they will be able to make real choices about their lifestyle. The service has a strong commitment to enabling people who use the service to develop and maintain social, emotional and independent living skills. Individuals are able to chose how they live and what hobbies or interests they want to do. Relationships with significant people are developed and maintained. Evidence: The AQAA told us: The clients no longer go to a day centre and so five of the clients are involved in further education during the week....from personal safety, healthy eating and dance classes. One person who completed our survey said: We do lots of different activities. I like my singing group and my cookery classes. Other people who had responded to our survey confirmed that they were able to access the community and keep in contact with friends Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: and family. Relatives or friend who completed a survey thought that the service responded well to individuals different needs,whether it is race, gender, disability. faith or sexual orientation. One person commented; They have been very encouraging in getting my sister to go out more particularly supported by their key worker. Site visit March 2010. On the day of our site visit we observed people making cakes and quiches for a fund raising event they were holding on the Saturday. Staff were giving support and making sure that individuals did as much as possible for themselves. Staff members reported that the idea for the event was the people that live in the home. We were able to evidence from care plans peoples preferred activities. eg cinema and pubs. Each person had an individual weekly plan. The plan included activities such as a and meal out once a month, food shopping every three to four weeks, swimming, time to do housework and preparation of a meal weekly. Two people were planning a holiday to Jamaica later in the year and they showed us where they would be staying and talked about what activities they were going to do on holiday. Throughout the site visit different people went with a staff member to do shopping for the fund raising event and personal items. All the people that live in the home assisted with unloading the food shopping from the car and helped to put it away. One person told us that they went to the Salvation Army and had been on retreats with them that they had enjoyed. The individual also said that they hoped to go and visit a relative for a holiday later in the year. A member of staff said that this was being planned. One persons plan stated Saturday night, beer, good-time, alright. Likes drama and keep fit. Goes bowling and is a DJ at discos. Attends curry club or Gateway. These hobbies and interests were detailed on the individuals assessment of need. We observed that staff treated people that live in the home with respect and encouraged individuals to participate, rather than forcing them to undertake activities. Mealtimes are flexible and individuals are encourgaed to eat a healthy diet. When people were preparing their lunch staff offered choices and empahsised gently the healthier options. Fresh fruit and vegetables were available and people could have drinks whenever they wanted one. Page 17 of 32 Care Homes for Adults (18-65 years) Care Homes for Adults (18-65 years) Page 18 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People received personal and healthcare support in accordance with their needs. Individuals privacy and dignity is respected. People have real choice in what happens to them and are consulted on care needs that they have. Support from health professionals in the community is accessed as needed. medications are only given when necessary. A persons end of Life wishes are sensitively recorded. Evidence: The homes AQAA stated that they: Assist the client to do as much as possible for themselves this way promoting independence, giving the choice about what they want to wear on a daily basis. A care plan is in place to assist staff, bank and agency workers of all care around the client and this is drawn up by the key worker and reviewed once a year or when needed. All clients have a Health Action Plan in place, so that all care needs are seen to. During our site visit we looked at peoples plans.The format was clear and easy to understand and gave good detail on what needs an individual had. At the front of the plan was a client information sheet that detailed a persons preferred name, date of birth, date of admission, religion, key worker, social worker, general practitioner, medication, allergies and next of kin. Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: There was a section on Dos and Donts that told staff what individuals preferences were or what activities where not safe if the person was unsupervised, for example: Do not leave alone with the kettle, risk of burns. The section on day to day living requirements gave information on when a person wanted to get up and when they had a bath or shower. Peoples routine for the day was documented and what assistance was needed to make sure all care is given. Each person had a communication profile that had been complied with input from the Speech and Language Therapy [SALT] team. The profile indicated what words an individual would use and their meanings. Instructions on effective communication included how many tasks to inform a person of, in order that they do not get confused. Peoples main care plan covered areas such as bathing, washing, showering, oral care, hair care and dressing. The format covered the individuals skills and what assistance was needed. Words such as supervision and prompting were used. For example: [the person] needs to be supervised, as [they] will shave the side of [their]head but leave [their] top lip. This evidenced that staff treat people with respect and encourage individuals to do as much as possible for themselves. Each plan had a review date and we noted that the person, their representative and their keyworker were involved in the process. Peoples preferred activities either based in the home or in the community were recorded. Dietary preferences had been detailed. There was information on whether an individual wanted to practice their religion. The health action plan recorded when a person had been seen by other health professionals, such as the optician, dentist or doctor and what treatment had been given. We saw that there was a Hospital Passport in place. This detailed Things you must know about me. For example allergies, medical intervention, heart or breathing problems, risk of choking, current medication, medical history and treatment plan. What to do if an individual was anxious. How the person communicates and How do you know I am in pain. We found that annual reviews covered: Home life, holidays, health, medication, optician, dentist, gynaecologist, family and finances. The person and their representative were involved in the review. Some people who live in the home have independent advocates if needed. Some of the people had had best interest meetings when they needed an operation. We noted that one plan had a pictorial health action section, to aid the person to understand what had been recorded. Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: There was good information on how to deal with challenging behaviours. One plan stated that: can become upset and verbally aggressive if [they] think people are talking about [them]. There was good information on how to dealt with challenging behaviours for example:[they] should be confronted by standing in front of [them], gaining eye contact and with a strong voice (not shouting)say and sign stop. Reasons for an individuals behaviour had also been documented and what triggered reactions. Peoples end of life wishes had been recorded. Whenever possible the person had stated what they would like, such as burial or cremation, hymns, carols or songs the person wants to be played at the service. When this was not possible advice had been sought from the individuals representative, for example; cremation and ashes to be placed on family Rose Tree. Funeral wish arrangements eg burial or cremation, Hymn, carols, songs want to be played. Medications were not checked as at previous inspection there have been no issues. We have not received any concerns about the handling of medications by the home.The manager reported that all the people that live in the home have medications only when needed. None of the people who used the service raised any issues regarding the health and personal care they received on their surveys. One staff survey brought up about same sex carers and how this could be managed. It is recommended that a protocol is implemented to make sure that needs are met according to individuals wishes for same gender care. None of the people who live in the home raised same gender care as an issue. Care Homes for Adults (18-65 years) Page 21 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that any concerns they may have will be taken seriously and action taken if needed. Good systems are in place to protect people form harm. Evidence: The AQAA told us that: All service users have access to a complaints procedure and are quite comfortable to talk to staff if they feel that they have a concern, a complaints procedure is pinned on their notice board and it is written in symbols for those who can not read to understand. Systems are in place to protect the clients finances and abuse, staff attend safeguarding training every two years and training around clients safety and well being. Respondents to our surveys confirmed this. Relatives stated that they knew how to raise any concerns. People who live in the home all said that that they would know how to make a complaint or raise concerns. One person commented: They look after me and make me happy. The home has not received any complaints in the past twelve months and there have been no Safeguarding Alerts. We have not received any concerns or complaints about the home. Staff were able to confirm that they had attended Safeguarding training. Some people have help to manage their money and records are maintained. Receipts are Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: kept for large items purchased and stored in the persons file. Individuals bank statements were stored securely. Care Homes for Adults (18-65 years) Page 23 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is suitable for their needs. Individuals are able to make choices on what decoration and possessions they have in their rooms. Staff make sure that people are involved in redecoration plans for the home. Evidence: The homes AQAA states: We continue to make the clients take responsibility for their room by choosing what they want in it, by cleaning their home, their bedrooms and individualising them. They have their own day for doing their laundry and preparing meals and clearing up. We are looking at making the home more homely with client involvement. During our site visit two people that live in the home kindly showed us around the premises. They were happy to show us their rooms. There is one single room downstairs with and en suite, that is also accessible from another door. Upstairs there are single bedrooms and one bathroom. People have chosen their own furniture and soft furnishings eg quilt covers and curtains. Each person had their own possessions such as CDs, DVDs, car collections and calendars. People are able to access the garden easily and we were told that in the summer months barbecues are held. Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: The home has lots of houseplants and people are encouraged to go into the kitchen to prepare meals; the kitchen has sufficient space for staff to work alongside individuals. We saw that the kitchen was clean and tidy. Food had been stored correctly and safely. People are able to take their meals at the dining table in the large lounge/diner. The lounge areas has comfortable sofas and chairs for individuals to relax in and watch television or listen to music. This room has recently been redecorated and staff were putting up curtains. Surveys were received commented that some redecoration is needed in the home. Staff reported that the kitchen flooring and carpeting on the ground floor will be replaced in the next few months. All survey respondents stated that the home was usually clean and tidy. The home was clean and tidy on the day of the site visit. There were no unpleasant odours. Care Homes for Adults (18-65 years) Page 25 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home can be confident that there are sufficient numbers of staff to meet their needs. Staff are recruited safely and given induction and training to carry out their role. Evidence: The AQAA stated: We meet as a team at least once a month to discuss the service and have good links with outside health services that benefit the clients. There is a training folder on site that all staff must fill in when they attend training, it is each key workers responsibility to make sure this is done. ..over the past year we have managed to have a couple of training days together as a team eg Moving and Handling, diversity and equality, health and safety. On the site visit we were told by the manager that all recruitment is undertaken centrally at the Council Offices. We were able to see the staff registered that is kept at the home. Two members of staff have been recruited recently and we noted that references and appropriate checks had been carried out prior to them commencing employment. Records show that the majority of staff have work in Learning Disabilities for seven years or more. Records of training were looked at and were satisfactory, with mandatory training being undertaken regularly. We observed staff working well with each other and the people that live in the home. For Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: example when people were asked to help with the shopping, staff made sure that they assisted also and worked alongside individuals. Staff who responded to surveys told us that they are given up to date information about peoples needs to make sure they are able to meet their needs. Staff confirmed that checks such as Criminal Records Bureau checks and references had been carried out before they started working in the home. All staff respondents said that they would know what to do if anyone raised concerns and considered that there were sufficient numbers of staff to meet peoples needs. The staff team consider that they are supported by their manager and receive supervision. Relatives who responded to our surveys considered that there are sufficient staff with the right skills and experience to look after people properly. They thought that staff always give care and support to their friend or relative. Surveys received from people who live in the home told us that they think that staff give individuals the support they need. Care Homes for Adults (18-65 years) Page 27 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is well run. Individuals are able to comment on how the home is run and their views are listened to and acted upon if needed. Support of independent advocates is available to make sure that people are able to speak freely. Evidence: Information from the AQAA told us that for the homes Quality Assurance System: The manager asked Advocacy partners to ask each client their views and write them down, this way staff were not influencing the answers of the clients. All the clients expect one has now got an advocate who will speak up for them and their views at important meetings. We do plan to look at our Quality Assurance questionnaire again in December 2010 to find out clients views and what may be happening for them. The views of all the clients will be taken into account and worked on by the staff team. The home runs well and clients views are taken into account and used. Staff who responded to surveys consider that the manager gives support and meets them to discuss work. Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: When we spoke with the manager during the site visit they told us that they had been managing the home for five years. We observed that the manager role modelled appropriate behaviour and was available for people that live in the home or staff to discuss what was happening. The premises was free from hazards and no health and safety issues were identified. It is recommended that when the AQAA is completed care is taken to fill in all sections, as this will help to evidence consistent ongoing compliance with the Standards. Care Homes for Adults (18-65 years) Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 30 of 32 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 18 37 It is recommended that a protocol is implemented for same gender care. It is recommended that the homes Annual Quality Assurance Assessment is completed fully to give an accurate picture of the service provision and demonstrate ongoing compliance with the Standards. Care Homes for Adults (18-65 years) Page 31 of 32 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. 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