Please wait

Inspection on 12/08/09 for Oaklands Road, 82

Also see our care home review for Oaklands Road, 82 for more information

This is the latest available inspection report for this service, carried out on 12th August 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What the care home does well

The residents are supported by a small and consistent staff team who are aware of their individual needs. The home is looking to offer support and care in a more person centred way and encourages the residents to make daily decisions about their lives. Observations during the inspection evidenced that staff interact positively with the residents.

What has improved since the last inspection?

Training had improved for the staff team with various subjects being made available. Systems are in place to obtain the views of the residents and their relatives.

What the care home could do better:

The care plans all need to be up to date and reflect the resident`s current needs. All known and potential risks need to be documented so that staff can support residents effectively. Medication systems need to be robust to avoid and minimise medication errors occurring.

Key inspection report Care homes for adults (18-65 years) Name: Address: Oaklands Road, 82 Oaklands Road, 82 Hanwell London W7 2DU     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: Sarah Middleton     Date: 1 2 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Oaklands Road, 82 Oaklands Road, 82 Hanwell London W7 2DU 02088405996 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: hm82oaklands@ealing.org.uk www.supportforliving.org.uk Support for Living care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home 82 Oaklands Road is a registered home for three people with learning disabilities and/or mental health needs. The home is registered to take residents over sixty-five years old if their needs can be met. The home is managed by Support for Living and owned by Catalyst, formerly known as Ealing Family Housing Association. It is located in a terraced house in a quiet residential road. It is close to local amenities, including shops in Boston Manor Road. There are transport links on the Uxbridge Road in Hanwell, which lead to larger towns such as Ealing Broadway. There are leisure facilities available in the local area. There are three single bedrooms, one on the ground floor and two on the first floor. There is one lounge, a dining room with adjacent kitchen and a small laundry area on the ground floor. The first floor has a bathroom/toilet and separate toilet with an office/sleeping in room. There is a garden to the rear, where there is decking leading off from the kitchen and a patio area with gravel, plants and shrubs. There is a small garden to the front and parking is on the Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 0 3 3 Brief description of the care home street. Placement fees range from £430.05-£467.74 per resident per week, with the rent varying from £69.90-£108.10. The residents have to contribute towards the rent. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: An unannounced visit was made on the 12th August 2009. Before the visit we looked at: Information we have received since the last visit on the 5th September 2007. The Annual Quality Assurance Assessment (known as the AQAA). The AQAA gives the Care Quality Commission evidence to support what the home says it does well and gives them an opportunity to say what they feel they could do better and what their future plans are. How the home has dealt with any complaints or concerns since the last visit. Any changes to how the home is run. The views of the people who use the service. During the visit we: Talked with the residents who live in the home, staff and the Registered Manager (who Care Homes for Adults (18-65 years) Page 6 of 30 will be referred to in this report as the Manager). Looked at information about the residents and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the residents they care for. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last visit. Before the inspection we sent out questionnaires to the residents. We told the Manager what we found. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 30 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 9 of 30 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. Good information is provided for prospective residents thinking about living in the home. The needs of prospective residents would be assessed before they moved into the home. Evidence: The Manager had updated the information about the home which is in the Statement of Purpose/Service Users Guide. This is comprehensive and contains the important details about the home. The home had not had any admissions for several years. We had viewed the preadmission assessment at previous inspection visits and was informed that this document had not changed since the last visit. We were satisfied, based on previous inspections, that prospective residents would be assessed before they moved into the home. Care Homes for Adults (18-65 years) Page 10 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans record residents needs but need to be up to date. Risk assessments viewed were not up to date and did not record all known potential risks. Evidence: We viewed one residents file in detail. We saw this resident had a review in 2009 but noted that the personal care assessments had been written in 2007. The care plan also needed to be updated. We viewed the new documentation that will be used which is more person centred. The new support plans will record the residents needs and other important information, such as how they make decisions and manage their medication and finances. One member of staff had completed most of the support plan for the resident they are keyworker for. This gave some good specific information about the resident. Daily routines were seen for the residents file we viewed. Preferences and likes and Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: dislikes were noted. The daily records were also viewed and these recorded what the resident had done each day and any significant events. Monthly summaries were also seen and were up to date. This process can ensure that the needs of the residents are considered each month and any changes are recorded. The recent review had discussed some of the preferences the resident has. Following on from this meeting the house is looking to arrange for a male worker to work once a month with this resident, as the homes staff team is female. This is seen as good practice, as the home had made steps to address what a resident likes and wants. The format for the review was different and the way the meeting was held had also changed. These changes were to support residents to be more interactive and to involve, where agreed, their relatives on a more informal basis. Contributions from all concerned were noted and will form part of developing the support plan. We spoke with the keyworker who was aware that the support plans need to be written up to ensure up to date information on the resident is available for all staff. It is recommended this is worked on as soon as possible. Consideration will need to be given if the Manager feels the Mental Capacity Act needs to be used or the Deprivation of Liberty safeguards. If these are used it would need to be clearly documented to show how and when it was used. The home has worked hard to look at ways to communicate successfully with the residents who have little verbal communication. One resident appears to respond to objects of reference. For example, if there is an activity or event the staff team will direct the resident to the object so that they will hopefully understand where they are going. The Manager recognises it is difficult to assess if the resident fully knows what the staff team are trying to communicate to them, but is using this as another form of communication. Another resident needs reassurance of when particular events are taking place and a calendar is in their bedroom and each day is marked off so they can visually see when an important event is coming up. In the past the home has sought advice from a Speech and Language Therapist and this has been useful in providing advice and guidance as to how staff can be creative when communicating with the residents. It is pleasing to see that the home seeks the support and advice from specialist professionals as and when needed. One resident used to have an advocate and another resident is on the waiting list for Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: an advocate. There is a peer advocate working for a local Mencap organisation who will be running groups on speaking out and other activities which could be something the residents of the home want to be involved with. Those staff asked said the residents choose what they want to do and can refuse to take part in tasks and activities. We viewed the new risk assessments that will be used for each resident. We viewed the risk assessments on one resident. The majority of the assessments seen were dated late 2007 and early 2008. There were no risk assessments on the risk of bruising which is known as a potential risk. This had been discussed at previous inspection visits. Potential and likely risks need to be assessed and recorded so that staff are fully informed of the residents needs. This was made a requirement and must be addressed. Guidelines were seen about bruising but these were not dated or signed. Information about all the residents need to be dated so that it is clear that it is up to date and current relevant information. Subsequent to the inspection we were sent a copy of the risk assessment on the resident who is likely to bruise. Care Homes for Adults (18-65 years) Page 13 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are able to take part in activities in the home and community. Visitors are welcome in the home and residents are supported to maintain relationships. The meal provision provides residents with choices of fresh nutritious meals. Evidence: The three residents take part in various activities depending on their interests. One resident attends the local day centre twice a week whilst another attends once a week. On the day of the inspection one resident had gone out to get food shopping with a member of staff and had then gone on public transport to the cinema. There is a plan each day so that both the residents and staff know what to do. One resident is supported to go to church once a week and all three residents go to a social evening Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: club at the week-end. One resident had been on holiday twice with staff support. The staff team are looking into a holiday with the other two residents. Although the residents could not comment in detail about the care and support they receive, we observed them all sitting in the living room and they all looked relaxed and content. Staff support the residents to see relatives and contact is encouraged. Due to the various activities in the community, residents have the opportunity to meet and socialise with other people away from the home they live in. Residents preferences and routines are recorded so that staff know how to effectively support each resident. We were informed that staff read residents personal mail to them as they are unable to read. Residents can choose to spend time alone in their bedrooms or in the company of others. We were informed that residents have keys to their bedrooms but do not use them. The Manager agreed to ensure it is recorded on each file if residents do not have keys to the front door of the home. We were informed that residents do not usually help prepare meals, but some like to spend time in the kitchen/dining room area and watch staff cook the meals. Residents are encouraged to do small tasks such as laying the table or getting a cup out of the cupboard if they want a drink. Residents are involved in choosing the meals they want to eat. We were shown pictures that are used when planning the meals. Pictures of the meals the residents will be eating are then put onto the notice board which is located in the dining area. Staff are aware of the health needs of the residents and we could see from the food shopping that fresh produce is purchased and used. We viewed a sample of the menus and saw that the meal provision was varied and well balanced. One resident spoken with said she liked the meals. Care Homes for Adults (18-65 years) Page 15 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can receive personal care support in their preferred way. The health needs of residents were recorded and were being met. Arrangements for the safe recording and administration of medication needs to be improved. Evidence: All three residents need support with personal care tasks and this is carried out in private. The new personal care assessments record if a resident has a preference for same gender care support. The staff team working at the home are all female, but it is good practice to assess this when supporting vulnerable residents. It is expected that all residents will have their needs recorded on the new personal care assessments as these will provide more detailed information. We observed that one resident was wearing a necklace and their nails were painted. The staff team are aware of the residents preferences regarding how they look and the personal touches they like. All residents have a GP and see other health professionals, such as opticians and Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: podiatrists. Appointments to health professionals are recorded on separate forms and these were seen. This can enable staff to monitor the health of each resident and to notice any changes in their needs. The Manager described how all three residents will have a Patient Passport. This document will be used if a resident is admitted into hospital and provides hospital staff with crucial information about the resident, such as, how they communicate and what support they need. This had been completed for one resident already and is a useful way to ensure, if they have a stay in hospital, that they are cared for appropriately. We looked at medication for one resident. Residents living in the home do not self medicate and all medication is stored properly and securely. The majority of medication is sealed in blistered packs. Medication that is given as and when needed is counted and checked every day and evidence of these checks were seen. The home had not been counting the loose medication that was in a box and this was discussed with the Manager who will ensure that this is carried out from now on. Counting all medication that are tablets in bottles or boxes can minimise any medication errors occurring and can identify any errors quickly so that appropriate action can then be taken. Medication guidelines are in place and information about the medication prescribed for the residents was seen. All staff receive training on handling and administering medication. The Manager also has books that are modules from the local Pharmacist. These cover different areas in each book and staff work through answering the questions, which will be checked by the Manager. We made attempts to count the medication that was in a box. However the quantity was not recorded on the Medication Administration record and so we were unable to carry out an accurate audit of this. We also noticed for another medication that a member of staff, who we were informed was an agency worker who is not working in the home anymore, had not signed for the medication that should have been administered. A requirement was made for medication systems in the home to be more robust to avoid medication errors occurring. The Manager was aware of the issues and we were confident that she would address this with those concerned. Care Homes for Adults (18-65 years) Page 17 of 30 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. Complaints procedures were in place and residents and their relatives could be confident that any concerns they raised would be listened to. Procedures are in place to report any safeguarding concerns. Evidence: The home had not received any complaints. The complaints procedure is freely available. One resident would be able to verbalise her concerns whilst the others would not be able to speak about any concerns or complaints. However the staff team are familiar with how the residents communicate and would be able to notice if a resident was unhappy. The home had recently had a safeguarding concern that is currently being investigated. As with previous unsubstantiated concerns, the staff team had not followed the correct procedures in reporting the concern to management and to Social Services. This had been an issue before and staff had received information as to what to do if they noticed something that could be a safeguarding concern. The procedure to follow is on the office wall and the Manager, who had only recently returned to work in the home, is keen to investigate this incident. There is currently no suggestion that abuse had taken place but this needs to be fully looked into before a decision is reached. The Manager will ensure staff receive information on responding Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: to a potential safeguarding concern and if necessary further training will be provided on the subject of safeguarding. Although this is not the first time this situation has occurred, now the Manager is back in post we were satisfied that the issues will be addressed. The residents are not able to manage their own personal finances. Counts on their monies are carried out every day. We viewed one residents money being counted, initially this was found to be incorrect, but the Manager looked into this during the inspection and she identified the error in the record keeping. It was then checked again and found to be correct. We were informed that the home is audited by the Providers internal finance department. Also we were told that once a year the local Community Learning Disability Team visit and they also check how the home manages the residents finances. Care Homes for Adults (18-65 years) Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have the benefit of living in a well-maintained and clean environment with personalised individual rooms. Evidence: The home overall is welcoming and clean and tidy. We saw the kitchen worktops had been replaced and a new oven had been fitted. The Manager had requested for the kitchen/dining room and living room to be decorated and new curtains. One resident would be having new carpet in their bedroom and personal items were seen in two of the three residents bedrooms. The garden is well maintained and is a pleasant place for residents to sit outside. The staff team keep the home clean and free from any odours. Care Homes for Adults (18-65 years) Page 20 of 30 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. Residents are supported by qualified staff who work effectively. Good recruitment procedures are in place. The staff are receiving relevant training and are supported by supervision sessions. This enables them to work to a high standard and deliver good care. Evidence: The staff team have had some changes to the team, with one person on long term sick leave and a new member of staff starting the week after the inspection visit. The three permanent members of staff have an NVQ either level 2 or level 3. Relief staff are used to cover vacant staffing hours and external agency staff are also used. The Manager explained that the home uses one agency and regular agency staff are used. Those staff asked said the staff team, including those from the agency, all work well together. We saw a file that is given to new agency staff which gives them an overview of the home and the residents. This is useful and provides the necessary basic information to agency staff who might be unfamiliar with the home. We viewed the rota and saw that one staff member works in the morning, having slept in the previous night, a member of staff then comes in to work a mid-shift. There is Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: then an afternoon/evening member of staff who also sleeps in. Staff felt there were sufficient numbers of staff working in the home at any one time. The Manager, having recognised that the staff team have administrative work to complete as part of their job, has planned on the rota approximately once a month, to give staff an admin day. This is so they can work on support plans and any other keyworker tasks. She is keen to provide this on a regular basis so that time spent doing administrative work is not time spent away from supporting the residents. We viewed the homes handover sheet which is used to plan each shift. This enables staff to know what jobs they are in charge of and is a good way to ensure all the tasks of the day get done and are fairly distributed. The homes recruitment records are all held at the Providers main head office. Therefore the information we could see was on a form that confirmed the three members of staff that we looked at had all the necessary information obtained, such as Criminal Record Bureau check and two references. The Manager confirmed that she also checks the information on candidates to ensure it meets with the Regulations. The Manager said that when a member of staff has come from another service run by the same Provider, they are interviewed and a reference would be obtained from their most recent Manager. This more recent reference should be noted on the forms we viewed, but were not. The Manager agreed to look into this to ensure there is evidence that a recent reference was obtained before the member of staff started working in the home. We saw evidence of the information the Manager receives from the agency they use. This confirms that the agency worker has had a Criminal Record Bureau check and notes the training courses they have attended. All new staff go through an induction, which comprises of being introduced to working for the Provider then attending training courses on the mandatory subjects. New staff also spend time in the home getting to know how the home is run and shadowing permanent members of staff. Once completed new staff then study for the Learning Disability Qualification. This takes six weeks and at the end of this an appraisal is carried out. We viewed a sample of individual training records. The Manager explained that there had been some difficulties in obtaining the training record for staff who had transfered from another service. However she had recorded all the training this member of staff had attended since working in the home. Overall staff were up to date with training, moving and handling training was due and we were informed would be booked. There Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: was forthcoming training on the Deprivation of Liberty and the Manager confirmed she would be booking staff onto this course. Specialist training is also accessed on topics such as Autism and person centred working. Those staff asked said they were happy with the training provided to them. The Manager agreed to develop an overall training plan to record the whole staff teams training record. Staff confirmed they had received one to one supervision with the Manager since she had returned to her post. Care Homes for Adults (18-65 years) Page 23 of 30 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 Manager is providing clear leadership throughout the home. The home has various ways it monitors the quality of the service provided for the residents. The health and safety of the residents is promoted with the home having maintenance and servicing checks in place. Evidence: The home has had some changes in management since the last inspection visit two years ago. The Registered Manager left her post, which had not been permanent, in January 2009. Whereby the previous Registered Manager returned to the home as Manager for a few weeks. They were then promoted and moved to another service and an Acting Manager worked in the home for a few months. This arrangement did not work out and the Registered Manager, who had only left seven months earlier Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: returned to work in the home. They were still on the Registration Certificate and therefore do not have to re-register as the Manager of the home. They had only been back in post for three weeks when this inspection visit was carried out. Those staff asked said they had managed with all the changes but were glad to to have the Manager back in post. The Manager had been proactive since her return and was aware of the areas of the home that need attention. The Manager works some shifts and does a sleep in approximately once a week. This enables her to see how shifts run and to spend time with the residents. The Manager is in the process of completing the Registered Managers Award and has completed a twelve week course on the Introduction to Management. A quality system is in place to monitor the quality of the service provided. This is done through a variety of ways. The home seeks the views of the residents in different ways. Weekly resident meetings are held. Once a year residents are supported to complete a survey about the home. The findings of comments are then looked at and acted on. We were informed that monthly Regulation 26 visits occur. The Manager also forwarded onto us after the inspection visit, a three year business plan and a short report on what improvements the home had made. The Manager also has to complete a report every quarter for the Provider, which looks at various areas of the home such as complaints and safeguarding. We checked a sample of servicing agreements and maintenance checks. All were up to date apart from the Gas Safety check, which had been due to be carried out in June. We notified the Manager of this and subsequent to the inspection we were informed that a Gas safety check had been carried out and the boiler was condemned. The home will be using hot water through the Emerson system until the home is fitted with a new boiler. There is currently no heating working, but as it is Summer this is not an issue at present. A fire risk assessment had been completed in March 2009 and had made a few recommendations. A fire drill had been last carried out in February 2009 and this should be carried out on a more regular basis, ensuring all the members of staff attend sufficient numbers of drills. An individual fire risk assessment was seen regarding a resident, which looked at how the resident would respond to a fire and the support they might need. Other safety checks such as testing the water temperatures and fridge/freezer Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: temperatures were taken on a regular basis. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Risk assessments must be completed on all known risks. To ensure the staff team can support the resident safely and effectively risk assessments need to be in place. 20/08/2009 2 20 13 Medication quantities must be recorded onto a Medication Administration record so that accurate counts and checks can occur. Robust medication systems need to be in place in order to protect the health and safety of the residents. 19/08/2009 Care Homes for Adults (18-65 years) Page 28 of 30 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 The new support plan should be completed to ensure the current residents needs are recorded and known by all staff. Fire drills should be held on a regular basis to ensure the safety of residents and staff. 2 42 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - 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!