Inspection on 06/11/09 for Pinewood

This is the latest available inspection report for this service, carried out on 6th November 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Pinewood 09/11/07

Pinewood 11/07/07

Pinewood 05/06/06

Pinewood 31/01/06

Pinewood 21/06/05

Pinewood 07/10/04

Pinewood 09/06/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Pinewood Pinewood Tringham Close Ottershaw Surrey KT16 0HL     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: Joseph Croft     Date: 0 6 1 1 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: Pinewood Pinewood Tringham Close Ottershaw Surrey KT16 0HL 01932872489 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): adu.aubad@welmede.org.uk Welmede Housing Association Ltd The registered provider is responsible for running the service care home 5 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 5. The registered person may provide the following category/ies of service only: Care home only - 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 - LD Date of last inspection Brief description of the care home Pinewood is small home accommodating up to five people over 65 years of age, who also have a learning disability. The home is a purpose built, single storey property, with five individual bedrooms and a spacious lounge / dining room. A garden is available to the rear of the property and Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 5 0 8 1 1 2 0 0 8 Brief description of the care home there is a large driveway, with parking space for a number of vehicles. Pinewood is one of a number of homes operated by Welmede, a local housing association. Pinewood is situated in a residential cul-de-sac in Ottershaw, which has a range of local facilities, including shops, post office, pubs and public transport. The larger town of Woking, with its greater range of shops and leisure facilities, is a short drive away. Pinewood is adjacent to Copse Lea, another home in the Welmede group, and the two homes have historically shared one manager. The fees for the home are £1193.00 per week. 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: The quality rating for the service is Two stars. This means the people who use this service experience good quality outcomes. The Care Quality Commission (CQC) (us, we) undertook an unannounced site visit to the service on the 6th November 2009 using the Inspecting for Better Lives (IBL) process. The site visit was undertaken by Regulation Inspector Mr Joe Croft and took over five and a half hours, commencing at 09:35 and concluding at 14:45. The manager was not present, therefore the deputy manager assisted throughout the site visit. The inspection process included a tour of the premises, direct observation of practice, sampling of medication records, care plans, risk assessments, health action plans, menu and policies and procedures. Discussions took place with the deputy manager and three members of staff during the course of their duties. Discussions also took place with three residents living at the home. Residents told us that they like living at Pinewood, that they chose the colours for their bedrooms, and that staff look after them well. They told us that they choose what they want to do including activities and choosing the weekly menus. Residents Care Homes for Adults (18-65 years) Page 6 of 30 told us that they help out with daily chores, one stated that they like doing the cleaning as they used to have a job as a cleaner. Staff were observed interacting with residents in an appropriate manner and were aware of residents communication needs. Staff were observed offering residents drinks and snacks, calling residents by their preferred names and knocking on bedroom doors before entering. Surveys were sent by us to residents, staff, and health care professionals. We received completed surveys from five residents and five members of staff. The manager returned the completed Annual Quality Assurance Assessment (AQAA) when we asked for it, and this, and the surveys, have been used as a source of evidence throughout this report. The inspector would like to thank the deputy manager, staff and residents for their cooperation during the site visit. Weekly fees charged are 1193 pounds. 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. People who use the service are provided with information that will enable them to make a choice about living at the home. The needs of prospective residents would be fully assessed to ensure their needs could be met at the home. Evidence: The service has a Statement of Purpose and a Service User Guide that includes the information as required. Both these documents are user friendly and use photographs and symbols to aid the reader. It is recommended that the date these were reviewed should be written on each document. Four of the current residents have been living at the home for many years. Evidence held by the Commission about the service indicated that any prospective new residents would have their needs and aspirations fully assessed prior to a place being offered to ensure that the service could meet their needs. Care plans are produced from the information obtained in these assessments with the involvement of the resident when possible. One new resident transferred to the home from another of the organisations care homes in March of this year. However, the deputy manager could Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: not locate the information or the previous assessment of need for this resident. A good practice recommendation has been made that pre- admission assessments should be maintained and available for inspection purposes. The deputy manager told us that the service would follow the organisations Moving In policy when they receive enquires from prospective residents. The service would obtain an assessment of need from the placing care manager, and the manager of the home would undertake an assessment of the prospective resident at their current placement. Prospective residents would be invited to visit the home for meals and overnight stays so they could meet the residents and staff. New residents would only be admitted on the basis that their assessed needs could be met by the service, and that they are compatible with the current residents living at the home. This information was confirmed during a telephone conversation with the manager on the 12th November 2009. The manager also told us that new admissions to the home would be reviewed after one, three and six months. The Annual Quality Assurance Assessment (AQAA) informs that comprehensive assessments are completed prior to admission to the home. Care Homes for Adults (18-65 years) Page 11 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. People who use the service have care plans that reflect their changing needs and personal goals. Residents are encouraged to make decisions about their lives and to take risks as part of furthering their independence. Evidence: Three care plans were sampled during the site visit. Each included information in regard to health care needs, personal hygiene, dressing, eating and drinking, social behaviour, privacy, cultural needs and health and safety. Each included goals and objectives and was signed by the key worker and the resident. The care plans viewed had been reviewed on a monthly basis and any changes had been recorded in the care plans. Evidence was viewed that annual reviews had been undertaken by the funding manager. During discussions residents told us that they were aware of their care plans. Five surveys were received from staff, of which three informed that they are always Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: given up to date information about the needs of residents, and this is reflected in the care plans. Two informed that they are usually provided with this information. During discussions with three members of staff, it was clear that they were very knowledgeable of the contents of the care plans, including the personal needs and preferences of residents. All staff spoken to told us that they review the care plans every month. Daily notes are maintained that relate to the identified needs and daily activities of residents. Entries were made for each morning, afternoon shift and night time. The care files sampled had a personal information sheet that included the residents next of kin, GP details and other personal information pertaining to them. During discussions the deputy manager and staff told us that all staff support residents to make decisions for themselves such as the choice of menu, clothes they wish to wear and activities they want to partake in. The emphasis is to enable residents to be as independent as they can. Risk assessments were viewed for the three residents, and included risks for manual handling, fire and activities outside of the home. Risk assessments viewed were clear and had been regularly reviewed. The Annual Quality Assurance Assessment (AQAA) informs that residents have individual care plans where detailed entries are documented. 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. People who use the service are encouraged by staff to participate in a range of activities. A balanced diet is provided for residents. Evidence: Residents are supported to participate in a range of activities according to their needs, preferences and wishes. Activities include shopping trips, visiting pubs, spiritual places of worship and annual holidays. Each resident has a copy of their weekly activities in their care plans. During discussions residents told us that they do activities every day, and they can choose what they want to do. During the site visit residents had attended a bowling activity, and one resident went off to do their favourite activity of train spotting. One resident told us that they like doing their pottery activity. Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: All resident surveys informed that they always do what they want during the day, evening and at weekends. Staff told us that residents regularly go on holidays. Recently residents had been on holidays to Corfu, the Isle of Wight and Devon. Residents are supported to maintain important relationships with friends and families. Care plans contain details of important contacts with addresses and telephone numbers. During discussions the deputy manager and staff told us that there are no restrictions on visitors to the home. Some residents have support from floating support workers who are employed by the organisation. Their role is to provide one to one support with residents that includes taking them on outings and activities outside in the community. Daily routines are flexible with bedtimes and mealtimes arranged to meet individual needs and timetables. Residents are encouraged and supported by staff to undertake daily household tasks. One resident told us that they like doing the cleaning, as they used to have a cleaning job at a local pub. The menus were viewed during this site visit. The deputy manager told us that the menus are produced with the residents every week, and we were shown photographs of different meals that help residents to make choices about the menu. Records are maintained when residents choose to have a meal that is different to the menu. The viewing of the menu informed that meals provided include fresh meat, fish, fresh vegetables and fruit. Staff told us that the food is bought fresh every week. Fresh fruit was freely available on the day of the site visit. The kitchen was appropriately stocked with ample food and fresh vegetables. The deputy manager told us that they receive advice from the GP practice nurse in regard to one resident who is a diabetic. Lunch time was observed during the site visit. This was a relaxed occasion with staff sitting and eating with residents, therefore available to provide support as and when required. During the site visit residents were being offered hot drinks and snacks. Residents told us that they can have a drink or snack when ever they choose to. Records confirmed that fridge and freezer temperature checks are undertaken and food is temperature probed regularly before serving. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: The AQAA informs that residents are encouraged to use all aspects of the home such as the laundry, kitchen, cleaning and gardening. Residents are encouraged to pursue activities, hobbies and interests both inside and outside of the home. The information provided in the AQAA was evidenced during the site visit. Care Homes for Adults (18-65 years) Page 16 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. Personal support provided to residents meets their preferences and their physical and emotional needs are met. The arrangements for medication are robust and protect residents. The principles of respect, dignity and privacy are put into practice. Evidence: The three care plans viewed provided information in regard to the level of support each resident requires with their personal care needs. As stated earlier in this report, it was evident through discussions that staff were knowledgeable of the personal care needs of residents. Staff told us that they attend to the personal care in the privacy of bedrooms and bathrooms. We observed staff always knocking on bedroom doors before entering, and calling each resident by their preferred names. From discussions with the deputy manager and staff, and the viewing of care plans for three residents, it was clear that residents have access to all health care professionals as required. Each resident had a health care action plan that included information in regard to appointments with the GP, Dentist, Psychiatrist, Opticians and other specialist health care professionals. Appointments with medical professionals were all maintained on one form. The deputy manager told us that records for each separate Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: health care appointment would be produced, which would make it easier to follow an audit trail in regard to each residents health care. Care plans included detailed information about the specific medication residents were prescribed, and also included information and guidelines in regard to PRN medication that had been signed by the residents GP, and the known side effects of medication residents were being administered. During discussions residents told us that they see the GP, Dentist and Optician when they need to, and always receive their medication on time. One resident told us of a recent operation they had had. Staff at the home follow the organisations Medication Policy and Procedure that was last reviewed in October 2007. The home uses printed Medication Administration Record sheets (MARs) from the local pharmacy. The Medication Administration Records for three residents were viewed. Medication was appropriately stored in a locked metal cabinet. The MARs sheets included the quantity of medication received, and were accurately maintained with no omissions. The home has a book for recording medication that has been returned to the Pharmacy. The deputy manager told us that no resident is taking a controlled drug or is selfmedicating. Evidence was viewed that residents had an annual medical review undertaken with their GP. On the day of the site visit the deputy manager made appointments for two residents to have their annual health checks in November 2009. The sampling of the staff training files provided evidence that all staff had received training in regard to medication. The deputy manager told us that only staff that had received this training administer medication. The deputy manager and senior staff undertake weekly checks of the MARs sheets and medication stock to ensure they are accurately maintained. The AQAA informs that staff who administer medication have an annual drug assessment undertaken. Residents have individual care plans where details of health related issues are recorded. Medication is well documented and the stock is checked weekly by two staff. Care Homes for Adults (18-65 years) Page 18 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. People who use the service have access to a satisfactory complaints system that enables residents and their families to raise concerns. Residents are protected from abuse through the homes provision of staff training and policies and procedures in regard to Safeguarding Adults. Evidence: The Care Quality Commission has not received any complaints in regard to the home since the last key inspection. The home follows the organisations Complaints Policy that was last reviewed in April 2008. The complaints policy included the timescales for responding to complainants. The deputy manager told us that all residents have a copy of this document, and it is also included in the individual care plans. It was noted that this document had the incorrect contact details for the Care Quality Commission (CQC). We were told that this would be addressed. A summary of this document is included in the Statement of Purpose that included the correct contact details for the CQC. The AQAA informs that the home has not received any complaints since the last key inspection. The viewing of the complaints book evidenced that the home has not received any complaints. During discussions staff told us that residents would talk to them if they were Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: unhappy. Staff told us that one resident has limited communication. However, they are able to tell by this persons body language, facial expressions and moods if they are unhappy, and the resident is able to verbalise some words. We were also told that there are regular in-house resident meetings, and a monthly meeting organised by Welmede Housing Association Ltd for all residents within the organisation, where they are encouraged to voice their views and opinions. During discussions residents told us that they would talk to staff if they needed to make a complaint. All resident surveys informed that they know how to make a complaint, and who to talk to if they were unhappy. Staff surveys all informed that they know what to do if a resident or any other person raised a concern about the home. The home has a copy of the recent Surrey Safeguarding Procedures, and staff follow the organisations Abuse Policy that was last reviewed in May 2008. The training matrix, and the sampling of staff files, provided evidence that all staff had attended training in regard to Safeguarding Adults, and refresher training dates had been booked throughout 2010. One member of staff is currently covering this in their NVQ level 3 training. Different scenarios in regard to abuse were discussed with the deputy manager and three members of staff. They were all knowledgeable about the procedures to be followed and were aware that the safeguarding issues must be reported to the local Safeguarding Team. Staff told us that Safeguarding Adults is always promoted at the home. They also told us that they would not hesitate in reporting bad practice to their line manager or the organisation. The home has had one Safeguarding Adults investigation that has been concluded. The deputy manager told us that staff do not have power of attorney for residents finances. Each resident has a building society account and the home holds a small amount of money for residents. This is kept secure in a locked cabinet. The records for three residents were checked during this site visit. Receipts are kept, and two members of staff sign each transaction. The records of residents monies are audited every six months by a representative of the organisation. On the day of the site visit, the monies held balanced with the records maintained by staff at the home. The AQAA informs that the complaints policy is user friendly. All staff have received training in regard to Safeguarding Adults, and the policies and procedures are read Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: and signed by all staff. Care Homes for Adults (18-65 years) Page 21 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. People who use the service live in a safe, well maintained and comfortable, homely environment. Evidence: The home is a purpose built, single storey property, with five individual bedrooms and a spacious lounge / dining room. A garden is available to the rear of the property and there is a large driveway, with parking space for a number of vehicles. A tour of the premises was undertaken. The general decor of the home was good, and had the usual signs of wear and tear. It was noticed that the wall thermostat in the hallway had become loose. The lounge/dining room was appropriately decorated and included wall lights, comfortable sofas, reclining chairs and armchairs. The kitchen had recently been refurbished and was very clean. Food was appropriately stored in the fridge, and fridge/freezer temperatures were being maintained on a daily basis. The training matrix provided evidence that staff are receiving training in regard to Food Handling and Hygiene. All staff have been booked on refresher training in May 2010. It was noticed that one of the light covers in the kitchen required cleaning. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: There is a laundry room that included a washing machine with a sluice facility, a tumble drier and ironing facilities. All Control of Substances Hazardous to Health (COSHH) were kept secure in a locked cabinet. We evidenced that the home has risk assessments for the COSHH substances used at the home. Four bedrooms were viewed. Each were appropriately decorated, and residents had their personal belongings that included photographs, televisions and stereo players. One resident had their art work displayed on the walls. During discussions three residents told us that they like their bedrooms, and that they chose the colours for them. One resident told that they like to spend a lot of their time in their bedroom. We were told that residents are provided with a key for their bedrooms. This was confirmed during discussions with residents. There are two bathrooms and toilets, one of which has an assisted bath that was last serviced on the 6th November 2009. The bath panel on one identified bath had been damaged. All communal areas had liquid soap dispensers and paper towels, and staff use protective aprons and gloves as and when required. All the identified issues in regard to the environment were discussed with the deputy manager who immediately recorded these in the maintenance book for the organisation to follow up. It was also noted that one resident did not have any lockable facilities in their bedroom. However, we were informed during a telephone conversation on the 12th November 2009 that this, and the other identified issues in regard to the environment had now been addressed. Staff and residents at the home have created a very homely and relaxed atmosphere. On the day of the site visit the home was clean, very tidy and free from odour. Surveys received from residents informed that the home is always fresh and clean. The AQAA informs that there is a warm and welcoming environment. Communal areas are tastefully decorated, and input is sought from residents when new decor is planned. Residents have significant input into the decor of their bedrooms. Care Homes for Adults (18-65 years) Page 23 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. The arrangements for staffing are satisfactory, ensuring staff have the qualities and training to meet the needs of the residents. People who use the service are protected by the organisations recruitment policy and procedures. Evidence: All but one resident living at the care home are White British, one is white European. They are supported by a multi-cultural team of male and female staff. Staffing at the home consists of the manager, deputy manager, four senior support workers and two support workers. We were told that agency staff are not used at the home. There are currently five residents living at the home. The deputy manager told us that there are three members of staff on duty during the morning shift on a Monday, Wednesday and Friday, and two on the mornings of Tuesday and Thursday. This is to provide extra staff for activities on these days. The afternoon shifts are covered by two members of staff. There is one waking night staff on duty every night. The deputy manager told us that there are enough staff on duty at all times, and they do utilise the organisations own bank staff as and when required. This was confirmed during discussions with staff. Staff surveys informed that there are always and usually Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: enough staff on duty to meet the individual needs of residents. The AQAA informs, and the deputy manager confirmed, that of the seven permanent staff employed at the home, fifty seven percent hold the minimum of an NVQ level 2 and above. One member of staff staff is due to complete their NVQ level 3 this month. Each member of staff has a training and development file. The sampling of these files provided evidence that staff are receiving training to help them fulfil their roles. Training undertaken included Dementia, Sex and Sexuality, Health Promotion, Bereavement and loss, Control of Substances Hazardous to Health, Equality and Diversity and Diabetes. Staff told us that training provided by the organisation is very good, and staff surveys inform that they always receive training that helps them to fulfil their roles. The home follows the organisations Recruitment Policy and Procedure that was last reviewed in April 2005. All current staff have been working at the home for many years. Three recruitment files were randomly sampled during the site visit. These included an application form, two referees, full employment history, health declaration and proof of identity and a photograph of the member of staff. Staff surveys inform that the organisation carried out all the checks as required before they commenced their work with the organisation. The deputy manager told us that all new staff would attend the organisations induction training programme that is in-line with the Skills for Care Council. During discussions staff told us that they receive formal supervision, however, through the viewing of these records it was noted that staff are not receiving these as required. A requirement has been made that all staff must receive the minimum of six formal one to one recorded supervisions each year, as required by Regulation. The AQAA informs that staff at the care home are extremely reliable, dedicated and flexible. CRB records are maintained. All staff have annual appraisals and supervision. Care Homes for Adults (18-65 years) Page 25 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. People who use the service benefit from a well managed home and their views influence the running of the service. The health, safety and welfare of residents are promoted and protected. Evidence: The home now has a manager who is qualified and experienced to manage the home. This was in compliance with a requirement made during the key inspection of November 2008. The manager is also managing the care home next door. We are aware that the manager has commenced the process of submitting an application to register with the Care Quality Commission. The current manager has been in post since the 20th March 2009. He is a qualified Registered Mental Health Nurse and holds the registered managers Award (RMA). The manager told us that he has over thirty four years experience of working with adults and children with a Learning Disability (LD). He was the manager of another of the organisations care homes for adults with LD for fifteen years prior to taking up his current role. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: During discussions staff told us that the manager is supportive, has an open door style of management and has made positive changes for the benefit of the residents and staff since commencing his duties Quality assurance is undertaken through two monthly meetings with residents and staff meetings. The minutes of these meetings were sampled during the site visit. Monthly Regulation 26 visits are undertaken by representatives of the organisation, and copies of these reports were available at the home. Evidence was viewed that the an annual survey of residents, their families and other associated stakeholders had been undertaken. However, a summary of the findings had not been completed. This was discussed with the deputy manager who told us that this would be done. The Annual Quality Assurance Assessment was completed and returned to us when we asked for it. This identified what the home does well, and plans for improvement during the next twelve months. The sampling of staff training files, and the viewing of the training matrix provided evidence that staff are receiving the mandatory training as required. Evidence was viewed of future dates for training. The organisation provides regular refresher training to all staff. Information provided in the AQAA informs that the health and Safety maintenance checks of equipment used at the care home are reviewed in accordance with the manufactures recommendations. We did view evidence that the fire extinguishers had recently been serviced and that fire risk assessments had been produced. Weekly testing of fire safety equipment used at the home is undertaken. The deputy manager told us that there are general risk assessements in place for the home. These are held in a large folder that was evidenced during the site visit. The AQAA informs that all Health and Safety and mandatory training are up to date. Care Homes for Adults (18-65 years) Page 27 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 28 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 36 18 The registered person shall 06/02/2010 ensure that persons working at the care home are appropriately supervised. The registered person must ensure that all staff receive formal recorded one-to-one supervision at least six times per year. 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 1 2 The Statement of Purpose and Service User Guide should include the dates they were last reviewed. The pre- admission assessments should be maintained and available for inspection purposes. 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. 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