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Inspection on 21/04/10 for Radcliffe Meadows Mental Nursing Home

Also see our care home review for Radcliffe Meadows Mental Nursing Home for more information

This is the latest available inspection report for this service, carried out on 21st April 2010.

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

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

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

What the care home does well

People who live at Radcliffe Meadows can have confidence in the home because it is managed by a qualified and experienced person who has developed her skills over time through training and personal development. People who are thinking of moving to Radcliffe Meadows are given good information to help them make decisions about the home. They are encouraged to visit the home so they are able to make an informed choice as to whether it is suitable for them. The information about the home, what it does and who it is for, is written in plain and clear language so people are helped to understand the information and know what the home provides. The service users` handbook is being illustrated with pictures and symbols to make it easier to read. This showed us that managers and staff understand the importance of providing people with the information they need to help them choose a home that is suitable for them. Each person`s individual needs are known and their rights to privacy and confidentiality are respected so the support they get from staff is given in a way that meets their needs and maintains their dignity. We could see that the people who live at Radcliffe Meadows have good relationships with staff . The atmosphere in the home is friendly and sociable. People are offered a range of activities in the home and are supported and encouraged to explore and take advantage of opportunities for leisure and socialising in the local community. We could see that there is a strong and consistent team of staff. They are well trained and were recruited through thorough procedures so they are suitable to work with the people who live at the home. Staff present as a cohesive team that benefits from good leadership and shared aims and objectives so the people who live at the home experience good quality outcomes.

What has improved since the last inspection?

Person centred care planning is being introduced so people receive the care and support they need in the way they want and prefer. This was not in place for all the people who lived at the home but where it was in place it was clear that the person enjoyed better quality outcomes because they were doing things that they had always wanted to do but had not had the opportunity to do them. Arrangements for safeguarding people had significantly improved. Most staff had completed training on safeguarding vulnerable adults so they know what to do in the event of any suspicion or evidence of abuse. This will help to make sure that the people who live at the home are safeguarded from abuse. The way complaints and compliments were records had been improved so managers and staff can show that peoples views are taken seriously and acted upon. A fire risk assessment had been put in place and shared with the fire officer so the people who live and work at the home would be safeguarded in the event of a fire.

What the care home could do better:

Person centred planning needs to be put in place for all the people who live at the home so they receive the help and support they need to work toward and achieve their life goals. Effective quality assurance and quality monitoring systems that are based on seeking the views of the people who live at the home and their representatives need to be put in place so the service is run in the best interests of the people who use it.

Key inspection report Care homes for adults (18-65 years) Name: Address: Radcliffe Meadows Mental Nursing Home Off Twiss Green Lane Culcheth Warrington Cheshire WA3 4DJ     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: David Jones     Date: 2 1 0 4 2 0 1 0 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 27 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Radcliffe Meadows Mental Nursing Home Off Twiss Green Lane Culcheth Warrington Cheshire WA3 4DJ 01925765550 01925767636 j.gilbody@wcl.uk.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Warrington Community Living Name of registered manager (if applicable) Ms June Gilbody Type of registration: Number of places registered: care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The Registered person may provide the following category of service only: Care home with nursing - Code N 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 The maximum number of service users who can be accommodated is: 12 Date of last inspection Brief description of the care home Radcliffe Meadows is purpose built. The home provides nursing care for twelve younger adults who have a learning disability and behaviouralmental health needs andor physical or sensory needs. The home is situated close to the village of Culcheth and is within a short walking distance of a bus service. The philosophy of the home is to help people to lead an independent and fulfilling lifestyle by providing opportunities to exercise their rights, and to enjoy the same range of options available to all members of society. The home is a single storey building that provides twelve single bedrooms, Care Homes for Adults (18-65 years) Page 4 of 27 12 Over 65 0 Brief description of the care home lounges, dining rooms, an activities room, two bath and shower rooms, four toilets, a laundry, kitchen, and large enclosed gardens to the rear of the property. Information about Radcliffe Meadows including copies of the most recent inspection report is made available to each resident and their representatives and can be acquired by contacting the manager on 01925 765550. Fees range according to the needs of the individual. Contact the home on 01925 765550 for further information. There are no additional charges other than agreed transport costs shared between the people who live at the home. Care Homes for Adults (18-65 years) Page 5 of 27 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 this service is two stars. This means that people who live at Radcliffe Meadows experience good quality outcomes. This visit was unannounced. It took place over one day, taking 7 hours in total, and was done by one inspector. This report will say we when referring to our activities and findings, as it is written on behalf of the Care Quality Commission. Our visit was just one part of the inspection. Before the visit took place we asked the manager to complete a questionnaire that we call an annual quality assurance assessment or AQAA for short. It gives us information about how the home is meeting the needs of the people who live there and includes plans for future development. We looked at the information that we already had about the home and this, with the information from the AQAA, helped us to form our inspection plan. Care Homes for Adults (18-65 years) Page 6 of 27 We checked the records of two people who lived at the home to see what care they receive. We spoke with some of the people who live at the home and some of the staff who support and care for them and their views were taken into account. We looked at the communal areas of the home to see how the home was decorated, maintained and furnished. We also looked at some policies and procedures to check that these were up to date and provided suitable guidance for staff. Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well: What has improved since the last inspection? Person centred care planning is being introduced so people receive the care and support they need in the way they want and prefer. This was not in place for all the people who lived at the home but where it was in place it was clear that the person enjoyed better quality outcomes because they were doing things that they had always wanted to do but had not had the opportunity to do them. Arrangements for safeguarding people had significantly improved. Most staff had completed training on safeguarding vulnerable adults so they know what to do in the event of any suspicion or evidence of abuse. This will help to make sure that the people who live at the home are safeguarded from abuse. The way complaints and compliments were records had been improved so managers and staff can show that peoples views are taken seriously and acted upon. A fire risk assessment had been put in place and shared with the fire officer so the people who live and work at the home would be safeguarded in the event of a fire. Care Homes for Adults (18-65 years) Page 8 of 27 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 9 of 27 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 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are thinking of moving to Radcliffe Meadows have good information to help them decide if the home is suitable for them. They have their needs assessed so they can be confident that their needs will be met when they move in. Evidence: People who are considering moving to Radcliffe Meadows are given information about how it works and who it is for so they are helped to understand what the home has to offer. This information includes the service users guide and residents handbook. These provide useful information about the home including philosophy of care and facilities and services provided. The service users guide is available in large print and the Residents had book was being illustrated with pictures and symbols to make it easier to read. This showed us that managers and staff understand the importance of giving people the information they need so they can decide whether the home is suitable for them. We checked the care records of two people who lived at the home and we spoke with them and a visiting relative. We could see that there were good procedures for Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: introducing new people to the home. Each person had an assessment before they moved so they could be confident that the home was suitable for them. Their assessment included a risk assessment so they and the staff who supported them were safeguarded. Care plans were developed with the person and where appropriate with their representatives so they received care and support in the way they wanted and preferred. Care Homes for Adults (18-65 years) Page 12 of 27 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. The people who live at Radcliffe Meadows are involved in developing their own care plans so the health and personal care they receive is based on their individual needs. Evidence: We looked at the care records of two people who lived at the home to check the arrangements made for their care and support. We could see that each persons care plan was based on their individual needs and reflected their personal preferences, likes and dislikes so they would receive care and support in the way they wanted and preferred. We spoke with some of the people who lived at the home and we could see they were happy and content living there. They had opportunities to take part in social, and leisure activities in the home and local community so we could see that they were supported to live a fulfilling lifestyle. Staff were skilled and confident in their abilities. They were well trained and had a clear understanding of each persons individual needs so they were able offer support in a way that promoted dignity, mutual respect and independence. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: Individualised procedures for the management of aggressive or potentially harmful behaviours had been established where they were needed. These were based on good practice guidelines and focused on positive outcomes so staff were able to respond to and manage challenging situations effectively and safely and in the best interests of all concerned. We could see that any limitation on a persons freedom of movement or power to make decisions was made in the persons best interests and in agreement with them or their representatives including health and social care professionals. Staff had received training on the mental capacity act so they were able to support people to make decisions themselves. A relative of one of the people who lived at the home told us that they were satisfied with the standard of care but were concerned because there was a lack of planning for the future. Their relative had complex needs but had expressed a desire to move on from the home. We could see that this had not been taken into consideration in the care planning process and had not been recorded in their care plan so it was not clear how staff were helping this person achieve their long term goal to move on from the home. The manager showed us how person centred planning was being introduced so people would receive the help and support they need to work toward their life goals. Risk assessment is an important part of the homes care planning procedures so the people who live at the home are helped to make their own informed decisions and have the right to take risk in their daily lives. Each persons care file contained a range of risk assessments addressing potential hazards in and around the home and local community. We could see that risk assessments balanced choice and risk so people were supported to take an element of risk in the interest of living an independent and fulfilling lifestyle. At the time of our visit the manager was in the process of developing policies and procedures on the Mental Capacity Act 2005 Deprivation of Liberty Safeguards. However, we could see that the people who lived at the home were able to make decisions about their lives and lifestyle and got the right type of help where needed. We could see that people were involved in the day to day running of the home. A residents action group had been established so people could meet with staff on a regular basis and discus issues that were important to them including plans for future development. One person told us that they had been invited to take part in a staff interviews so they could have a say in who provides there care and support. Care Homes for Adults (18-65 years) Page 14 of 27 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 live at Radcliffe meadows are supported to make choices about their lifestyle and are offered a range of activities in the home and local community that meets their needs and expectations. Evidence: The homes activity records show that people are supported and encouraged to enjoy a full and stimulating lifestyle. Individual hobbies and interests are supported and promoted and people have opportunities to take part in a range of social, and leisure activities in the home and local community. People told us that they were able to do a range of activities including shopping and visiting interesting places in the community. Records show that people living in the home are encouraged to maintain contact with family and friends. A visiting relative told us that they were always made to feel welcome. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: The atmosphere in the home is sometimes relaxed and sociable but often vibrant. Staff tend to take the lead on most domestic tasks such as meal preparation but encourage people to take part in washing pots, clearing away and doing their own laundry. Meal times were enjoyable social occasions and records of meals served show that a varied and nutritious diet is on offer. Care Homes for Adults (18-65 years) Page 16 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and wellbeing of people living at Radcliffe Meadows is monitored by staff and other health and social care professionals so they get the care they need. Evidence: Personal health care needs, including specialist needs and dietary requirements, are clearly recorded in each persons care record file. Care records provide an overview of the persons health care needs and act as an indicator of change in health requirements. Care plans show that all people living at the home are registered with a local doctor and other health care specialists monitor their mental heath. This helps to make sure that people stay healthy and their specialist heath care needs are met. Medicines management and administration was checked. Most of the medication prescribed for the people who live at the home is packaged in a monitored dosage blister packs but this is not appropriate for some medicines which are supplied in the original packaging. We looked at medicine administration records (MAR) sheets and found that these were accurate and up to date. Stock records of loose medicines were kept in the required detail so people received their medicines as their doctor Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: prescribed them and their health care needs were met. . Care Homes for Adults (18-65 years) Page 18 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Radcliffe Meadows are able to express their concerns and have access to an effective complaints procedure. They are safeguarded from abuse and have their rights protected. Evidence: We could see that the manager and staff share positive attitudes toward receiving and acting on complaints and people who live at the home say staff listen and act on what they say. The complaints procedure is illustrated with pictures and symbols so it is easier to read. Compliments and complaints records showed that two complaints and four written compliments had been received since our last inspection. We could see from the complaints records that the concerns raised had been taken seriously, acted upon and addressed appropriately. Staff have access to written policies and procedures for responding to suspicion or evidence of abuse including a whistle blowing policy so they know that they can report poor practice. Staff training records showed most staff had received training on adult safeguarding procedures so they know what to do if there is any evidence or suspicion of abuse. Records and information provided by the manager showed that there had been three safeguarding referrals to the local authority since our last inspection of the home. Information provided by social services department showed that the home had acted appropriately and worked in partnership with them to ensure vulnerable people were safeguarded. Care Homes for Adults (18-65 years) Page 19 of 27 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. The home is clean, tidy and well maintained so people live in comfortable, clean surroundings that meet their needs. Evidence: Radcliffe Meadows is a purpose built home located in its own spacious gardens in a residential area of Warrington. It has ample care parking and good access to local shops, cafes, pubs and public transport. People who lived at the home told us that they liked it and were very comfortable there. One person showed us around the home and the gardens, which offer excellent recreational and leisure opportunities. We could see that people were encouraged to decorate their bedrooms to reflect their characters and personal requirements so they see the home as their own. The home was very well equipped and was accessible to people with a physical disability. It is well maintained and comfortably furnished throughout. The standard of cleanliness was good. There were no noticeable odours and polices and procedures on infection control were in place and followed to make sure that risk of infection spreading was reduced. Care Homes for Adults (18-65 years) Page 20 of 27 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. Managers and staff are trained and have gone through thorough recruitment processes so they are suitable and have the right skills to work with the people who live at the home. Evidence: Radcliffe Meadows is registered to provide nursing care so there is always at least one qualified nurse on duty on each shift throughout the day and night. Our observations and discussions with staff and the people who live at the home showed that there were enough staff on duty to meet the needs of the people who live there. Staffing rotas take account of the changing needs of people so more staff are employed at times of higher demand. We could see that nursing and care staff were skilled and experienced. They carried out their work in good humour with sensitivity and understanding, helping people to achieve what they wanted to do, with the minimum of fuss and intervention. We checked the recruitment file for one new staff member and we discussed recruitment procedures with the manager and some staff. Records showed that the homes recruitment procedures were thorough so staff are suitable and have the right skills and knowledge to work with the people who live at the home. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: We talked with the manager, three nurses and a care worker about training opportunities and we looked at the staff training records. We could see that there was a comprehensive staff training and development programme with opportunities for training in a range of relevant topics. These included training on infection control, challenging behaviour including safe physical intervention, safer handling, moving and handling, health and safety, fire awareness, emergency aid, food hygiene, equality and diversity, mental capacity act, medication and health care procedures and adult safeguarding procedures. All new staff complete the Skills for Care induction training programme. This includes the common induction standards so they have the skills they need to do their jobs effectively and competently. The staff team comprises of eight qualified nurses including the manager and nineteen care workers. The training matrix shows that seventeen of the homes nineteen care workers have achieved a national vocational qualification (NVQ) in care at level two or above. This means that the home had exceeded the target for a minimum of fifty percent of staff to achieve a nationally recognised qualification in care by a good margin. This showed that people who live at the home are in safe and competent hands. All staff spoke highly of the manager telling us that communication in the home is good and they appreciated her leadership and support. They had the benefit of an annual appraisal, and regular supervision and staff meetings. This showed us that the staff have opportunity to discuss care practice and personal development needs so they are well supported. Care Homes for Adults (18-65 years) Page 22 of 27 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. Radcliffe Meadows is well managed so people receive the care and support they need to live in a safe and comfortable environment. Evidence: Radcliffe Meadows has been without a registered manager since our last inspection However, the post is advertised and an acting manager has been appointed until the post is filled. The acting manager is a qualified registered nurse specialising in learning disability who has worked at the home for a number of years as an assistant manager. Currently she is working toward NVQ level 4 in Leadership and Management in Social Care. Our observations and discussions with staff, the people who live at the home and a visiting relative showed us that the acting manager is person centred and has a clear understanding of what needs to be done to make sure the home is run in the best interests of the people who live there. All staff we spoke with were familiar with the concepts of equality and diversity and told us how they recognised and met each persons individual needs by providing care in the way they wanted and preferred. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: Much has been achieved since our last inspection with significant improvements in safeguarding vulnerable people and person centred care planning. The staff present as a cohesive team that benefits from good leadership and shared aims and objectives so the people who live at the home experience good quality outcomes. This shows us that the home is managed well by a competent person. A new system to help people to manage there money was being introduced. We could see that the new system helped people to get better access to their money so they could take advantage of opportunities to do activities in the local community such as shopping or visiting an attraction without needing to make prior arrangements. This meant that people enjoyed a better quality of life. Records relating to the handling of peoples money were checked and found to be accurate and up to date so they were safeguarded from financial abuse. Warrington Community Living the registered charity that runs the home has a quality assurance system but this had not been put into practice at the home in the last 12 months period. However, the views of people who live at the home have been sought through the Residents Action Group which had been established since the last inspection and the acting manager told us that she will put the quality assurance system into practice in the near future. We could see that the health and safety of people who live and work at the home is promoted. Staff have received training in health and safety and have access to a health and safety policy so they know what to do to ensure the safety of the people who live, work and visit the home. We spot checked some maintenance records and found that they were up to date so the home is well maintained. The acting manager confirmed that a fire risk assessment was in place and it had been shared with the fire officer so people will be safeguarded in the event of a fire. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 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 Person centred planning needs to be put in place for all the people who live at the home so they receive the help and support they need to work toward and achieve their life goals. Effective quality assurance and quality monitoring systems that are based on seeking the views of the people who live at the home and their representatives need to be put in place so the service is run in the best interests of the people who use it. 2 39 Care Homes for Adults (18-65 years) Page 26 of 27 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 27 of 27 - 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!