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Inspection on 31/03/10 for Rose Villa

Also see our care home review for Rose Villa for more information

This is the latest available inspection report for this service, carried out on 31st March 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

Residents are well cared for and well supported and they feel safe at the home, one resident said, `it`s really good living here`. The service is trying to be person centered this means staff try to treat each resident as the unique individual they are. Care plans are helpful and informative and guide staff to support the residents really effectively. There are a really good variety of very relevant and suitable social and therapeutic activities put on for residents. Residents can enjoy a well cooked nutritious diet. Residents complaints are dealt with well. There is a suitable amount of staff training being undertaken. This means staff are well trained to meet residents needs. There are good practices put in place in the home to try and keep people safe and to ensure that their legal rights are upheld. The home is being well managed and well run.

What has improved since the last inspection?

This is not applicable as this is the first inspection of the home since it opened

What the care home could do better:

Ensure all new staff have two references taken up on them before they start work at the home. This is for the protection of the residents.

Key inspection report Care homes for adults (18-65 years) Name: Address: Rose Villa 167 Talbot Road Bristol Avon BS4 2NZ     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: Melanie Edwards     Date: 3 1 0 3 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 28 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 28 Information about the care home Name of care home: Address: Rose Villa 167 Talbot Road Bristol Avon BS4 2NZ 01325252001 01325252004 peterharrison@castlebeck.com www.castlebeck.com Castlebeck Care (Teesdale) Limited Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Elaine Joy Cotterell Type of registration: Number of places registered: care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who may be accommodated is: 9. 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 category: Learning Disability - Code LD. Date of last inspection Brief description of the care home Rosevilla is registered to provide accommodation and nursing care for up to nine persons aged 18 to 65 years, in the learning disability category. The home accommodates people with a variety of complex needs The aim is to provide a supportive environment in which individuals can be supported to participate in community living and eventualy maybe to move on to more independant living. Fees are around 2000 to 4000 pounds a week. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 9 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: We did the unannounced inspection over one day. We met six of the residents to find out their views of the home and what daily life is like for them. We looked at eight completed survey forms from residents, as well as a number from staff who work at the home. We met the registered manager, Mrs Elaine Cotterill, the deputy manager, a registered nurse, two support workers and the cook. We discussed with them their roles, responsibilities, training needs and what they do to assist and support residents. We also met a Consultant Psychiatrist. We saw residents being helped and supported by the staff who were on duty. We inspected a range of records to do with the running and managing of the home. We Care Homes for Adults (18-65 years) Page 5 of 28 saw one residents care plan and assessment information, a copy of the statement of purpose, the service user guide, five medication records, menus, the complaints record,the complaints procedure, staff training records, the procedure for keeping people safe from abuse,the staff duty rota, three staff employment records, quality monitoring information and the fire book. We read the homes annual self assessment document called the aqaa. We have quoted from the aqaa in this report. We saw most parts of the home. The only parts of the home we did not see were a small number of bedrooms. We found the home was operating within the required conditions of registration which we impose. The conditions of registration set out the type of care and the needs of the residents who may stay at the home. Care Homes for Adults (18-65 years) Page 6 of 28 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 7 of 28 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 8 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Resident are well supported to make choices in their daily lives. There is a really helpful amount of information available for people to find out about the services that the home offer. Evidence: We read a copy of the service users guide and statement of purpose to find out what sort of guidance information there is available for people to know what sort of care and service the home aims to provide. Each resident has their own copy of both documents kept in their bedroom,so that they have easy access to useful information about the home. We found the information in the statement of purpose and the service users guide was detailed and helpful. We saw photos included, the aims and objectives of the home, the type of care and the support that people can expect. We saw the name and contact details of manager of the home included. This information helps the reader to understand how the home will aim to support and care for people who live there. Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: We read one persons initial assessment information, to find out if the right care and support has been well planned for the person when they moved to the home. We saw information about the life the person has led so far, mental health history and information about family, friends and people who matter to them. We saw clear evidence that the assessment records included information about how to promote the independence of the person in their daily lives. The assessment records had been evaluated and updated on a regular basis. This helps show that the home have a really clear idea of the right sort of care and support to give to the residents, as well as how to give it. The consultant psychiatrist reviews the care of the residents at the home on really regular basis. Each resident care is planned with their involvement and the involvement of a multi- disciplinary team of staff who are involved in their care and welfare.This means that residents needs are being really thoroughly assessed and their needs reviewed to make sure that they can get the right care and support that they need. The aqaa document explains in detail how prospective residents needs are assessed and the aims and objectives of the home are met.We have quoted this extract: All residents in their previous placements received a full assessment by the Consultant Psychiatrist and the manager to assess their individual needs to ensure that Rose Villa could meet their needs. The manager has an open door policy. All residents chose their bedrooms. Residents were fully involved with the recruitment selection. Residents were fully involved with the decor and furnishings. All residents have had lengthy transition from their previous placements. At Rose Villa we ensure we provide a high standard of care which aims to meet the individuality of our residents. Care Homes for Adults (18-65 years) Page 10 of 28 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. Residents individual needs and choices are well respected and promoted in the home. Evidence: We read one residents care plan to see how people are assisted to meet their care needs. The care plan contained a really helpful amount of information about the persons range of needs and what to do to help them meet those needs. We saw a good level of information in the care plan about the persons life history and what matters to them, such as important family and friends. We saw that the care plan had been reviewed and updated regularly. This shows us that residents needs are clearly understood and the home can still give the best help and support to each person. We saw evidence that the residents had been involved in writing their care plans. Two residents we met told us that they are involved in planning their care. They told us they often go to a meeting with the staff and the Consultant Psychiatrist to talk about what help they think they need. This is really good evidence of residents being well involved in planning what is important for them in their daily lives. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: We read helpful information in residents care plans that showed us staff support residents really well to keep their independence in daily living activities in and out of the home. This shows residents are well supported by staff to make decisions and keep independence in their lives. One resident told us how the staff will support them to go to local shops and then they are left alone for some time to meet a friend as this is what they prefer. This is a really good example of supporting residents to keep independence and control in their lives. We also saw residents going out with staff during the morning to different community based activities. We read some useful information in the aqaa document about how residents individual needs and choices are promoted. We have quoted this extract:All our residents have Multi disciplinary team meetings monthly. All our residents have Care Programme Approach meetings every six months to review progress, assess needs and plan future goals Residents care plans, risk assessments, coping and tolerance programmes incentive programme and a timetable reviewed on a six monthly basis or sooner should the need arise. All residents have a care plan that is updated regularly. These plans are individual and reflect the needs of each person. We work with families and the multi-disciplinary team. All residents are supported and respected to express their needs and aspirations. Residents that attend college chose their courses themselves. Care Homes for Adults (18-65 years) Page 12 of 28 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 well supported to live a varied and fulfilling life, both in and out of the home. Residents are supported to keep in contact with the people who matter to them in their lives, if this is their choice. Residents are provided with a well cooked diet. However the management of the home should ensure residents views about the overall standard of cooking are listened to and acted upon if need be. Evidence: We were told by the staff that residents are well supported to keep in close contact with people who matter to them. We met residents who told us they regularly see their family and also keep in touch with friends. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: We saw art works on display in the home. There is a dedicated arts, crafts and training room,(with its own self contained garden area) and we saw arts and crafts projects taking place involving residents and staff. These are really good examples of how residents are helped to do meaningful activities. The home has Internet access and residents use this. We met residents who showed us some really interesting research work they had been doing from the Internet. One person we met told us are looking forward to going on holiday this year with the staff for the week. This is a really good example of a therapeutic activity for residents to be part of if they want to. We looked at a copy of the current records of meals that residents have eaten over the last four weeks. We saw a choice of dishes recorded as available for each day. We saw a choice of dishes recorded as available for each day. We saw residents being asked what meals they would like. This is a really good way that residents make choices in their daily lives. We saw a variety of of meal options available for the residents. Meal choices included a range of traditional nutritional meals. The lunchtime meal choices were pasta and spaghetti sauce, a rice dish or a salad. We sampled the pasta dish which was tasty and looked appetising. The residents told us that the food at the home is mostly good, but that the overall standard can be variable and sometimes food has been burnt. We told the manager about these comments and she agreed to address any concerns. We read some useful information in the aqaa document about how residents are supported to life a fulfilling lifestyle. We have quoted this extract :All residents are encouraged to follow a varied and healthy diet. We encourage and promote a healthy diet. We encourage residents to live their lives how they wish with the staff support and structure by means of a timetable home leave and community access. All residents have the opportunity to access the community on a regular basis taking into consideration their personal choices interests and hobbies. Care Homes for Adults (18-65 years) Page 14 of 28 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 health and personal care needs are well met. Residents are treated respectfully by staff and their privacy is maintained. Evidence: We met the Consultant Psychiatrist during the inspection, who gave us some very constructive feedback about the success of the home so far since it opened. They also told us that they visit the home once a week and carry out regular reviews of residents care,with their full involvement. This is really good evidence of residents being actively involved in decision making in their own lives. To learn more about how residents are supported to meet their care needs we looked in detail at one care plan. We read some very clear and detailed information in the care plan. The care plans showed how to give the support and care to the residents who have really complex learning disabilities that may have a real impact on their daily lives. We saw that care plans had been reviewed and updated on a regular basis.This is done to show us that the home continues to understand residents needs and to make sure they can still give them the support and care that they need. Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: We saw staff helping residents with a range of different needs and activities in in a skilled and sensitive way. This show us that residents are well supported by the staff. Residents also told us in the survey forms we read, that they are very well supported by staff. We looked at how residents medication is given to them stored and disposed of to see if this is done in a safe and proper way. We checked the medication administration charts of five residents. The medication administration charts looked legible up to date and had the signature of the staff giving out the medications. This helps demonstrate medication is given to residents safely. We also saw extra information written by the staff, to explain the ways that people like to take their medication as well as what they are for. This information should mean residents are given medication in the way that suits them best. The stock of medication we saw was satisfactorily organised. We read some really useful information in the aqaa document about how residents personal and health care needs are met. We have quoted this extract :All residents have a Health Action Plan in place. Medication is administered in accordance of agreed protocol. All personal health care and support is reviewed on a monthly basis by the Multi disciplinary team for all residents. All residents have been registered with the local GP, dental, optician and chiropodist who visits here. All staff are trained in the administration of rectal diazepam and other similar medication .There is a qualified Nurse on duty 24 hours per day. All those residents who have a diagnosis of asthma diabetes and epilepsy attend relevant check up appointments. Care Homes for Adults (18-65 years) Page 16 of 28 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. Residents complaints are addressed well in the home. The home takes proper measures to keep residents free from abuse. Evidence: We checked the complaints records to see how complaints are dealt with by the home. There had been one complaint made. We could see from the information we read, that residents are listened to and given a chance to make their views known if they feel they have been treated wrongly by another resident. We also saw that when needed, action was taken to properly address the complaint. In our discussions with the manager and the deputy manager they demonstrated a really clear understanding of the importance of supporting residents to make their views known if they are unhappy. The residents who we met said they could talk to the staff if they need to. We saw a copy of the complaints procedure kept in the home. This has been written in an easy to understand format. It has our contact information as well if people need to get in touch with us. We were told by the residents there are regular residents meetings. The meetings are used as a way for residents to make known any complaints they may have. This is a Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: way residents take control in their lives and to make complaints if they need to. We saw a copy of the policy to do with the topic of protection of vulnerable adults from abuse. The policy is to help to guide staff to take the correct course of action if they ever have to respond to an allegation of abuse. We read some useful information in the aqaa document about how residents can complain and how they are kept safe in the home. We have quoted this extract:The Manager has an open door policy. Castlebeck Complaints procedure is in place. A Whistle blowing policy is in place. There are abuse policies available for all staff .Safeguarding Adult referral and helpline available to all staff. All staff have attended Safeguarding Adult training. Complaints folder in place which hold any complaints made and the outcomes. The how to make a complaint guide issued to all residents and one available in the reception area. All residents have access to Advocacy service who visits on a monthly basis. All residents have a Named Nurse and Key worker to raise concerns and issues with. All residents are supported in the community by at least one member of staff to ensure their safety. All residents have individual risk assessments in place to assess the risk of exploitation and are reviewed and updated 6 monthly. CCTV camera in use looking out onto the street for the protection of the residents and staff. There are two safes available at Rose Villa where the residents can keep their money secure. Care Homes for Adults (18-65 years) Page 18 of 28 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 environment and its location is really suitable for the residents who live there. Evidence: Rose Villa care Home is a large two storey building in the residential suburb of Brislington in Bristol. The home is really near to bus routes into town. It is near to a really large open park area, a local church, pubs a range of shops, a cinema and a bowling alley. Residents we met told us that they go to these community facilities on a regular basis. There is a lift to the second floor to assist people who may have reduced mobility. The environment looked safe very clean and very well maintained in all the parts that we saw. Bedrooms are all for single use and they have en- suite toilet and shower facilities. Two residents kindly showed us their room. They said they really like living there. Many bedrooms look personalised with personal possessions, photographs and pictures displayed in some rooms to give a more homely feel to rooms. Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: There is a spacious dining area as well as two lounges. The residents we saw looked really relaxed and settled in their surroundings. There is a training and arts and crafts room that is very well used by the residents. there is an enclosed back garden as well as a spacious and enclosed front garden. Both these areas are well used by the residents. Residents have been involved in making some of the garden furniture that we saw, this is a really good way of involving residents in the running of the home. We read some useful information in the aqaa document about how the environment is safe and suitable for the residents. We have quoted this extract : All residents have spacious warm bedrooms with en suite facilities. All residents have their own bedroom key however if their mood is assessed to be unsettled and the risk of misuse of the key, either to self harm or barricade themselves in the key will be temporarily taken from them until mood assessed to be settled again. Each resident has a specific risk assessment in place identifying the potential risks involved with holding their own key. Rose Villa is situated near to the Bristol city centre and has public transport available. Local college is within driving distance. Disabled toilet and lift available . CCTV camera in use looking out onto the street for the protection of the residents and staff. Laundry facilities are available either through the main laundry which can be used with the support of the staff or there is a washing machine available in the training kitchen. Care Homes for Adults (18-65 years) Page 20 of 28 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 a sufficient number of competent qualified staff. The procedures to employ new staff are generally safe and robust, however there needs to be a tightening up of them, to ensure all staff have the required preemployment checks undertaken. The staff are supported and supervised in their work. Evidence: All of the residents who we met, as well as those who sent us back survey forms made really positive comments about the staff who help them. One resident said,they look after me and are really good, another person said that the staff are, kind but can put their foot down, they said this was, a really good thing. We were also told by residents we met, about staff who were their named key worker who take an extra special interest in them and their care. We checked the number of staff on duty for four weeks of March of this year. We saw that there is always one qualified nurse on duty at all times. There are four support staff on duty for a day shift. At night there are three staff who are on duty. There are Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: also catering staff, housekeeping staff, administration staff and maintenance staff who work at the home but we did not check in details the numbers of these staff. Based on the evidence from the inspection and from what the residents told us, the numbers of staff on duty are meeting the needs of the residents. We checked the staff employment files of three staff to make sure that safe recruitment procedures are followed. We saw two written professional references for staff before they start work at the home. However one staff member who had been recruited had only one reference taken up about them, before they started work at the home. We advised that two references are needed as a safety check to try and ensure only suitable people are employed at the home. The staff must undertake a criminal records bureau check before starting employment. These checks aim to make sure the home takes on only suitable people to work with residents. All of the staff who we met and who sent us back survey forms, said that they feel very supported in their work. We were told by the staff that they have regular support meetings with the manager. These meetings take place to guide and support staff in their work. We saw records that demonstrated staff have regular one to one support meetings with the manager. We did tell the manager to make sure that records are kept of all supervisions sessions with staff including,with the deputy manager, this is for their learning and development. We saw written evidence in the staff training files that confirmed that a really good range of training, in relevant subjects related to the needs of the residents has taken place over the last year since the home opened. We read some useful information in the aqaa document about the staff team who support the residents. We have quoted this extract :All staff were given a fourweek full induction before working with our residents in a secure setting environment. All staff are trained in the use of physical intervention techniques to ensure the safety of the residents and staff should it be needed. All staff worked closely with our residents who were placed in Winterbourne View the Assessment and Treatment Hospital before the residents moved in to Rose Villa. The majority of staff have completed Learning Disability Qualification .Two Support Workers are currently completing their National Vocational Qualifications (NVQ). Three Support Workers are due to start NVQ courses. Our Senior Support Worker will have completed his NVQ level three within the next six weeks. All staff have supervision session six times a year and the staff were given the choice of supervisor. All staff were given their individual job descriptions when applied for their posts. At Rose Villa we fully understand the importance of effective communication and active listening skills . Care Homes for Adults (18-65 years) Page 22 of 28 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. Residents are being well involved in the running of the home which is being run in their best interests. The overall quality of the care and the service in the home is being properly and regularly checked and monitored. The health and safety of people in the home is well protected. Evidence: Mrs Elaine Cotterill is the registered manager of the home. She has been registered with us, this process shows that we judge her to be a fit and suitable person to manage a care home.Mrs Cotterill is a trained nurse who has many years experience caring for people who have learning disabilities. We saw residents going into the office to see the manager during our visit. We noticed that residents clearly have a very warm and close relationship with her. We saw that residents are really relaxed about going into the office when they need to see her. Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: We met the registered manager and the deputy manager. The manager and deputy manager explained clearly to us their roles and responsibilities. The staff and some residents are given different areas of responsibilities. The evidence we found from the inspection demonstrates that this allocation of different areas of responsibility in the home works effectively for residents. We saw written information that showed us that the quality of care and the overall service is regularly checked in the home. The deputy manager explained to us that the overall standards of care and service for residents are looked at really closely on a very regular basis. Good practice is reviewed and areas that may need improving are actioned and addressed. We found that residents records were satisfactorily maintained up to date and in good order. The environment looked safe and well maintained. We saw some helpful health and safety risk assessments carried out of the whole environment on a really frequent regular basis. These are done to address health and safety concerns and problems in the home. We saw evidence that confirmed that staff do regular training in health and safety matters including first aid, food hygiene training and moving and handling practices. This should help protect residents health and safety if staff are knowledgeable and well trained in health and safety matters.The home has also been awarded a five out of five star award from environmental health inspectors. This award demonstrates that really safe food handling practices take place in the kitchen. The fire logbook records showed fire alarm tests are being carried out. There are also fire drills carried out on a regular basis to help protect the health and safety of residents and staff. We read some useful information in the aqaa document about how the home is run in the best interests of the residents. We have quoted this extract :The registered manager is very passionate about the residents mental health and well being. The registered manager has worked closely with many of the residents for nearly three years. The registered manager takes her role seriously and acts as a professional role model. The registered Manager feels that the care staff are building good relationships and are developing into a good team. All staff focus on the well being of the resident using a holistic approach. The registered Manager has allocated specific roles and oversees such as Infection Control nurse Health and Safety Medication Fire Marshal Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: Quality Auditor and training Coordinator. Each member of staff takes their role seriously and attends all relevant meetings to enhance their awareness, knowledge and understanding in their topic. The registered Manager ensures that the periodic specific reviews are completed on a monthly basis. The registered manager ensures she maintains regular contact with the residents families. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 34 19 All new staff must have two 02/04/2010 references taken up on them before they commence employment. Protection of the residents. 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 Care Homes for Adults (18-65 years) Page 27 of 28 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. © 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. 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