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Inspection on 16/02/10 for Stephendale Road, 78-80

Also see our care home review for Stephendale Road, 78-80 for more information

This is the latest available inspection report for this service, carried out on 16th February 2010.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What the care home does well

We spent time talking to five of the six residents who all told us they are happy living at the home.The residents were all sitting in the dinning room together and were seen to be interacting happily with each other. We spent time talking to staff who were very knowledgeable about the required care needs and support of all of the residents. The residents were asking for assistance from staff who were supporting them to make decisions.

What has improved since the last inspection?

The statement of purpose and service user guide have been updated and contain the relevant information to inform prospective people and stakeholders about the aims and objectives of the home. All of the food was seen to be stored appropriately with frozen food having the relevant information on the packaging when it had been opened. We looked at the medication records and all entries MAR sheet were correct. The storage of all medicine bottles was checked and the bottle looked at had the date opened on the label,all staff are now seen to be following the correct procedure.

What the care home could do better:

There are a number of areas for improvement for this service. The most important one is to review the staffing levels in the home now that two new residents have moved in. This is to ensure there are enough staff to meet the individual needs of the residents and to enable them to go out and have fulfilling and active lives. In addition further work needs to be done to support each person to have an activity programme that reflects their individual interests and that is stimulating and enables people to develop new skills and access a range of opportunities. Care plans need to be developed for the two new residents to ensure that their individual needs are met,their wishes to reflected and to ensure that all staff know what care and support they are providing so this happens consistently. The staff in the home need to keep records of when the people living in the home attend their annual healthcheck, so that it can be seen that these are taking place. The flooring in one bedroom needs to be deep cleaned to ensure that unpleasant odours are eliminated as this is unacceptable for the resident and staff as well as being a potential health and safety risk.

Key inspection report Care homes for adults (18-65 years) Name: Address: Stephendale Road, 78-80 78-80 Stephendale Road Stephendale Road Fulham London SW6 2PQ     The quality rating for this care home is:   one star adequate 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: Jackie Derbyshire     Date: 1 6 0 2 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 31 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 31 Information about the care home Name of care home: Address: Stephendale Road, 78-80 78-80 Stephendale Road Stephendale Road Fulham London SW6 2PQ 02073718908 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): rob.walker@yarrowhousing.org.uk Yarrow Housing Name of registered manager (if applicable) Robert George Walker Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home Stephendale Road is the home for six people with a learning disability. The care is provided by Yarrow Housing Limited, which is a voluntary organisation. Notting Hill Housing Trust owns the property. The home is located in a quiet residential street in Fulham and is close to transport links and local amenities. There are 6 people living at Stephendale Road presently, each person has a single bedroom. There are two bedrooms on the ground floor, two bedrooms on the first floor and another two Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 6 Brief description of the care home bedrooms on another level up three steps. Washbasins are in each bedroom. There are WC, bathrooms and shower rooms situated close to bedrooms and communal areas. There is a passenger lift to the first floor. There is a garden to the rear of the home and a lounge and kitchendinning area. The weekly charge for Stephendale Road is 1,503.22. Care Homes for Adults (18-65 years) Page 5 of 31 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: one star adequate 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 1 star. This means the people who use this service experience adequate quality outcomes. Throughout this report the word we will be used as meaning the Care Quality Commission CQC. This unannounced inspection took place on Tuesday 16th February 2010, we spent 4.00 hours visiting the home. We spent time talking to five of the six residents. We spent time talking to the acting manager, deputy manager and a member of bank staff. We checked the care records of two residents and all medication and finance records were looked at. We had a full tour of the home and looked at all of the residents bedrooms. Stephendale Road is in the process of going through the planned cyclical redecoration in all communal areas including the toilets and bathrooms. Residents told us they are happy with the decor in their own bedrooms. Four requirements set in June 2009 have all been met, four new requirements have been set from this inspection. Care Homes for Adults (18-65 years) Page 6 of 31 Care Homes for Adults (18-65 years) Page 7 of 31 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. Care Homes for Adults (18-65 years) Page 8 of 31 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 31 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 31 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 using the 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 provides a statement of purpose that is specific to the individual home and the resident group they care for. Evidence: Comments from residents I like living here at Stephendale Road I am happy here and my boyfriend likes to visit me here We looked at the statement of purpose and service user guide, both documents have been up dated and include all information on the aims and objectives and philosophy of Stephendale Road. Both documents are also available in different formats if required. Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: We looked at assessment records in the two new residents files that show that their needs have been assessed as records of introductory visits were looked at for both residents. A lot of the information looked at was from the previous home they lived at and we were told by the acting manager that he would be up dating both files with the residents and key workers imminently. We looked at the two new residents agreements, the records were up to date and we were told they would be reviewed annually. Both records were signed and dated by the residents. All original contracts are kept at the Yarrow Head office. Care Homes for Adults (18-65 years) Page 12 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each individual has a care plan but practice of involving people who use the service in the development and review of the plan is variable. The plan includes basic information necessary to deliver the residents care but is not detailed or person centered. The care plan is not being used as a working document and does not consistently reflect the care being delivered. Evidence: We looked at the two new residents files, both included person centered plans from the last home they lived at with lots of reviewed records. The PCP plans are in need of up dating to reflect the care and support required in Stephendale Road and what the aims and aspirations of the residents are now. We were told by the acting manager that he would work with the residents and key workers to ensure all information is bought up to date. We spent time talking to other residents who told us they like to go on holiday, which they are, two of them told us they are going to the Isle of Man. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: Another resident commented that they have continued their relationship with their girlfriend when they moved into Stephendale road. We looked at the financial records for all six residents, all of the financial information including the cash balance was correct for all residents. We discussed the financial procedure for a resident that is unable to make financial decisions for themselves. We were told by the acting manager and deputy manager that the deputy manager is the agent at this time and the resident is escorted to the bank when monies are required for daily living needs. We discussed having a referral for an advocate for the resident as they had little contact with any family or friends. The acting manager stated he would liaise with the social services to look at reviewing the residents financial situation. There was support plan summaries in each file looked at that had been put in place at the last home and Stephendale Road that show what support staff was providing to each resident daily.Throughout the morning staff were seen to promote the residents independence assisting them when requested and not telling the residents what to do. We looked at the risk assessments for all of the residents, all of the risk areas identified in the care plans had an action plan in place to inform staff of the risk and how to eliminate or minimize the risk. The risk assessments did work in conjunction with the care plans.We discussed the two new residents risk assessments with the acting manager and was told that he would be working with the key workers to ensure that all relevant documents reflect the care needs of the residents. We were told that the risk assessment are reviewed regularly. We were sent updated risk assessments for both of the new residents showing the action plans and how staff would assist to minimize any identified risks Care Homes for Adults (18-65 years) Page 14 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 12,13,15,16,17 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people using the service are not always given the opportunity to take part in activities both in the home and in the community because the staffing levels are not sufficient on certain shifts, mainly daytime. Evidence: Comments from residents. I like going to see my girlfriend. Im going out, I am happy. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: Its holidays this week so I am not going to the center We looked at the activity plans of all six residents,we also looked at the care plan records of the two new residents. The records contained a information about each residents likes, dislikes, hobbies and leisure interests. We also looked at the daily records books for all of the six residents that had information about what activities they had done daily that included attending a local shops and cafes, going to the local community center, attending art classes, discos, eating out, and for two residents visiting their partners at their homes. We spent time discussing activities with the acting manager who told us that the in house activity programme is being looked at as there is not enough being provided to individuals at this present time. We discussed staffing levels with the acting manager as there were clearly not sufficient staff on duty to provide all of the residents with activities. We also looked at the staffing rotas for The last 3 months and the month of February, the information showed that not at all times are there sufficient staff on duty to meet the social care needs of the residents. We saw the residents dancing in the dinning room with a member of staff, no other activities were provided on the morning of this inspection. We were told by the acting manager and a resident that it was half term and the centers were closed for a week. We looked at the contact information for all six residents, one resident contacts a family on the telephone on a regular basis. Another resident goes to spend time with their boyfriend at their home regularly. Two other residents have their a boyfriend and girlfriend visit the house on a regular basis. On the day of this visit one of the residents boyfriend came to visit and stay for lunch. In discussion with the acting manager we were told that residents are always encouraged to continue relationships with their family and friends. We were told by the acting manager that the shopping is done regularly with residents as written in their support plans and staff and residents will shop more regularly for perishable items for the house. We saw fresh food at the home. We were told by residents that they enjoy the food, residents were seen to request what they wanted for breakfast and hot and cold drinks when they wanted them. One residents has a special diet and staff will liaise closely with them to make sure they are provided with variety. We were told that the residents choose the menus at their by-weekly house meeting. Care Homes for Adults (18-65 years) Page 16 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use services have access to health care services both within the home and in the local community, all of the residents are registered with a local GP. The records of health care treatment and annual checks have gaps in the information. Evidence: We looked at the personal support plans for the two new residents that showed what support they required on a daily basis. Staff were seen throughout this visit supporting residents in making decisions rather than doing the task for them. We were told by residents that staff support them when requested. One comment was I like all of the staff they help me when I ask. Another comment was I can wash and dress myself, the staff always tell me I look really nice and that makes me happy. We looked at the health care information in the two new residents files. There was information in both including records of health care appointments and information from professionals including psychologists, psychiatrists, and out patient clinical appointments. The information regarding annual check ups was not in either residents Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: files and we did not see records of the last GP annual check up or other clinical appointments made for the residents. We were told by the acting manager that both residents files would be up dated by himself, the residents and key worker. We looked at the medication MAR sheet records and storage of medication for all six residents. All of the information looked at was recorded appropriately. The storage of the medication is in the dinning room in a lockable cabinet. There are no controlled drugs currently kept at the home. We received the medication training information from the acting manager that shows all staff have completed medication training. There are two staff that have not kept their first aid training up to date, the acting manager told us they will not work on their own in the home until they have had the updated training. Care Homes for Adults (18-65 years) Page 18 of 31 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 using the 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 service has a complaints procedure that is clearly written and easy to understand. It is available in different formats to help anyone staying at or involved with the service to complain or make suggestions for improvement. Evidence: Comments from residents I will speak to staff if I am not happy about anything I will speak to the manager if I have a complaint We looked at the complaints file that had no complaints logged. We were told by the acting manager that all staff is aware of what to do if a complaint or issue was raised. The complaints procedure was on the residents notice board in the kitchen, dining room. The complaints procedure is available in different formats including pictorial. We spent time discussing the complaints procedure with two residents who stated they would tell a member of staff if they were unhappy about anything. We spent time discussing the complaint procedure with the acting manager who told us that he is going to discuss the procedure at resident and staff meetings so that suggestions can be made by residents and staff to improve any area that requires it. We were told this Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: would be a standing agenda discussion area at all meetings so that residents can know that they are being listened to and action will be taken. We spent time discussing the safeguarding policy and procedure with the acting manager. We asked the acting manager if there had been any safeguarding incidents at the home, and were told not in the last nine months. The acting manager informed us that he has put in place the organisations safeguarding policy and procedure and the local authority procedure for staff to follow if an incident occurs. We looked at the training records of all staff and all staff has attended safeguarding training. Care Homes for Adults (18-65 years) Page 20 of 31 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. Standards 24, 25, 28 and 29 People using the 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 standard of home is reflected in the statement of purpose, it is comfortable and homely. Residents are encouraged to personalize their own bedrooms. All of the homes fixtures and fittings meet the needs of individuals and can be changed if their needs change. The flooring in a residents bedroom has to be deep cleaned because of unacceptable odours. The home is accessible for people with a physical disability as there is a lift to access upper level floors. Evidence: Comments from residents The home is always clean and tidy The staff makes sure the home looks nice I love my bedroom Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: We had a full tour of the home and all areas were seen. We looked at all of the communal areas that were being decorated with new lino flooring also being layed in all communal areas. Stephendale Road is comfortable and homely for all of the residents as written in the statement of purpose and service user guide. We spent time looking at all of the residents bedrooms, all of which had their personal photographs, pictures and five of the six bedrooms was seen to be comfortable. One residents bedroom requires a deep clean as the odour in the room was unpleasant. All of the residents told us they were happy that the home was being decorated and they liked the colors.We spent time with three residents in their bedrooms and all were very happy with their rooms, we were told that they liked living at the home. The home was clean and tidy on the day of this unannounced inspection, we were told that all staff are responsible for ensuring the home stays clean and tidy. Care Homes for Adults (18-65 years) Page 22 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service recognises the importance of training and tries to deliver a programme that meets the statutory requirements and the NMS. The acting manager is aware that there are some gaps in the training programme. The level of staffing is not sufficient at all times taking into account the home is now fully occupied. Evidence: We looked at the staff rota for November and December 2009, January, February 2010, there was not adequate staffing on each shift to meet the social care needs of the six residents. We spent time discussing staffing with the acting manager and was told that there are 1.5 vacancies in the home at the present time, the vacancies are filled by bank staff that are familiar with the residents. As written in this report the staffing levels are not adequate to enable residents to participate in a planned activity programme of their choice. We were told by residents that they liked all of the staff. We were told by a member of staff that the team work closely to make sure that all of the residents needs are met. The acting manager told us that there is a recruitment drive at the home and the deputy manager has been involved in shortlisting applications for the staff vacancies. The acting manager will have to look at the hours required for staffing for each residents needs as we were told that three of the six Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: residents require one -one support when out in the community. We were sent the CRB information on all staff and bank staff currently working at the home, all disclosures were up to date. We looked at the training records of all staff that show that all staff are not up to date with mandatory training. We discussed training for staff with the acting manager and spent time looking at the training records and information sent to the CQC, it does show that some staff are in need of updates. We spent time at the organisations head office in December 2009 looking at staff recruitment records, all of the relevant checks were seen to be in place. All staff recruitment records are kept by the human resources team in safe storage at the head office. The acting manager has been at the home since 4th January 2010, he told us that he has 12 years experience in social care and has a Postgraduate Health and Social Care qualification also a Degree in Economics. He has the Registered Managers Award that he gained in 2006. We spent time discussing the continuous training of all staff with the acting manager who told us that he is putting a lot of effort into making sure all staff is bought up to date with training. All permanent staff have an NVQ qualification. We spent time discussing supervision with the acting manager, deputy manager and a member of bank staff. We were told that staff are receiving supervision however not as frequently as required. We were told by the acting manager that he will be putting a structured supervision programme in place to ensure all staff are kept up to date with the organisations aims and objectives. Care Homes for Adults (18-65 years) Page 24 of 31 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. Standards 37, 39 and 42. People using the 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 acting manager has a clear understanding of the key principles and focus of the service, based on the organisational values and priorities. Evidence: We spent time throughout this site visit discussing all areas of running the home, the acting manager is very positive about the care provided by the staff team and discussed the person centered approach that he is promoting all staff to follow making sure all six residents independence is promoted. The issue of sufficient staffing levels was discussed throughout this visit and we were told by the acting manager that he is liaising with the organsation to increase staffing. We spent time discussing the organisations quality assurance procedure with the acting manager. We looked at questionnaires that had been completed by residents, We saw positive comments about the care provided at Stephendale Road.We discussed the use of advocates for residents specifically around the finances of one the Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: residents, we were told that the acting manager would liaise with the social services for support. The organisation produces an annual survey of all of the homes including Stephendale Road. We discussed Regulation 26 visits by the registered provider, we were told by the acting manager and deputy manager that the home is visited monthly by senior management and we looked at the records of the visits. We looked at all of the health and safety records in the home and was also sent information by the acting manager that shows that all health and safety checks are completed on a regular basis. We looked at records for checks for the fire alarm system, tests and evacuation records, safe food storage, water temperatures and gas and electric maintenance, all were seen to be well recorded and up to date. All staff training records were looked at and information sent from the acting manager that shows that staff has completed first aid training, however there are staff that are required to attend refresher first aid training as their certificates have run out. Care Homes for Adults (18-65 years) Page 26 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 31 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 6 15 The organisation to ensure that the two new residents care plans are up to date and relevant. For the home to show how they are meeting all of the care and support needs of the two new residents. 26/03/2010 2 13 18 The organisation to ensure that there are adequate staffing levels in the home to meet all of the residents social care needs. To provide appropriate activities in the home and the community for all of the residents fulfilling their social care requirements. 26/04/2010 3 19 17 The organisation to ensure that the two new residents have up to date health care plans. To show what health care checks are being done and 26/04/2010 Care Homes for Adults (18-65 years) Page 28 of 31 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 what has been done since the residents moved into the home. 4 30 16 The organisation provides a deep clean for one residents bedroom. To provide a comfortable, fresh environment for the resident. 5 33 18 The organisation to make 26/04/2010 sure that there are sufficient staffing on each shift to meet the social care needs of the six residents. To ensure all residents are being provided with the social care needs as written in their care and support plans. 6 36 18 The organisation to provide all staff with regular structured supervision. To ensure all staff are up to date with the aims and objectives of the organisations and their own. Also to make sure as key workers they are keeping clients records up to date. 26/05/2010 26/03/2010 Care Homes for Adults (18-65 years) Page 29 of 31 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 30 of 31 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 31 of 31 - 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!