Inspection on 07/09/09 for The Bungalow

This is the latest available inspection report for this service, carried out on 7th September 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Bungalow 25/07/06

The Bungalow 06/03/06

The Bungalow 20/09/05

The Bungalow 09/03/05

The Bungalow 04/08/04

The Bungalow 20/02/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 14/03/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: The Bungalow Raby Hall Road Bromborough Wirral CH63 0NN     The quality rating for this care home is:   three star excellent 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: Diane Sharrock     Date: 0 7 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 34 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 34 Information about the care home Name of care home: Address: The Bungalow Raby Hall Road Bromborough Wirral CH63 0NN 01513347510 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.wirral.autistic.org Wirral Autistic Society care home 3 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 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 The maximum number of service users who can be accommodated is: 3 Date of last inspection Brief description of the care home The Bungalow is registered to provide personal care and accommodation to 3 adults who have autism. The Bungalow is set within the grounds of Raby Hall, which contains other services operated by Wirral Autistic Society. The home provides each resident with a single bedroom. There is a lounge, kitchen dining area, two separate toilets and a bathroom and a staff office/sleep in room. The home is close to local shops and to public transport services. Parking is available. The fees at the home are 1170. pounds per week. A copy of the statement of purpose, which describes the services offered at The Bungalow, is made available to relatives and social workers. The service users guide to the home is made available before a prospective resident comes to live at the home and the content is discussed with them, where possible, to ensure their Care Homes for Adults (18-65 years) Page 4 of 34 Over 65 0 3 Brief description of the care home understanding. Care Homes for Adults (18-65 years) Page 5 of 34 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: three star excellent 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 overall quality rating for this service is 3 star. This means that people who use the service experience excellent quality outcomes. This unannounced visit took place on the 7th September 2009 over a period of 4 hours. This was carried out with the help of the registered manager. Every body was at day service during our visit so we met people on their return home. We gathered information for this visit in a number of ways. We sent surveys to 2 staff, and to 2 people who live there and to 2 health professional. We (the commission) looked at records and included comments made in comment cards returned to us and surveys carried out by Wirral Autistic Society. We also sent comment cards to relatives so they could offer their opinions about the home. Case tracking was used as part of the visit to the service. This involves looking at the Care Homes for Adults (18-65 years) Page 6 of 34 support and care a person gets from the staff as recorded in their support plans, including information on medication, money, daily life and their living conditions. The manager completed a questionnaire called an aqaa that we sent before our visit. The information from this was used by us to plan this visit and in writing this report. The document was completed and was returned to the commission before this visit took place. It gave alot of information to show how the service was managed. It gave various details of how the manager is continuing to develop the service for the benefits of people living there. Care Homes for Adults (18-65 years) Page 7 of 34 What the care home does well: What has improved since the last inspection? We received one survey from a person living at the home who was overall very positive about living at the Bungalow. We met people who live at the Bungalow who were happy and settled in their home. We noticed a friendly atmosphere throughout our visit were everyone was included and made to feel welcome. Everyone seemed to have a good rapport with each other. We received two survey from health professional who were overall mostly positive in their comments about the Bungalow, stating, eg, Well managed house. Health needs and concerns raised and met with appropriate level of attention and actioned appropriately. Good care to a diverse group of people. We received 2 staff surveys which overall were very positive about working at the Bungalow. Staff comments included,eg, We look after our clients very well ....... The focus of the home is on providing the best for people living there and responding to their needs. This was evident in reading the aqaa before our visit. The manager had submitted a detailed pre inspection questionnaire (aqaa) which gave us alot of information about the work and development of the Bungalow and was easily able to show alot of good practices with good outcomes for people living there. The service is meeting the vast majority of the national minimum standards and has met all of those assessed on this occasion. In a number of respects these standards are being exceeded. The manager continues to look at ways in which the service can be exceeded. The staff have developed communication records. These records are developed over time by staff who get to know each persons needs and help to identify how they Care Homes for Adults (18-65 years) Page 8 of 34 express their choices in how they live their life. The communication records are a good example of the time taken by staff to produce records that help everyone to be kept updated in each persons likes, dislikes, choices and emotions. Staff had good practice documents called, My health action plan and they also had another health needs document called a Health passport. Both documents were good examples of staff identifying the health care needs and the support needed to keep each person healthy and safe. 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 Care Homes for Adults (18-65 years) Page 9 of 34 order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 10 of 34 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 11 of 34 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. Good information is given to people about the home which helps them to make decisions about the service. Evidence: The aqaa (the pre inspection questionnaire) showed alot of developments and work carried out over the last 12 months at the Bungalow and told us, The current statement of purpose and service user guide further developed in line with the regulations and the information within these documents. This is to make them meaningful to the people who live in the Bungalow. Within the last 12 months, we have become increasingly aware of the need to adapt a number of documents into a simpler format to enable the clients to better understand their content. One new client moved into the Bungalow in the last 12 months and they were given a copy of the service user guide as part of their decision making process. This was then supported by a period of transition in accordance with the clients individual need. The guide includes good information on the purpose of the home and the facilities on offer and includes visual pictures which may help some people understand the Care Homes for Adults (18-65 years) Page 12 of 34 Evidence: information given. We noted that these documents still referred to the old address and name of the commission and would benefit from being updated in case anybody wanted to contact our department. Good information is given to any new prospective person including the option of having a trial visit to the home. This makes sure the home is the right place for the person to live in and and that their needs can be met. Although there are currently no vacancies at the Bungalow, the company do have good detailed policies and procedures which help people to choose were they want to go and helps them to gradually move into a home and get to know the people they would be sharing with. We looked at an internal move assessment plan. This plan showed good details in how people are supported to gradually choose and make the move to live at the home. Staff also consider the compatibility of people to make sure they have some consideration in deciding if people would be able to get on with each other to eventually live. We received one survey from a person living at the home who was overall very positive about living at the Bungalow. We met people who live at the Bungalow who were happy and settled in their home. Care Homes for Adults (18-65 years) Page 13 of 34 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. The individual needs of the people living at the Bungalow are identified by staff and in support plans so staff can support them to meet those needs. Evidence: The aqaa gave us alot of details about developments over last 12 months, Due to the clients communication limitations, their known areas of interest are built in to the day service timetable and residential hours including service user holidays. Each service user has a comprehensive care plan which sets out all aspects of support & health care required. This is reviewed on 6 monthly basis or as needs change. The last 12 months has seen the staff team becoming more aware of supporting the clients right to make choices and decisions in their lives with visual aids..... Detailed individual support plans were available for each person. Each person has a person centred plan in place. We looked at 2 plans. The plans were detailed and were overall regularly reviewed and gave enough information to show how their personal, Care Homes for Adults (18-65 years) Page 14 of 34 Evidence: health and social needs would be met and covered a diverse range of needs and requests. These plans have various pictures to help each persons understanding and help keep everyone updated about the person. This includes things such as what they like and dont like to do especially with their daily routines and weekend and night time routines which are individually developed. The staff have developed communication records. These records are developed over time by staff who get to know each persons needs and help to identify how they express their choices in how they live their life. The communication records are a good example of the time taken by staff to produce records that help everyone to be kept updated in each persons likes, dislikes, choices and emotions. In discussions with the manager he was able to explain the way in which people living at the Bungalow make decisions and how they are supported to make those decisions. He felt that group meetings do not work at the home so they try to encourage regular one to one discussions with people to gain their views and opinions. When everyone returned home that evening there was a friendly atmosphere were each person did there own thing on their return home. Some people went visiting their friends at the other houses locally and some people came to visit their friends at the Bungalow. We noticed a friendly atmosphere throughout our visit were everyone was included and made to feel welcome. Everyone seemed to have a good rapport with each other. We looked at a sample of financial records kept at the service of personal allowances which were well kept and accurate and in good order. Staff had developed records called, Me and My money were they had tried to show were people were being supported with their finances. Staff had worked hard in developing capacity assessments to show why various decisions were made to support some people with the management of their finances. The service and staff help each person to manage small amounts of money were its identified they may need some support. We discussed how the financial procedures were carried out and how they were maintained at the Bungalow to help safe guard the financial affairs of each persons. However in looking at each persons financial records there was no information, procedure or update on why or how some of their money was managed and stored at head office. The manager and people living at the Bungalow had no details of were their monies were stored at head home. They had no details of the name of the account , or details of any savings or updated statements. There was no information regarding what Care Homes for Adults (18-65 years) Page 15 of 34 Evidence: benefits each person had stored at head office or the name of an agreed appointee. We were told that most people had always had their benefits and money stored at head office and that the appointee-ship is held there. We were told that people contribute to the communal transport and the costs are taken from peoples monies stored at head office. However we could not see any clear information or consent given by people living at the bungalow or their representatives for their monies to be stored and managed at head office. We had previously discussed this with senior managers within the society and we have been told that various reviews and developments are taking place regarding the current procedures for managing and supporting people with their finances. The management of each persons finances would benefit from being person centred. Clear records and procedures must show how each person could be supported in choosing methods of managing their money which is best suited to them. The service did not have a policy or procedures to describe the current processes offered to people to support them with their money and to explain the procedures of how their money was managed at head office. Updated support plans will help to show were people are supported in giving their consent in choosing how they want their support or management of their finances. Care Homes for Adults (18-65 years) Page 16 of 34 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the Bungalow are always supported so they can live a lifestyle of their choice. Evidence: The aqaa gave us a lot of details and told us of all the work and developments over the last 12 months, such as, Each client has an individual day service timetable and a range of social activities available to them throughout their week. This includes activities such as, swimming, walking, cinemas, theatre, pubs, clubs, restaurants, art groups, football groups, zoo trips, bowling, and holidays, to name but a few. In our last accreditation review it was acknowledged that we offer and support clients in a structured yet varied lifestyle that benefits their autism. Service users have the opportunity to learn & use practical life skills through their day services timetable & through activities on residential services. Service users regularly access the local community including social clubs, walks, shopping, library, pubs, etc. Service users Care Homes for Adults (18-65 years) Page 17 of 34 Evidence: are supported to pursue their own interests. In discussions with the manager and meeting some of the people living at the Bungalow and in looking at records, they showed that the people living there always receive the support they need to get out and about regularly in their local community. Most people are out at the day service each day Monday to Friday in accordance with their wishes and abilities. During our visit everyone was out in the day and they were being supported with their weekly activity plan. Each person is provided with a range of opportunities to help their personal development and they have a time table of activities that they would do during the week.eg such as, computers and technology, horticulture, art therapy and woodwork, etc. The records showed a variety of activities that each person is involved in to enhance their enjoyment and quality of life. Each persons file showed that staff do try to plan social events and activities and also carry out risk assessments to help make activities as safe as possible. People told us they use the societys communal minibuses for transport to go to day service however there was no information regarding whether people were charged for this form of transport . There was no evidence in the files to show if people had given their permission for their money to be withdrawn to pay for these transport costs. The records around the management and funding of the communal vehicle wasnt clear. This needs to be reviewed to show that everyone is included and in agreement to the current arrangements regarding who manages, maintains and funds this service. People should be supported in getting value for money and should be given the opportunity to choose how they want support with the management of their finances. People are involved with all aspects of planning and choosing what they want to eat. We noted that everyone was looking forward to their evening meal and the atmosphere was relaxed and friendly with everyone relaxing after getting home from day service events. The house has one lounge in which people can relax. The manager explained that they are hoping to have some redecoration and a new settee but they are not sure when this will be done. Care Homes for Adults (18-65 years) Page 18 of 34 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the Bungalow are supported to stay healthy and safe. Evidence: Detailed support plans were available for each person we looked at two of them. The plans had been recently updated in parts and revised and gave enough information to show how their personal care and support would be met. The plans provided staff with guidance and were appropriate instructions as to the support each person needed. They showed that they are supported in accessing health care services if it was needed, especially any hospital or specialist appointment and included regular visits to the doctor, and care managers. We noticed that some records were offering the same information in different formats which might benefit from being revised to make it easier to identify updated needs in one document. One persons file had good practice documents called, My health action plan and they also had another health needs document called a Health passport. Both documents were good examples of staff identifying the health care needs and the support needed to keep each person healthy and safe. However some information was repeated in both documents and may benefit from being revised. Care Homes for Adults (18-65 years) Page 19 of 34 Evidence: The company and staff have also managed to deal sensitively with one subject that is often difficult to discuss. They have produced a sensitive document requesting information regarding bereavement. The questionnaire helps identify personal wishes such as, are there any instructions or requests that effect how the individual should be treated after death. One plan had information with details of their personal wishes and requests and their family had helped to fill in the necessary details to help staff with their wishes. The manager advised that some staff would be attending training on the use of, anticipatory care calendars in October 09. He explained that once staff received updated training they would look at introducing these tools to help support people with their health. We received two survey from health professional who were overall mostly positive in their comments about the service, stating, eg, Well managed house. Health needs and concerns raised and met with appropriate level of attention and actioned appropriately. Good care to a diverse group of people. We looked at the storage and procedures of managing medications at the service and they were found to be well maintained and safely managed. The medications records were detailed and everyone had worked hard to offer accurate and up to date medication records, providing a safe system of supporting people with the administration and storage of their medications. Care Homes for Adults (18-65 years) Page 20 of 34 Evidence: Care Homes for Adults (18-65 years) Page 21 of 34 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 are protected by the homes procedure for responding to concerns and complaints. Evidence: The aqaa gave us alot of information and told us about their developments over last 12 months,ie, The Wirral Autistic Society takes the issue of complaints concerns and protection very seriously. In September 2008, a parent carer survey was sent out to families to gauge what their opinions of the services offered to their family members of was. The overall feedback was very positive and we have been able to improve some areas such as the phone system at Raby Hall which also includes the Bungalow. This survey was repeated in 2009 and once again the results are very positive. The Society has a written complaints procedure for all departments and responses to any complaints are time limited. There is also a client complaint procedure ensure that client views and concerns are listened to and action taken to resolve them. Due to the impaired communication abilities of the clients who live in the Bungalow it was difficult to use client meetings or client complaint forms in a meaningful way. In response to this we use key workers and families as advocates on behalf of individual clients and are responsive to comments concerns and complaints from them. Our plans for improvement in the coming 12 months includes a repeat of the Parent Carer questionnaire in 2010, Updating polices, this process has begun by the senior management team of the Wirral Autistic Society Care Homes for Adults (18-65 years) Page 22 of 34 Evidence: Information about how to raise a concern or complaint is made available to the people living at the Bungalow in a pictorial format. This is good practice as it helps to increase the opportunities for people living at the Bungalow to have a better understanding of the ways in which they can raise concerns. We saw an example of how one person had been supported with raising their concerns and objections regarding not being able to go to the houses were staff lived. The organisation had helped support people in trying to understand why this had to be changed and helped them to come up with a compromise. People are supported regularly to meet staff socially in a local cafe bar were they can still meet up socially and maintain the same contact with each other. We could not find the complaints record file and the manager agreed to locate this file to make sure the staff and people living at the Bungalow always had access to it. Staff had started to complete capacity assessments which helped identify if a person needed any type of support in managing their money. However in looking at each persons financial records there was no information, procedure or update on why or how their money was managed and stored at head office. The manager and people living at the Bungalow had no access to any details of were their monies were stored at head home. The management of each persons finances would benefit from being person centred and being clear and accessible to show what methods are in place to safeguard peoples finances. Care Homes for Adults (18-65 years) Page 23 of 34 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 bungalow offers a homely, comfortable and safe environment that is well managed. Evidence: The aqaa gave a lot of information and details about the work and developments over last 12 months around the environment, such as, The environment at the Bungalow is both homely and well kept. The house is cleaned regularly the client bedrooms are all individualised according to clients known likes and dislikes. ....The premises are suitable for the stated purpose. They are safe well maintained comfortable homely accessible. The house is based in the local community. The premises meet the requirements of the fire brigade. The fire log book has been updated. Fire checks are all up to date......... Our plans for the future of the environment within the Bungalow include continuing with plans for refurbishment as monies are made available. In addition we are also doing a plan to replace the stable doors with more appropriate alternatives to improve service users dignity within the boundaries of current risk assesment....... need new 3 piece suite in lounge We were shown around the home and looked at a sample of areas. Each person has their own bedroom were they are encouraged to have personal belongings and to individualise the room the way they want. Some peoples rooms were noted to be a bit Care Homes for Adults (18-65 years) Page 24 of 34 Evidence: darker than others depending on which side of the building the rooms was situated. This could be reviewed to see what work could be done to improve the natural light into each room. The Bungalow has one lounge and the manager explained that they are hoping to get permission to buy a new settee very soon as the present one is old and shabby in appearance. The open plan kitchen and dining room offers a domestic style facility accessible to everyone. Again they are hoping to eventually get a new kitchen to improve on the present facility. The bathroom offers a basic facility that was clean and tidy. The manager had developed wish list of improvements that they would like to eventually see developed, including needing a new washing machine and a larger updated television. The home was decorated to a good standard offering a homely environment to live in. However the Bungalow would benefit from a review of its facilities to look at the possibility of modernising the environment to meet younger adults opinions and requests. We looked at a sample of maintenance certificates which showed up to date checks as listed in the homes pre inspection questionnaire. Updated contractual and in house checks helped show what actions were taken to keep the home safe and well maintained. The last fire risk assessment seen in the Bungalow was dated 2006. We could not find a more recent review. This should be updated as a matter of priority to make sure that all actions taken by staff to make the home safe are up to date and meet the fire precautions guidance. Care Homes for Adults (18-65 years) Page 25 of 34 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported and protected by the services recruitment and selection procedures. Evidence: Records showed that before anyone is appointed to work at the Bungalow they have a series of checks that are carried out. These include obtaining written references and checking with the criminal records bureau (CRB). These checks help to make sure the people living there are safe and that staff are suitable to support them. The manager explained that they have all had updated police checks as a matter of good practice. Staff personnel records are stored and managed at head office but the manager accessed the staff files during our visit and managed to get a summary print out of the necessary personnel details. We discussed this with the manager as he should always have this information so he is assured that the right checks have taken place for any staff working at the Bungalow to ensure people are safely supported. We looked at staff training records which showed what training had been provided. Staff had received various training while employed by the service. The manager was developing the training action plan for the five staff employed at the Bungalow and had developed a training plan to show people when they could expect updates to their mandatory training. Staff had been given advice and updates regarding when they Care Homes for Adults (18-65 years) Page 26 of 34 Evidence: could expect certain training. eg. The organsiation had decided that all staff would received updated refresher training in safeguarding every 12 months. This helps the staff and managers to be fully informed regarding how they will be supported with their training needs. The manager felt they had 100 per cent of staff with a care qualification (nvq). This is an example of how the manager has exceeded the national minimum standards with all staff being up to date in a care qualification. We received 2 staff surveys which overall were very positive about working at the Bungalow. Staff comments included,eg, We look after our clients very well ....... The staff gave a suggestion to improve the service, eg, Have a team leader/deputy working alongside under the manager. Staff comments should be reviewed and discussed within the team so that feedback can be given regarding their comments. Care Homes for Adults (18-65 years) Page 27 of 34 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Bungalow was well managed and the health and safety of everyone at the home was promoted and protected. Evidence: The aqaa gave us alot of information about development over last 12 months at the Bungalow such as, The current registered manager is qualified to NVQ level 4 in care and is a work based assessor with 8 years experience within various roles within the society. He supports staff within boundaries of organisational policies and procedures, ...................... The manager maintains records and does spot checks on the standards within the Bungalow. The manager holds regular staff meetings and is a direct line manager for the staff. The managers office is based in the Bungalow so can be contacted easily if required. The manager also has a mobile phone to enable contact when away from the unit. The manager is a member of the registered managers team which meets bi weekly to discuss issues related to the continued good management of care services. It also looks to further develop these services in line with good practice legislation and policy changes. The manager is supervised monthly by the head of residential services and an action plan is made at each meeting to Care Homes for Adults (18-65 years) Page 28 of 34 Evidence: ensure the continued development of client well being and development within the Bungalow.... The Bungalow continues to benefit from an experienced and appropriately qualified manager who is able to demonstrate that he effectively manages the home in the best interest of everyone living there. Due to a company review and reorganisation the manager has only recently been moved to the bungalow. The focus of the home is on providing the best for people living there and responding to their needs. This was evident in reading the aqaa before our visit. The manager had submitted a detailed pre inspection questionnaire (aqaa) which gave us alot of information about the work and development of the Bungalow and was easily able to show alot of good practices with good outcomes for people living there. The manager meets with the staff on a regular basis and the minutes of these meetings shows good communication keeping everyone up to date and included with the developments of the home. We saw a sample of questionnaires filled in by relatives in 2009 which gave alot of positive comments to the company about their experiences and opinions regarding the Bungalow. The home is visited on a regular basis by a representative of the organisation. We looked at a sample of these reports which showed detailed checks and audits on the standards offered and achieved at the Bungalow. These visits form part of the quality assurance process and form an opinion on the standard of care and support provided. These visits are also a requirement of the care home regulations and a report has to be produced to show evidence of these checks. Records and certificates showed that regular checks are carried out on the building and equipment. This includes checking electrical installation, portable appliances and the gas supply. These checks help to make sure that the environment is well managed and is a safe place to live and work in. We noted that the last fire safety brigade check in 2007 made various recommendations but staff were unsure if they had been carried out and responded to. The manager agreed to review this report to make sure the recommendations had been carried out and acknowledged the need to update the homes fire risk assessment to comply with necessary safety checks to continue to keep everyone safe. The manager explained that various records such as, personnel files, training and financial records still remain stored at head office. This meant that the manager was not always in receipt of necessary records for the management of the Bungalow. Care Homes for Adults (18-65 years) Page 29 of 34 Evidence: However the manager was able to access summary records of staff training records and recruitment checks. We discussed the managers responsibilities within the care home regulations whereby all necessary information should be accessible to him. This will allow him to evidence that the service is safely managed and show evidence of good practice and management of peoples finances and management of staff personnel checks. Care Homes for Adults (18-65 years) Page 30 of 34 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 31 of 34 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 7 20 To have updated financial 06/11/2009 records, support plans in place. These records must be clear and accessible to everyone residing at the Bungalow and their representatives and should show that finances are being managed in each persons best interest and with their consent. To show clear and transparent records as to how each persons monies, benefits are managed and safeguarded. 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 7 The manager should have clear procedures and records to show how each persons finances are managed. To provide people with the name of their appointee and summaries of financial procedures. This will help to evidence they are Page 32 of 34 Care Homes for Adults (18-65 years) 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 kept in the best interest of everyone living at the Bungalow. People should be included in the management procedures offered in managing their finances and clear records will help show they are managed in each persons best interest and with their consent and are person centred to meet their needs and requests. 2 22 To locate the complaints file to make sure the staff and people living at the Bungalow always have access to it so they are aware of the policy and procedure and records to use to raise concerns and comments. The fire risk assessment should be updated as a matter of priority to make sure that all actions taken by staff to make the home safe are up to date and meet the fire precautions guidance. To review what work could be done to improve the natural light into each bedroom. To keep everyone informed and up to date with the developments of their home including any suggestions regarding what people would like to improve their home such as when they can have eg, a new television, new kitchen and sofa. The manager should always have evidence of necessary recruitment checks for all staff working at the Bungalow including bank staff, so he is assured that the right checks have taken place for any staff working at the Bungalow to make sure people are safely supported. The manager should have all necessary information accessible to him so that he can evidence safe systems are in place for the management of finances and personnel checks. The manager agreed to review the fire brigade safety report to make sure their recommendations had been carried out and acknowledged the need to update the homes fire risk assessment to comply with necessary safety checks to continue to keep everyone safe. 3 24 4 5 24 24 6 34 7 39 8 42 Care Homes for Adults (18-65 years) Page 33 of 34 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. 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