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Inspection on 30/04/09 for The Pines (Birmingham) Ltd

Also see our care home review for The Pines (Birmingham) Ltd for more information

This is the latest available inspection report for this service, carried out on 30th April 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 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

Good information about people`s needs is collected before people are admitted and this helps to ensure that people`s stay in the home is successful. People are assessed to see if they need any health services such as opticians, dentists and so on quickly after admission, health services are then obtained and this helps to maintain people`s well being. Care plans and risk assessments are written in a positive way about people`s abilities as well as when they need help and this helps to keep skills they have. People have a variety of activities. Activities are organised in small groups so for example 2 people may go to a butterfly farm or a cinema whilst others make cakes, and go into the garden. People are encouraged to be involved in some domestic tasks in the home and this helps to maintain their skills. People are helped to go on holidays. People are assisted to maintain relationships with people that are important to them. A relative said `They look after my (relative) very well it is the best home they have ever been in and the staff are very helpful.` People have times when they can raise any concerns and worries and these are dealt with. There is a good atmosphere in the home. One person said `We all get on.` ` We choose what we want to watch and do, not the staff.` People are safeguarded in this home by well-trained staff that understand the policies and procedures. Staff showed that they understood the needs of people and cared about their wellbeing. Staff are recruited well and this protects people living in the home. This home well managed and run in the best interests of people living there. There are checks undertaken to ensure that people`s needs continue to be met and to ensure that health and safety measures are in place.

What has improved since the last inspection?

Medication administration had improved with systems put in place to ensure that medication was accurately recorded and any allergies noted on the medication administration record. The reasons for medication being given is now recorded and this improves staff`s knowledge and is safer for people in the home. The home manager Helen Brooks has been registered with us and has completed a Registered Manager`s Award the recognised qualification for people managing a care service. Life history books are now in place and this assists people to remember activities and events they have enjoyed. The home has introduced 3 monthly supervisions with people and their key workersabout the care people receive. They have weekly meetings with people to discuss activities for the following week and food they would like to eat.

What the care home could do better:

Information about how people have experienced their visits to the home before admission would be useful in planning how people are to be welcomed into the home permanently. Medications that are given as required need individual protocols about how and when they should be given. Homely medications the home keep such as paracetamol should be checked with the GP for each person to ensure that they do not react with any of their existing medications. When people raise a concern about the home`s performance this should be logged as a complaint as it is important to the person and merits a proper response from the organisation. Some areas of the home needed refurbishment and repair. We saw lists of where the repairs and so on have been requested but dates of when these are to be done were not available. A programme of repairs and intended improvements should be kept. Some people have long standing transferred Criminal Record Bureau checks from other employers. On a risk assessment basis these need to be redone. It would benefit staff to have some training on autism.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Pines,The (Birmingham) Ltd 29 Bishopton Close Shirley Solihull West Midlands B90 4AH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jill Brown     Date: 3 0 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Pines,The (Birmingham) Ltd 29 Bishopton Close Shirley Solihull West Midlands B90 4AH 01217443945 01217443945 pines@cttm.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Care Through The Millennium care home 6 Number of places (if applicable): Under 65 Over 65 0 0 learning disability mental disorder, excluding learning disability or dementia Additional conditions: 6 6 Care may be provided to people, subject to appropriate assessment, who have both a learning disability and a mental disorder. That Mary Teresa Read undertakes a recognised accredited training programme in physical intervention by 30th September 2005. Date of last inspection Brief description of the care home The Pines is a detached property located in the Shirley area of Solihull in a quiet residential area. It is close to local bus routes for Solihull, Hall Green, Kings Heath and Birmingham City Centre. The service is also in close proximity to local amenities including the GP surgery, library, Shirley shopping centre and places of worship. It provides a permanent accommodation for service users with a learning disability who may have also complex needs including challenging behaviours and mental illness. The accommodation comprises on the ground floor a spacious lounge with kitchen and separate dining room. There are two ground floor bedrooms one with en-suite shower Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home facilities. The other bedroom has a dedicated bathroom. An office is located on the ground floor that is also used as a sleep in room. There is a separate laundry area with an activity room as part of a conversion of the garage. There are four bedrooms on the first floor of which three have shower facilities. There is a large well-maintained garden with a patio area and there is some off road parking. Fees are assessed according to peoples needs at the time of the inspection the new rates were not available. Fees do not include hairdressing, toiletries, magazines or the cost of leisure activities after 5pm. It also includes up to £300 towards the cost of an annual holiday. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We visited the home without notice in April 2009 and undertook a key inspection where we looked at the majority of the National Minimum Standards. We previously inspected this home in April 2007. The home gave us information in an Annual Quality Assurance Assessment (AQAA) before the key inspection. The AQAA shows how the home rates their performance in the areas set out in this report and how they plan to improve the service. During the inspection two peoples care was case tracked, this involves looking at all the records about this person and how the home manages their care and we looked at parts of another persons care records. Care Homes for Adults (18-65 years) Page 6 of 30 We looked around parts of the building and viewed the health and safety checks that had been undertaken. We spoke to all of the prople in the home, one relative, 2 staff and the manager of the home. Prior to the inspection, completed questionnaires had been received from all six people living in the home half of which were completed with assistance from staff. These were all positive and feature in this report. A survey form was also received from three relatives, which were positive about the service. We have received no complaints about this service. What the care home does well: What has improved since the last inspection? Medication administration had improved with systems put in place to ensure that medication was accurately recorded and any allergies noted on the medication administration record. The reasons for medication being given is now recorded and this improves staffs knowledge and is safer for people in the home. The home manager Helen Brooks has been registered with us and has completed a Registered Managers Award the recognised qualification for people managing a care service. Life history books are now in place and this assists people to remember activities and events they have enjoyed. The home has introduced 3 monthly supervisions with people and their key workers Care Homes for Adults (18-65 years) Page 8 of 30 about the care people receive. They have weekly meetings with people to discuss activities for the following week and food they would like to eat. 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is available to people and their representatives in a way that is useful to them. People have a contract that explains the terms and conditions of their stay and this protects their rights. Good information is collected about peoples needs before admission and people can visit the home. This helps people and the home decide whether all of the persons needs can be met. Evidence: The homes Annual Quality Assurance Assessment (AQAA) stated that the home has a service user guide and statement of purpose available. These had been reviewed since we last visited in the home in April 2007 and now contained pictures to assist people coming into the home. People have the benefit of a contract that outlines the terms and conditions of their stay. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: The home has had two new people admitted since the last inspection. There was good information collected from their previous placements to determine whether the home could meet their needs. This information included details of the persons health conditions, behaviours, contact details of people important to them and professionals involved in the persons care. Details are collected about peoples cultural and religious needs so that these can be met. Both people needed to move to another placement quickly and the usual slow admission process was unable to be carried out. People came to look at the home before they were admitted. The home did not keep not keep details of what happened on these visits and whether for example they got on with a specific member of staff or other person in the home, or what they found difficult to manage. This information could be used to make the subsequent admission easier for the person. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can be assured that plans are developed to show are their needs are to be met and that they will be supported to make choices and to take risks. Evidence: Each person has a written care plan and two of these were looked at in detail. Care plans were written in a way that focussed on the persons abilities and not their difficulties and this helps to promote a positive view of the person. Interviews with staff showed that staff thought well of the people they cared for. Information was available for staff about how to assist people with their personal care, medication, dental, foot and eye care as well as plans to improve peoples skill such as tidying away clothes and cooking. There were plans to assist people to maintain their contact with significant people in their lives like family and friends and this helps people have more interests in their life. Care plans are reviewed on a monthly basis and they are discussed with the person to ensure they are meeting peoples needs. Life Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: history books had been put in place as recommended at the last inspection and this helps to ensure that people can be reminded of activities and events they have enjoyed.. During the inspection we found that all the people that we spoke to were welcoming and were observed to be smiling, showing good eye contact and other signs of wellbeing. We spoke to all the people living in the home and received comment cards we were told: - We all get on I have no problems talking to anyone. I like the Pines because the staff are my friends and its a nice house to live in and they help me a lot. Risk assessments were found for all activities undertaken and had been regularly reviewed to ensure that risks of injury were minimised as far as practically possible. For one person we found that where incidents of challenging behaviour had started to escalate there had been referrals made to Health professionals for advice. The home started recording how and when these events occurred looking for patterns and this helps health professionals make decisions about the best way to intervene. Staff have had training on how to intervene safely when people show challenging behaviour. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have a variety of activities planned and that caters for peoples individual interests. People enjoy a healthy diet that caters for individual choices. Evidence: People have activities that are arranged to suit them. The homes AQAA stated that two people attend flower-arranging classes and this was confirmed by one persons relatives. One person attends an animal care course and they have a pet rabbit at the home, which they look after. Although other people may stroke the rabbit the home ensure that this is only with the persons agreement. One person attends a sheltered workshop. The home has a weekly plan of activities to ensure that people do something on a daily basis. On the day of the inspection the weekly activity record showed a trip with all people to Stratford, to Lickey Hills for most, two people were going to a butterfly farm, one assisted to play on x-box as well as baking, drive out, Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: hairdressing, safari park, swimming, snooker, going out for a drink and out having a meal being planned. Some people were going to the cinema on the day of the inspection, some baked cakes and one person assisted in making the curry for the evening meal. People had leisure facilities within their bedrooms; for example a mixture of computers, televisions and music centres were found in peoples rooms. It was clear that peoples interests were encouraged. One person became very animated when we talked about a dog that regularly comes to the home. People have the opportunity to have a holiday a way we found evidence of three people having a holiday in Tenby and plans for others to go to Lanzarote later in the year. The home has developed life history books that show photographs of activities that people have been involved in to help people remember what they have enjoyed and helps to make choices in the future. People were helped to maintain relationships with their relatives and people were able to have visitors if they wished. One relative said They are brilliant (they) make me welcome every time I come. Anything different they phone me up. Another said They look after my (relative) very well it is the best home they have ever been in and the staff are very helpful. Maybe they could go out on trips a bit more and some activities. The manager reported that the local community are supportive of the people living in the home and people are encouraged to involved with the community. The homes AQAA assessment stated that the home needed to improve in showing when they had responded to specific requests for certain meals. There are monthly meetings with people living in the home and food provided is discussed at this meeting. We looked at the food available in the kitchen and found that food was stored well and that was enough food to meet the needs of people including fresh fruit and vegetables. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health is maintained by the home ensuring that people have access to health professionals. People who develop health difficulties are referred to specialists so staff can act on their advice. Medication is administered safely and this helps to promote peoples well being. Evidence: Following admission people have access to health professionals to look at any health issues identified during the admission assessment. So appointments with GPs are made and appropriate referrals for screenings medication reviews and consultants are requested if needed. People are also referred to dentists, opticians and for chiropody if people have not received this service for some time. We looked at the homes accident records and people living in the home had few accidents. Where people develop health issues appropriate action was taken to ensure that Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: people keep as well as they can. We found that the medication was administered well with people being given the medication they were prescribed. The medication is securely stored, recorded when it comes into the home and is disposed of appropriately when necessary. Medication is normally sent to the home in a monitored dosage system (MDS), which ensures that medication is separately packed for each time a medication needs to be given. Where the medication cannot be put in the MDS the home has separate check and counts the numbers of tablets left on each administration; this is good practice. The home disposes of the copies of the prescription when the Medication Administration Record (MAR) has been checked and this would be better kept with the MAR until the medication administration period has finished. We found an as required medication which did not have a protocol specific to the person and the drug and this could mean inconsistencies about how and when the medication is given. We noted that this medication has not been given during this months medication supply. Similarly homely medications such as paracetamol that the home keeps should be agreed with the doctor for each person just to ensure there is no adverse reactions with the medications they are currently taking. Most staff have completed their medication administration training and these staff are the ones that administer medication. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in this home can be assured that their concerns are listened to and efforts made to respond to them. People are safeguarded by staff that are aware of the policies and procedures. Evidence: The commission and the home have not received complaints about how this service provides care for people. The homes AQAA states any complaints are reviewed on a monthly basis by the Care Director for the service. There are friends, family and relative meetings, resident meetings and supervisions with people living in the home. Supervisions are meetings with person on their own and this point peoples grumbles are discussed. At one of these a person made it clear they were unhappy with the time taken to address maintenance issues in their bedroom. This should be logged as a complaint and a response from the organisation made to the person. (See environment standard). The homes adult protection policy was seen at the last inspection and was considered appropriate. Staff spoken to were clear about the need to report any areas of concern in the way people are treated. They were aware of the agencies involved in the safeguarding the interests of people living in the home. All staff in this home have completed a Protection of Vulnerable Adults course and this helps to ensure the safety of people living in the home. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: We looked at how the home manages peoples money and found that money held for people is checked on daily basis and this helps to ensure that mistakes are found quickly. There are receipts kept for money that is spent. The home ensures that receipts are gained for any withdrawal of money from bank accounts. People in this home contribute towards activities after 5pm and holidays. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in this home have the benefit of having a warm comfortable environment. However some repairs and refurbishment need to be completed in a more timely way to ensure the continued comfort of people. Evidence: The home blends in well with other domestic properties in the area. It was clean bright and airy on the day of the inspection. The lay out of the home and the atmosphere within it was good. However it was clear that in some areas refurbishment was needed. Although the manager was aware that the organisation had plans for some improvements there was no dated refurbishment plan to assure us that the improvements needed would be completed in a timely way. The homes AQAA suggested that were delays on some refurbishment. A person living in the home made comments about the delays in redecoration of their room in a meeting in March 2009 and the room remained unfinished at this inspection. The room had considerable water damage following an overflow of water from the room above. The lounge area had an adequate number of sofas but these were stained and due for Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: replacement. The kitchen surfaces were broken in some areas making it hard to clean. Some handles were missing off one persons furniture. One shower although it had been repaired since the last inspection had difficulty providing warm enough water during peak periods. There is a slip hazard in the garden due to dripping water. Peoples bedrooms were of different sizes and shapes. It was clear that staff had looked at the best ways for the environment to used to meet the needs of the people in the home. People had things in the room that reflected their interests. For example one person showed us their work from college, their bubbles and photographs they kept in there. Some people in the home have keys to their bedrooms and this helps to preserve their privacy. The home has systems in place to ensure the safety of food and the control of infections. The fridge in the kitchen needed to be turned down to ensure that it maintained a safer temperature for food. The kitchen and laundry areas were clean. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in this home are supported by enough trained staff that know them and these means that peoples needs are met. Staff are recruited appropropriately and this safeguards people living in the home. Evidence: Rotas and observation during the inspection showed there were enough staff to meet peoples needs. The rotas showed 3 care staff were available to care for the 6 people, the manager being additional to numbers from Monday to Thursday. The service avoids the use of agency staff as they would be unfamiliar with the needs of people living in the home. A sample of staff files were looked at. The more recently employed staff have all the checks required including Criminal Record Bureau (CRB) and Protection Of Vulnerable Adults checks, and two written references. Induction, training and supervision of staff takes place as required. In two staff files looked at we found that staff had been working with the home for a number of years with CRB checks that were for other organisations these should be redone on a risk assessment basis as part of the homes renewal of CRBs. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: Staff spoken to were able to demonstrate a good awareness of safeguarding people from harm, and peoples needs. Staff talked about people living in the home with warmth and were seen to work with people well. We looked at the training matrix the home supplied and spoke to staff interviewed about training and found that staff received training. All care staff had completed the National Vocational Qualification in care level 2 and a large number of staff are enrolled to complete the level 3. This means that staff have knowledge about the care needs of people. All staff have completed infection control training and most physical intervention training and some training is now being given in Mental Capacity Act and deprivation of liberties. All of this training is relevant to the needs people have in this home. Only 2 staff have completed training in autism and this needs to be increased to match peoples needs. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living this home experience a well run, happy home. Staff and management work well to ensure that people are safe and have good experiences. Evidence: The registered manager has the Registered Managers Award; this is the recognised management qualification that ensures that the manager has the knowledge to manage the home. She has substantial experience of working with vulnerable people. She was undertaking an NVQ 4 in care and has also attended other courses to update her practice. The organisation takes monitoring of the service seriously. They and the manager ensure that there are audits of the service provided and consultations with people living in the home and other significant people about how the home can improve. The audits included checks on the quality of the food, maintenance of the building and fire safety. The manager completed the Annual Quality Assurance Assessment well and this can be developed to add to their Quality Assurance systems. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: We looked at the certificates of health and safety for fire, gas and electrical safety and found that these were in place and this ensures that this is a safe place for people to live. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 22 22 Where people living in the home raise concerns about how the service is performing this should be logged as a complaint. This is to ensure that people living in the home get a formal response and assurances about their concerns. 30/06/2009 2 34 19 Where staff have staff have CRBs from another or previous employers this must be renewed. This is to ensure that the home can be assured that the staff member remains safe to work wiht vulnerable people. 30/07/2009 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 28 of 30 1 4 A record of peoples visits would help to determine how the persons admission can be planned in a way that is easier for the person to manage. The copies of prescription should be kept with the corresponding Medication Administration sheet to act as a further check that medication supplied is correct. Where people are receiving medication as required a protocol should be in place to determine when and how it should be given. This is to ensure that it is given appropriately. All non prescribed (homely medications) should be listed for each person so the GP can determine whether these are safe with the other medications the person is taking. Training in autism should be arranged so that all staff are aware of the needs of people with this condition. 2 20 3 20 4 20 5 35 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or 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. 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