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Inspection on 13/04/10 for The Yellow House

Also see our care home review for The Yellow House for more information

This is the latest available inspection report for this service, carried out on 13th April 2010.

CQC found this care home to be providing an Good 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.

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

The Yelllow House is an established service which provides a safe and reasonably comfortable environment for the residents,reflecting the general stability and commitment within the staff team and the open and inclusive style of management. Staff have formed close working relationships with residents, the majority of whom have lived at the home for many years, and have awareness and understanding of their care and support needs.

What has improved since the last inspection?

There has evidently been significant improvements made at the Yellow House since the last inspection. As previously documented, there was a sense from both the physical environment of the Yellow House and certain institutionalised care practices evident within the home that the service had not devloped or progressed over recent years. There had been an increasing lack of focus within the staff team which had consequently had a negative impact on outcomes for the residents. The manager acknowledged the many shortfalls identified during the last inspection and in the subsequent report, which she described as a `wake up call for everyone`. Prospective residents must have accurate information to make an informed choice. Improvements to the admission policy and procedures have been made to ensure that no person is admitted to the home unless their needs and aspirations are appropriately assessed. Person centred care plans, including risk asessments, have been developed and residents are now consulted with and have the opportunity to participate in all aspects of daily life. In a welcome development, and in accordance with their wishes, residents are now supported and enabled to be far more involved in the choice and preparation of their own food. Professional advice has been sought regarding the provision of specialist diets, including meeting the dietery requirements of residents with diabetes. Systems for the safe storage and control of medicines have significantly improved following a complete overhall of medication policies and procedures. Individual Health Plans have been completed and are evidently reviewed regularly to ensure that information is accurate and up to date, reflecting changing needs and circumstances. An accessible complaints procedure has been implemented to consider concerns made by residents, their relatives and other persons acting on their behalf. Residents are now protected from potential abuse by appropriate staff training and revised policies and procedures, relating to safeguarding vulnerable adults. To help ensure the safety and welfare of residents, the home now operates a much improved, thorough and robust staff recruitment procedure.

What the care home could do better:

It is important that all care pans are developed with the involvement of the individual resident and regularly reviewed to reflect their changing needs and circumstances. Certain infection control procedures, although improved, remain unsatisfactory and, specifically, arrangements for dealing with soiled linen are inadequate and unaccepatable.

Key inspection report Care homes for adults (18-65 years) Name: Address: The Yellow House 154 - 158 Sackville Road Hove East Sussex BN3 7AG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Nigel Thompson     Date: 1 3 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: The Yellow House 154 - 158 Sackville Road Hove East Sussex BN3 7AG 01273727211 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Gwen Wells-Brown Name of registered manager (if applicable) Donna Hunt Type of registration: Number of places registered: care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 15 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Learning disability (LD) Date of last inspection Brief description of the care home The Yellow House is a privately owned care home that is registered to provide care and support for up to fifteen adults aged between 18 to 65 years who have learning disabilities. The home is run as a family type home. The home is comprised of three semi-detached houses, which have been converted for there current use. Accommodation is provided over two floors and includes fifteen single rooms some of which have en suite facilities. The home is close to local transport and communal facilities. The fees range from £460.00 to £630.00 per week. Additional charges are payable for hairdressing and chiropody services. Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 15 0 5 1 1 2 0 0 9 Brief description of the care home 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: The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. This key unannounced inspection took place over four and a half hours in March 2010. It found that, since the previous inspection, clearly a lot of effort and hard work had been put in by the manager and staff team to address the identified shortfalls. The majority of the National Minimum Standards that were assessed are now being met or partially met and the overall quality of care provided is good. The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. On the days of the inspection there were twelve residents living at the home. Care Homes for Adults (18-65 years) Page 6 of 30 The inspection involved a tour of the premises, observation of working practices, examination of the homes records and discussion with four residents, two relatives, two members of staff, the manager and the proprietor. The self assessment document, the Annual Quality Assurance Assessment (AQAA) had been returned by the manager, as required, prior to the inspection. The focus of the inspection was on the quality of life for people who live at the home. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? There has evidently been significant improvements made at the Yellow House since the last inspection. As previously documented, there was a sense from both the physical environment of the Yellow House and certain institutionalised care practices evident within the home that the service had not devloped or progressed over recent years. There had been an increasing lack of focus within the staff team which had consequently had a negative impact on outcomes for the residents. The manager acknowledged the many shortfalls identified during the last inspection and in the subsequent report, which she described as a wake up call for everyone. Prospective residents must have accurate information to make an informed choice. Improvements to the admission policy and procedures have been made to ensure that no person is admitted to the home unless their needs and aspirations are appropriately assessed. Person centred care plans, including risk asessments, have been developed and residents are now consulted with and have the opportunity to participate in all aspects of daily life. In a welcome development, and in accordance with their wishes, residents are now supported and enabled to be far more involved in the choice and preparation of their own food. Professional advice has been sought regarding the provision of specialist diets, including meeting the dietery requirements of residents with diabetes. Systems for the safe storage and control of medicines have significantly improved following a complete overhall of medication policies and procedures. Individual Health Plans have been completed and are evidently reviewed regularly to ensure that information is accurate and up to date, reflecting changing needs and circumstances. An accessible complaints procedure has been implemented to consider concerns made by residents, their relatives and other persons acting on their behalf. Residents are now protected from potential abuse by appropriate staff training and revised policies and procedures, relating to safeguarding vulnerable adults. To help ensure the safety and welfare of residents, the home now operates a much improved, thorough and robust staff recruitment procedure. Care Homes for Adults (18-65 years) Page 8 of 30 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 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. The recently revised admission policy and procedures ensure that residents are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective residents are provided with sufficient relevant information to know that the home is able to meet their individual care and support needs. Evidence: Information is available to prospective and existing residents in various formats. The Statement of Purpose and Service Users Guide have evidently been reviewed and expanded in December 2009. The manager confirmed that further improvemnts are being made to both documents, including the use of photographs and diagrams. There have evidently been no admissions to The Yellow House since the previous inspection. However as part of the homes revised admission policy and procedure, a comprehensive pre admission assessment form, the Prospective Residents Assessment Portfolio, has been developed and includes information relating to the individuals personal, medical, social and psychological care and support needs. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: Howwever, as discussed, it is recommended that the asssessment be dated to indicate when the information was accurate and that it be signed by the resident, to confirm their involvement in the process and agreement with the details recorded. Through discussions with the proprietor and manager, it is evident that there have been occasions in the past where placements have broken down due to people being admitted without a thorough assessment. The manager confirmed that the safety and welfare of existing residents is paramount and consequently despite having vacancies at the home, the admissoin policy and procedures are now closely adhered to. She added that, despite pressure at times from social workers, nobody would be admitted to the Yellow House until their care and support needs had been fully assessed and their suitability and compatibility established. As a consequence of these experiences, the manager confirmed that emergency admissions will no longer be accepted at the Yellow House and she is to amend the Statement of Purpose accordingly. Prospective residents and their relatives are encouraged to visit the home and have the opportunity to look around and meet with members of staff and existing residents. Having moved in, the manager confirmed that residents undergo a flexible trial period, during which time their suitability for the home and their compatibility with existing residents are further assessed and it is established whether their identified care and support needs are able to be met. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Newly developed person centred support plans enable staff to meet the assessed care and support needs of residents in a structured and consistent manner. Systems for consultation and participation are effective and residents are treated with respect and are increasingly encouraged and enabled, as far as practicable, to make decisions about their day to day living. Evidence: The manager confirmed that since the acknowledged wake up call of the last inspection and subsequent report, independence, individuality and choice are promoted within a risk management framework. Residents are increasingly being consulted, encouraged and supported in many aspects of their day to day living. They are now evidently far more involved in selecting colour schemes for their room and communal areas, deciding what clothes to wear, menu planning and choosing recreational and leisure activities, including holidays. Effective communication systems, including monthly staff meetings and regular Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: individual supervision, are in place to ensure that all staff are kept up to date and made aware of residents changing care and support needs. Regular Residents Meetings are held and minutes are taken. Minutes that were viewed indicated that residents were clearly consulted about various aspects of day to day living, including activities, menus and positive changes. Staff spoken to during the inspection confirmed that, despite the variable and limited verbal communication of some residents, effective and regular interaction and consultation takes place constantly throughout the home. This was evident from direct observation of staff supporting residents in a professional, sensitive and respectful manner. Person centred care plans, including health action plans and personal and environmental risk assessments have been developed for each resident, clearly linked to the individuals assessed needs. The plan, including Goals from last year and Goals for this year is formulated by the key worker, manager and evidently with the direct involvement of the resident or family member, as appropriate. Following discussion with the manager, it is required that specific guidelines for staff, incorporating a daily support summary, be developed and implemented for each resident to ensure that their identified care needs are met in a structured and consistent mannner. In addition to the annual care plan review, the current and changing needs of all residents are evidently closely monitored and discussed and any significant changes are able to be addressed immediately. In care plans that were examined, there was still no clear evidence of the direct involvement of the resident or a relative in the reviewing process. Residents relatives spoken with as part of the inspection prcess were able to confirm their involvement in the developing and reviewing of individual care plans: We have the peace of mind of knowing she is very happy here and so well cared for. We feel very involved and are always kept informed of any changes. 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. Residents are enabled and supported to maintain contact with family and friends as they wish and links with the community enrich their social and educational opportunities. Residents benefit from improved recreational and leisure activities and menus that are balanced and nutritious, reflecting their individual likes and preferences. Evidence: The manager confirmed that, where appropriate, residents family links continue to be supported, however not all residents have regular family contact. Community participation remains a focus in the home and residents are evidently encouraged and supported to visit the cinema, theatre, local shops and other amenities. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: The recreational and leisure interests of residents are identified and recorded in their individual care plan an, as previously documented, since the last inspection, they are increasingly supported to access activities and facilities, reflecting their individual needs, preferences and abilities. In person centred care plans that were examined, there was evidence of a weekly programme of activities, including cookery, music, bowling and day services. Menus are varied and balanced and are based on residents identified likes and preferences. An alternative to the main meal is always available and details of the daily menu are displayed in the dining room. A member of staff working in the kitchen confirmed that residents likes and dislikes are recorded and they are regularly consulted regarding menu planning. Since the last inspection, and in accordance with their wishes, many residents are supported by staff in the kitchen with meal preparation. This was confirmed by residents, spoken with during the inspection. I like helping in the kitchen and Im a good cook. The food is good here and they do ask me what I like. The manager confirmed that, to promote choice and independence, some residents are also encouraged to become involved in food shopping. 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. Staff have developed close and positive relationships with residents and demonstrate an awareness and sound understanding of their individual support needs. Residents are protected by improved policies and procedures in place for the control and safe administration of medication. Evidence: In accordance with their personal care plan and individual health action plan, residents are fully supported and enabled, as far as practicable, to exercise control over their lives and maintain maximum levels of independence and individuality. During the inspection, residents were observed being supported in a sensitive, professional and respectful manner by members of staff. Documentary evidence was in place to demonstrate that the health and emotional care needs of residents continue to be met within the home. All residents are registered with local GPs and have access to other health care professionals, including district nurses, physiotherapists and dentists, as required. It was noted, in care plans that were examined, that all appointments with, or visits by, Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: health care professionals are recorded. Up to date and detailed policies and procedures relating to the control, storage, administration and recording of medication are in place. Medicines are stored and recorded appropriately. The manager confirmed that only senior staff have responsible for administering medication and all have received appropriate training and are individually assessed and authorised to do so. Since the previous inspection, as required, significant improvements have clearly been made regarding the control and storage of medication. The manager also confirmed that, following risk assessments, six resident currently self administer their own medication and have a lockable facility in their bedroom for the purpose. 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. The open and inclusive atmosphere within the home enables residents, staff and visitors to feel able to express any concerns, confident that they will be listened to and acted upon. Residents best interests are safeguarded through relevant staff training and revised policies and procedures. Evidence: For the benefit of residents living in the home, a simple illustrated complaints procedure has been developed, with the use of symbols, including a very suave Inspector! The manager confirmed that due to the variable levels of mental capacity among some of the residents, it is unclear as to the individual awareness or understanding of the process. Close working relationships, effective and ongoing communication and consultation and regular residents meetings provide adequate opportunities for any concerns to be raised and discussed, before they become complaints. Residents, their relatives and members of staff, spoken with during the inspection, confirmed that they would have no hesitation in speaking to the manager or making a complaint if necessary and each person was confident that they would be listened to. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: It was evident that one complaint had been received by the home since the previous inspection. The manager confirmed that this was resolved to the satisfaction of the complainant. The service has produced policies and procedures relating to abuse and safeguarding vulnerable adults, including a whistle blowing policy. The manager confirmed that since the previous inspection she had been on a training course, organised through the local authority, regarding safeguarding for managers. She also added that care staff at the home have either already received or are due to undertake specific adult protection training, in June, in accordance with the multi agency guidelines for the safeguarding of vulnerable adults. This was supported through discussions with members of staff during the inspection and evidenced through individual training records. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is accessible, safe and clean and suitable for its stated purpose. Reidents benefit from accommodation that is comfortable, reasonably well maintained and decorated to a satisfactory standard. Evidence: There has evidently been some changes in the physical environment since the previous inspection and with the generally well maintained decor and good quality furniture and furnishings it continues to provide a safe and comfortable environment for residents. Looking around the home it was evident that certain bedrooms are in need of redecoration. When discussed with the manager, she confirmed that this had already been identified and was part of the maintenance programme for the comimg year. It was noted that two new settees have been provided for the main lounge. Many of the residents rooms have been personalised, with pictures, family photographs and other possessions and small items of furniture, to reflect individual taste, choice and interests. Although generally clean, many of the rooms appeared cluttered and untidy. This was discussed with members of staff and the manager. She confirmed that, since the change of approach from doing for residents to doing with Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: residents, there is an ongoing need for balance between staff intervention and promoting residents choice and independence, which we havent got quite right yet, but were working on it!. Residents, spoken with during the inspection, were generally satisfied with the home and their individual room. I like it here and Im very happy with my room. Concerns raised at the last inspection regarding the cluttered and untidy laundry room and unsatisfactory levels of infection conrtrol have been partially addressed. Arrangements for dealing with soiled linen have been improved, as required since the previous inspection, by the installation of a sluicing sink. However, following discussions with staff it is recommended that current procedures in place for transferring soiled linen to the laundry room be reviewed and improved. 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. There is always sufficient trained and competent staff on duty to meet the assessed care and support needs of the residents. Residents are protected by improved staff recruitment policies, procedures and documentation. Evidence: Staff turnover at the Yellow House remains very low and the stable and dedicated staff team are evidently able to meet the assessed, individual and collective needs of residents within the home. All new employees are provided with a job description and staff spoken with demonstrated a sound understanding of their individual role and responsibilities. All new staff receive induction and foundation training, the Common Induction Standard, which is compatible with Skills for Care, formerly TOPSS, and is flexible and compatible with an individuals level of relevant experience. Mandatory training is ongoing and is recorded in individual staff files. This was confirmed through discussions with staff and supported by training records examined, The manager confirmed that all but one member of care staff hold the National Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: Vocational Qualification, NVQ, level 2. The recent introduction of occasional one to one staffing within the last year has enabled more residents to be supported out in the community. Formal supervision is provided for all care staff on a regular basis. This was evidenced by supervision records examined and through discussions with staff acknowledged the benefits of effective supervision and confirmed feeling valued and supported by the manager: Supervision is very useful and the manager is always very supportive. It is evident, from discussions with members of staff that the manager continues to operate an open door policy, with staff feeling confident and able to discuss any issues at anytime. Although there have been no new memebers of staff appointed since the preovious inspection, certain concerns highlighted at that time, relating to the recruitment of staff, have evidently been addressed with improvements introduced to the relevant policy and procedures. 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. The home is generally well run. Residents benefit from a competent and dedicated manager and are protected by satisfactory health and safety procedures. Their best interests are safeguarded by improved and effective quality monitoring systems. Evidence: The manager has been in her current post for 8 years and completed the Registered Managers Award (RMA) in 2005. During the last inspection she readily acknowledged that she has undertaken very little interim training to update her managerial skills, knowledge and awareness of recent legislation and current practices. However since that time she has attended a number of training courses, including nutritional screening and, as previously documented, safeguarding training specifically for managers. Several issues identified during the course of the last inspection have now evidently been addressed, through more efficient management, including the unsatisfactory storage of medication and inconsistent care planning systems. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: Quality monitoring procedures within the home have improved and satisfaction questionnaires have been developed to obtain feedback from residents and relatives. Positive responses from recent surveys indicate general satisfaction with the home and services provided. The staff at the Yellow House are always friendly and helpful and have helped ...... settle in to her new life. ....is very happy here and she has been able to develop her skills. I think you all do a marvellous job. Good atmosphere and welcome. The manager confirmed that the health, safety and welfare of residents and staff remains of paramount importance within the home. Staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. All staff training is recorded. COSHH assessments and guidelines are in place. Regular fire drills are undertaken and recorded. Temperature regulators are fitted to all hot water outlets, accessible to residents. All accidents, incidents and injuries are recorded and reported, as required. 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 6 15 It is required that specific 30/06/2010 guidelines for staff, incorporating a daily support summary, be developed and implemented for each resident. To ensure that their identified care needs are met in a structured and consistent mannner. 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 1 It is recommended that the Statement of Purpose and Service User Guide be revised and amended, as discussed, with the use of photographs and illustrations. It is recommended that individual asssessments be dated to indicate when the information was accurate and are signed by the resident, to confirm their involvement in the process and agreement with the details recorded. It is recommended that the resident or a relative be directly involved in the reviewing process and that this is clearly recorded in the individual care plan. Page 28 of 30 2 2 3 6 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 4 24 It is recommended that more consideration be given to residents bedrooms, regarding any necessary redecoration and also addressing the current level of clutter in many rooms. It is recommended that current procedures in place for transferring soiled linen to the laundry room be reviewed and improved. 5 30 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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