Inspection on 03/12/09 for Upton Cottage

This is the latest available inspection report for this service, carried out on 3rd December 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Upton Cottage 07/12/05

Upton Cottage 26/01/05

Upton Cottage 26/08/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Upton Cottage 18 Bay Road Clevedon North Somerset BS21 7BT     The quality rating for this care home is:   three star excellent 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: Melanie Edwards     Date: 0 3 1 2 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 27 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 27 Information about the care home Name of care home: Address: Upton Cottage 18 Bay Road Clevedon North Somerset BS21 7BT 01275878601 01275878601 joanne.paterson@btconnect.com 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) : Mrs Hazel Paterson care home 16 Number of places (if applicable): Under 65 Over 65 16 learning disability Additional conditions: Date of last inspection Brief description of the care home 16 Upton Cottage is a residential home for up to sixteen people with Learning Disabliity. It is family owned and run and is situated close to local amenities. The home has its own minibus for taking residents on outings and on holiday. The accommodation is located over three floors. There is no lift available but some rooms are located on the ground floor for those who are unable to manage the stairs. A large lounge overlooks the Bristol Channel at the front of the building. A second lounge has a large snooker table and the conservatory/dining room is at the rear. A terraced garden at the front has wooden steps leading down to the road. The fees for the home are variable and based on individual assessment. Care Homes for Adults (18-65 years) Page 4 of 27 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: We met seven residents living at the home. We met the manager of the home, Ms Joanne Paterson. We met the owner of the home, Mrs Hazel Paterson. We also met two support workers. We talked to them about the work they do. We saw staff help residents with their needs. We looked at a number of records to do with the running of the home. We looked at the statement of purpose, three care plans, three assessment records,five medication records, menus, the complaints book, staff duty records, staff training records, three Care Homes for Adults (18-65 years) Page 5 of 27 staff members employment records,accident records, fire records and some information about quality assurance in the home. We toured the environment. We have referred to the aqaa, an annual quality assessment document that all homes are required to complete to help form the judgments in the report. We found the home was operating within the required conditions of registration which we impose. The conditions of registration set out the type of care and the needs of residents as well as the numbers of residents who may stay at the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 7 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 27 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 care that residents need is worked out with their involvement really effectively. This process means people get the right support and care, when they move to the home. There is helpful information available to inform people about the home. Evidence: We read a copy of the homes statement of purpose. This document explains in detail how a home will achieve its aims and objectives. The information we read was helpful and clearly explained what will be done to make sure residents are well cared for. We read helpful information in the service users guide. This helps people to know about the care and daily life in the home. There is also a website that tells people some usefull information about the home and about the service provided. We read three residents assessment information to find out more about how they are supported to meet their complex needs. This information is used to plan and work out Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: the right sort of care and support that the person may need. We saw that up to date assessments of each persons physical, mental health and social needs had been completed. The assessments included a really interesting personal history about the person. This includes the persons life history, mental health history and information about family friends and significant others. We also read in the assessment records information about how to promote the independence of the person in their daily lives. We saw that the assessment records had been evaluated and revised on a regular basis. This helps show that the home have a really clear idea of the right sort of care and support to give to the residents,as well as how to give it. We read some really useful information in the aqaa document about how the home ensure that the views of people who use the services are promoted and incorporated into what they do. We have quoted this extract: We have keyworker systems, regular service user reviews, individual person plans,service user house meetings,service users complaints procedure in pictorial format, an open door policy for service users to come and put their ideas forward. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents individual needs and wishes are respected and promoted. Evidence: We read some really useful information in the aqaa document about how the home ensure that peoples individual needs and choices are well promoted. We have quoted this extract: We are well known for supporting people whose needs have deteriorated, we will not move them on, we will always find and seek support from outside agencies e.g community learning disabilities nurses and district nurses. If we are unable to support them which has never happened before, we will always ensure we support them to find the right accommodation to support their needs. We have regular review meetings with day care and employment to ensure needs are being met and dreams fulfilled. We will always try and encourage individualisation where possible We will seek the help of advocates where needed. We cater for individualised taste around food we now have several different types of menus for one day also some service users have to have food soft only and liquid down. These are catered for at the request Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: of speech and language regarding eating and drinking guidelines. The residents we met told us that the staff help and support them to take part in activities that they enjoy both in and out of the home. We saw detailed risk assessments explaining the best way to support people safely in their lives,both in and out of the home. We were told that one of the key aims of the service is to promote residents rights and to encourage them to develop their independence in their daily lives. This is also clearly explained in the service users guide. A really good example of this is that some residents have jobs. There are also residents who are being supported to maintain personal relationships in the home. We saw really good evidence written in residents care plans, that they are really well involved in their choice of meals that they have in the home. Residents are also well supported to express their own views and have regular house meetings. We saw that residents can set their own agenda and discuss what is important to them. Care Homes for Adults (18-65 years) Page 12 of 27 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 live a varied and fulfilling lifestyle in the home. Residents are really well supported with their personal relationships. Residents enjoy a a varied diet based on their own likes and dislikes. Evidence: We read in the aqaa document some really good ways that residents are well supported to live a varied and fulfilling lifestyle. We have quoted this extract: We have extra staff to support group and individual outings. We support service users who live here to maintain boyfriend and girlfriend relationships. All post is given to service users staff are available to support them with reading where appropriate. All service users are given the option to have locks on bedroom doors with their own key. All Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: services users are offered front door key to their home. Adaptations are put in place where and when needed for less able service users. Service users are free to stay in bed if they so wish. Breakfast can be taken to peoples rooms, tea coffee etc. Staff to encourage service users where appropriate to get up for work and to made aware of their responsibilities etc. No strict timescales on lunch and tea, if service users wish to have their tea later this is ok to do so mealtimes are relaxed and not rushed. Service users have the choice of what they wish to eat if they do not like what is on the menu. Service users who have speech and language guidelines are catered for separately and will have a different menu to cater for their needs. Service users actively involved in the shopping of the homes weekly food. Support given to service users to maintain their job. The residents we met kindly showed us some of their art works on display throughout the home and in their bedrooms. Many of the residents are involved in work projects and arts and crafts projects that take place outside the home, at different community venues. These are really good examples of how residents are encouraged to take part in meaningful activities. We were told that there is a relaxed and flexible policy for residents who wish to meet visitors. We were told that residents are supported by staff to keep in touch with people who matter to them. We saw this information explained really well in residents care plans. We saw visitors coming to the home and we saw staff be very welcoming to them. We saw the cook ask residents what meals they would like. This is a really good way that residents make choices in their daily lives. We saw a varied choice of meal options available for the residents. Meal choices included a range of traditional nutritional meals. The lunchtime meal of a variety of freshly prepared sandwiches looked tasty. We also saw people who did not want this option eating alternative meals. We reviewed a copy of the current menu of meals that residents have eaten over the last month. We saw there were a variety of healthy and well balanced meals available for each day. We saw a menu telling people what meals were going to be served that day. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents health and their personal care is well looked after. Residents medication is generally well looked after and given to them safely. Evidence: We read in the aqaa document some really good ways that residents are well supported with their health and their care needs. We have quoted this extract: Service users are never moved on if their health deteriorates, we will apply for the extra funding to enable our staff to give the one to one care. We will seek the support of the G.P. community nurses and local community learning disabilities team. If no funding is available, or we are awaiting notification we will continue with the support to ensure the continuing care the service users needs. We will support all service users to use community facilities e.g. the dentist,optician and G.P. We source in a local chiropodist, so service users get the right treatment needed for their feet, as this is no longer available on NHS for them. Extra staff are drafted in to support service users to appointments. Service users are, risk assessed where possible to self medicate. Dignity cards given out to all current and new support staff. The ten points of the Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: dignity challenge put around the house. Staff to be encouraged to become a dignity champion. Aids and equipment provided to encourage maximum independence where possible specialist advice sought to ensure the right equipment is being used. We saw the staff help and support the residents in a really kind and sensitive way. We saw useful information written in residents care records about the preferred daily routine of the residents and particular likes and dislikes in their daily lives. This helps staff to be able to meet residents needs in the way that they want. The residents are supported with their health needs they can use local GP practices. There is also specialist support provided from other external professionals including the psychiatrists, dietician and if needed the community nurses. We checked procedures for giving out, storing and disposal of medication to see if residents medication is handled correctly. We looked at the medication administration charts of five residents. The stock of medication we saw was satisfactorily organised. The medication administration charts we looked at were legible, up to date and contained the signature of the member of staff giving out medication. We saw staff giving out medications in a safe way to the residents. This demonstrates medication is given to residents safely. The staff who give out medication do regular training to enable them to do this safely. We were told by residents that they are very satisfied with the care that is provided. We saw staff helping the residents in the correct way written down in peoples care plans. This helps to show staff are providing residents with consistent, well planned care and support. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are well supported to make complaints. Residents are kept safe in the home. Evidence: We read in the aqaa document some really good ways that residents are kept safe and are able to complain if they need to. We have quoted this extract:Full checks are carried out on all staff before employment commences. Photo copies of passports obtained on staff files. Service user complaints procedure is in pictorial format, in all bedrooms. Policies and procedures are in place. Common induction standards carried out by staff, this includes a section on abuse. All staff giving training on the Mental Capacity Act, leaflets and guidelines given. We have Deprivation of Liberty training for staff, who are also given guidance leaflets. All staff trained in safeguarding adults issues. All service users money documented on an in and out system, all signatures obtained and money kept in safe. Full time handyman available for any security issues. We do six monthly fire and annual emergency lighting checks by a competent electrician. Annual fire checks are done on all fire fighting equipment and systems. Our handyman carries out full weekly testing on fire door guards and alarms, checking visually all equipment is in its place. Complaints are acted on immediately and a response within twenty four hours, family, friends and professionals will be kept up to date. Security checks at night before staff go to bed carried out and also visually on Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: the wall for all to see. We have a whistle blowing policy in place. Staff have challenging behavior training and use. Management have an open door policy where staff can come and air their grievances. We saw a copy of the complaints procedure kept in the home. This has our contact details on it if people need to get in touch with us. There are frequent residents meetings held in the home, the meetings are used as a way for residents to make known any complaints or worries they may have. This is a good way to help residents make complaints if they need to. We checked the complaints records to see how complaints are dealt with by the home. There had been one number of complaint made by about the alleged poor attitude of an ex member of staff. We could see from the information we read that the complaint had been properly investigated and action taken by the home,to make sure residents are safe. We saw a copy of the homes policy relating to the subject of protecting the residents from the risk of harm and abuse. The policy used to make sure staff take the right action that keep residents safe if they ever have to respond to an allegation of abuse. The staff do training courses in understanding the topic of the keeping the residents safe from abuse. The staff have also some training on understanding the deprivation of liberty law. This law is in place to protect the rights of residents, if important decisions ever need to be taken on their behalf. Care Homes for Adults (18-65 years) Page 18 of 27 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. Residents live in a safe and really homely,well maintained environment. Evidence: We read in the aqaa document some really good ways that the environment is made safe and suitable for residents to live in. We have quoted this extract: We do risk assessments on all rooms to ensure a safe environment. Rooms are decorated to suit service users taste. Any adaptations needed for any change in health needs will be seeked and paid for by the home. Handyman available five days a week full time. A cleaner works monday to friday, cleaning at weekends is done by staff and service users. Locks available to all service users who require one and front door keys. All bathrooms and toilets lockable. We have large shared communal rooms. All service users have access to sky t.v from their rooms, at an extra cost of fifteen pounds per month. All staff provided with a lockable cupboard to put their personal belongings. Office available for service users to use now we have two. Full use of washing machine and tumble dryer where appropriate. Upton Cottage is an older style residential building, located among private houses overlooking Clevedon bay. The home is a short distance from the main part of the town of Clevedon. There are buses from the town into the city centre of Bristol, this Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: helps residents to be a part of the community and to enjoy life away from the home if they want to. The home looked clean and tidy in all areas that we saw. The building is wheelchair accessible there are a number of adaptations in the home to help support people with disabilities and reduced mobility. There is no lift to get to the first and second floor. Residents looked very relaxed and comfortable in their surroundings. There are two spacious lounges, as well as a good sized conservatory area that is used as a dinning area. The home had been decorated for Christmas and looked very festive. Although sensitivity is paid to those who may not benefit from this and one communal room is always left undecorated. The communal areas and bedrooms looked really homely, as there are photos, art works and a range of figurines on display all adding to the ambiance of the home. We saw that the toilets are in parts of the home near to communal areas and peoples rooms. The bathrooms and toilets were really clean and were well stocked with towels and soap to help reduce risks from cross infection. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are really well supported and cared for, by staff who are properly trained to do the work they do. Evidence: We read in the aqaa document some really good ways that the staff are supported and trained. We have quoted this extract: There is a full job description given to all new staff. Staff aware of the home aims and objectives on induction. the staff handbook is given to all staff old and new. Code of practice given to all new staff. All staff get the opportunity to do national vocational qualifications to level two, three and four. Staff meetings happen every two months or more, if issues need to be discussed as a team. No staff under the age of twenty one left in charge at anytime. Never used agency staff, we feel as a team that this would not work for the environment we are trying achieve. Checks are done on all staff, references obtained before starting their position. We have a minimum of three staff on shift. There is regular supervision for staff. We have an on call rota between one senior staff member and management, ensuring there is always someone on call. This allows staff to call if there are problems with shifts, or major incidents that need to be dealt with as soon as possible. We checked the recruitment records of three recently employed staff, to find out if the Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: right safety checks are done before the home take on new members of staff. We saw written confirmation that all new staff have a criminal records bureau check undertaken, to confirm that they are suitable to work with vulnerable people. We also saw two references are taken up before a new employee starts work at the home. The staff told us they can do a really good range of study days in subjects to do with the needs of residents. Study days that staff have been on include a range of topics designed to help them support the residents really well. The staff do training in food hygiene, first aid and fire safety. The majority of the staff team have done national vocational qualification in care awards to level two or level three. The staff we saw have clearly built up warm and really close relationships with residents. The residents we met told us the staff are,really helpful,really nice and they,look after me really well. We checked the numbers of staff on duty over the last month to see if there are enough staff on duty at any time, to give the right level of care and support to the residents. There are a minimum of two to three support staff on duty, as well as at least one senior member of staff working during the day. There are also extra staff available at busy periods to make sure that there is enough support to ensure residents can take part in the activities that they like to do. There are two support staff who work at night and an on call manager available if needed. Ms Paterson works full time hours. This is really good evidence of how the staff team work flexibly to the needs of the residents. We did not fully count the number of catering and domestic staff, however we saw these staff working hard during the inspection. Care Homes for Adults (18-65 years) Page 22 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a really well run home. Residents would benefit even more, if there was a more structured system for monitoring the quality of the whole service. The health and safety of people who live and work in the home is well protected. Evidence: We read in the aqaa document some really effective ways that the home is run. We have quoted this extract: The registered home manager been in position for over thirteen years. The manager has done a higher diploma qualification in learning disabilities. The management and senior staff are trained in national vocational qualifications to level three. The manager communicates clear sense of direction and leadership. We have excellent feedback from outside agencies and staff. We have an on call rota, so the home is always well managed. The deputy manager and home manager have regular weekly meetings to discuss weeks ahead and passed. Our maintenance man is on hand five days a week who also manages the health and safety and fire risk assessment of the home. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: Ms Joanne Paterson is the registered manager of the homes, she takes responsibility for much of the day to day running of the home. Ms Paterson is really well supported by the owner of the home, Mrs Hazel Paterson who takes a very, hands on approach in the home and works as a carer full time, as she told us she, loves caring for the residents. Ms Paterson attends regular managers meetings with other managers who run care homes in Clevedon. This is a really good way for managers to get support from each other and to keep up to date with current practice to do with care homes. As we have already referred to in the report, there are residents meetings held regularly, where residents can talk about what ever they want to. This is a good example of the open management style in the home. We saw some evidence of monitoring the quality of the care and the monitoring of the medication systems in the home. However we advised Ms Paterson that there needs to be a structured system in place, to formally monitor the overall quality of all aspects of the running of the service. The staff undertake a range of training in health and safety matters such as first aid,infection control and fire safety. This should help protect residents, if staff have a good understanding of health and safety principles and practices. The staff do regular training in food safety practises. This is a really good way for staff to help residents to prepare and cook food in a safe way. We saw records that confirmed for us that staff check the temperatures of all high risk cooked food before it is served to people. This is done to make sure it is hot enough and is safe for people to eat. The home looked safe and satisfactorily maintained in the parts that we viewed. We saw detailed,written health and safety risk assessments done about the home environment. This information is used to keep people safe in the building. We looked at the fire record, we saw that the required weekly and monthly tests of the fire alarms and the fire fighting equipment are done and are up to date. This helps to ensure that fire equipment will work in the event of a fire. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 1 38 24 There must be a suitable 04/02/2010 system of quality assurance in place. This requirement relates to the need for a formal system to monitor the overall quality of care in the home. Quality monitoring of the service. 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 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 26 of 27 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. 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. 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