Inspection on 15/04/09 for Winston Lodge

This is the latest available inspection report for this service, carried out on 15th April 2009.

CQC found this care home to be providing an Good 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

Winston Lodge 18/04/06

Winston Lodge 11/11/05

Winston Lodge 01/07/05

Winston Lodge 07/01/05

Winston Lodge 15/10/04

Winston Lodge 06/04/04

Winston Lodge 29/09/03

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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: Winston Lodge 362 London Road Waterlooville Hampshire PO7 7SR     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: Christine Bowman     Date: 1 5 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 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2010) 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 28 Information about the care home Name of care home: Address: Winston Lodge 362 London Road Waterlooville Hampshire PO7 7SR 02392647895 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 Management Group Ltd (trading as CMG Homes Ltd) care home 13 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 13 The maximum number of service users who can be accommodated is 13. The registered person may provide the following category/ies 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 categories: Learning disability (LD). Date of last inspection Brief description of the care home Winston Lodge is a care home registered to accommodate up to thirteen people in the category of learning disability. The home is owned by the Care Management Group who are based in Wimbledon. The group owns two other houses close to Winston Lodge. This home is situated within walking distance of Waterlooville town centre and is close to a range of amenities. The registered manager of the home also manages another home in the vicinity. Care Homes for Adults (18-65 years) Page 4 of 28 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: This inspection report includes information gathered about the service since the previous site visit on 24th April 2007 under the Commissions Inspecting for Better Lives (ILB) process. The registered manager completed an Annual Quality Assurance Assessment (AQAA) giving up to date factual evidence about the running of the home and informing us of what they think they are doing well, how they have improved the service and of their plans for further improvements. Five service users completed surveys with staff support giving their views on the service provided, and five staff members also completed surveys. An unannounced site visit was conducted on 15th April 2009 by regulation inspector, Ms Christine Bowman, to assess the outcomes of the key inspection standards for younger adults with respect to the service users living at the home. The registered manager, Mr Ben Chance, was interviewed and provided Care Homes for Adults (18-65 years) Page 5 of 28 support for the inspection process by making service user and staff files and other documents available to be sampled. A tour of the premises was undertaken and communal areas and some of the service users bedrooms were viewed. A number of staff and service users were spoken with throughout the day and observations were made of the service users and of staff as they carried out their duties. Service user and staff records, maintenance certificates and complaints and compliments records were sampled and the Statement of Purpose, the Service User Guide and some policies and procedures were viewed. 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 28 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 28 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. Prospective service users have the information they need to make an informed decision about living at this home and their needs are fully assessed to enable a personalised plan of care to be drawn up for their support. Evidence: The home provided full and accessible information to prospective service users in the service user guide, which was illustrated with colourful photographs and symbols to facilitate their understanding. A map was also included to show other nearby towns and cities, which were accessible by the local bus service. On the day of the site visit, the registered manager was returning a prospective service user to their home after an overnight visit. A full assessment of their needs had been completed. A bedroom, which had originally been shared by two service users had been prepared for them, by redecoration, the purchase of new furniture, and the provision of en-suite facilities. Personal information with respect to equality and diversity was included in the information collated during the assessment process to Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: inform the care plan and the full assessment of prospective service users needs included physical health and sensory needs, medication, dietary requirements, mental health needs, behavioural issues, daily living skills, communication, relationships and compatibility and community participation. Care Homes for Adults (18-65 years) Page 10 of 28 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. Person-centred planning promotes the involvement of the service users in decisionmaking about their lives and independence is promoted. Service users are enabled to take risks and positive strategies are in place to guide the staff to support them and keep them safe. Evidence: Service users care plans sampled were person-centred and showed how they were being given support to develop life skills to promote their independence. The extent of the individuals ability to complete personal care tasks independently was recorded and the support required, taking into consideration the preferences and likes and dislikes of the service user, to inform the staff. Service users method of communication was recorded and guidelines to the staff were included to help them to communicate with individuals by their preferred method. The manager recorded in the AQAA that, If there is a need by a service user we will also ensure we access the Speech and Language specialist. Of the five staff who completed surveys, two thought they always Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: had the right support, experience and knowledge to meet the different needs of the service users with respect to equality and diversity issues, and three thought that they usually did. Care plans sampled had been recently reviewed to ensure they contained up to date information about the service users needs. The manager recorded in the AQAA, it has been hard over the last twelve months to get commitment from care managers to attend reviews due to some service users having only the duty care managers who have no real or little knowledge of the service users. This has an impact on the service user when it comes to their reviews as often nobody will turn up. Individual service user action plans illustrated how they had made decisions about their lives such as having a new hairstyle, going out to buy new clothes and taking a holiday. Photographs of the process confirmed the service users involvement in making the decisions and their happy smiles at the outcomes. Four of the five service users, who completed surveys, confirmed that they were able to make decisions about what they do each day and one that they sometimes were. Risk assessments recorded identified risks, the possible consequences of taking the risks and informed the staff team of the action they should take to reduce the risks. The risk assessments sampled, which covered service users behaviours such as aggressive behaviour and not eating, and also included the risks involved in travelling in the homes vehicle, accessing the community, road safety, visitors and using electrical equipment, had been signed by key workers and service users to confirm agreement. Care Homes for Adults (18-65 years) Page 12 of 28 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. Service users are supported to engage in a range of activities that take account of their needs and preferences. They are supported to maintain personal relationships and be part of the local community. Service users rights are recognised and they are offered a healthy diet which reflects their individual tastes and dietary needs. Evidence: On the day of the site visit, some of the service users were attending day services and college or accompanying the manager, who was returning a prospective new service user home after an overnight stay to experience life at the home. Four service users were at home completing their domestic chores or relaxing. One staff member was supporting service users to prepare their sandwiches for lunch and the second staff member on duty was supporting the inspection process. A service user asked about going out and was told that a shopping trip had been arranged for the following day to Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: the town centre. As no service user was risk-assessed to access the community without staff support and with nine service users currently living at the home, it was difficult to see how activities could be arranged other than as a group, except for special trips such as holidays, when arrangements would be in place to cover for the missing staff. One service user, whose file was sampled, attended college regularly and was involved in independent living and work skills workshops. They also enjoyed cooking, dancing and keep- fit. All the service users, who completed surveys, recorded that they could do what they wanted during the day, in the evenings and at the weekend. There was a rota for carrying out daily chores and a staff member stated that some service users particularly liked to carry out certain tasks such as drying up the dishes, hovering and polishing or laying the tables. One service user, whose file was sampled, included household chores and long walks in the things they didnt like to do, and included eating out, dancing, visiting the sensory room, bowling, short walks and swimming as activities they enjoyed. Flexibility allowed service users to swap their daily tasks and everyone took responsibility for their own laundry boxes by putting out their laundry and putting away their ironing. The manager recoded in the AQAA, we provide and support service users with the opportunity to feel part of the community, by regularly visiting the local pub and using the local shops. We always encourage service users to develop any interests they may have and try to seek out local clubs if appropriate, three of the service users do access the local college. By accessing these services some service users have made new friends, especially in the local pub. Service users had scrapbooks full of photographs of all their aspirations, which had been fulfilled over the time they had lived at the home. One service user had recently been on the trip of a lifetime to visit Elvis Presleys home in America, and another had celebrated a 60th birthday. Service users files sampled contained their life story, informing the staff about the important people in their lives from relatives, neighbours and friends to staff and other people who helped them, to those people they say hello to. Positive information, on which service users could build relationships, were included such as what others like about me and nice things people say. The home arranged social events to which service users relatives and friends were invited. A recent Mothers Day buffet had received a number of compliments from visiting relatives with respect to the food and the staff. The dining room was adjacent to the well-equipped and modern kitchen and was furnished with solid pine tables and chairs. The four of the service users, who were not attending college or day services on the day of the site visit were enjoying sandwiches Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: with a variety of fillings for lunch. A menu was on a notice board in the dining room to inform the service users of the choices for meals, and a talk buddy had a prerecorded message of what was available for lunch for those who found following the menu difficult. The manager explained that the service users were involved in choosing from a pictorial menu of colourful photograph of meals. The menu provided choices and a good balance of nutritious meals with plenty of fruit and vegetables. On display in the dining room were decorated eggs, which the service users had painted for Easter. Care Homes for Adults (18-65 years) Page 15 of 28 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. Service users personal and healthcare needs are met according to their preferences and safe procedures are in place to promote their access to medication. Evidence: Service users person-centred plans sampled, indicated their preferences with respect to any personal care provided and included guidelines to inform the staff of their support needs. The main area of support was by prompting as the service users were being supported to remain independent or to gain skills, which they had not been supported to use in the past. Service users had been allocated key workers to offer consistency and continuity and to work with them on their plans to achieve their goals and aspirations. Since the previous site visit there had been a decrease in the use of agency staff, an increase in staffing levels and bank staff, and the home was in the process of building a staff team to ensure that the staff working with service users on a regular basis knew them well. The AQAA recorded that all the staff had completed the Skills for Care Common Induction Standards, which introduce new carers to the caring role and help them to understand and meet the needs of the service users with respect to privacy and dignity and equality and diversity issues. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: All the service users whose files were sampled had health action plans, which were in symbolic format to aid their understanding. They included the action required to support the service user to live a healthy lifestyle, the person responsible for providing the support and a review date to look at the progress made. Evidence of the involvement of specialists such as General Practitioners (GP), psychiatrists, physiotherapists, community nurses, dentists, opticians and chiropodists was recorded in the service users files sampled. One service users plan included staff encouragement to eat healthy meals and a weight chart. Medication was stored appropriately and was blister-packed at the local pharmacy for safety and convenience. Records were kept of medication received and returned to the pharmacy, and a sample of one service users medication, confirmed that the balance of medication recorded was correct. A controlled drug was recorded in the controlled drugs register and each entry was double signed for safety. The manager stated that staff were only allowed to administer medication after training and confirmation of competence. The staff training matrix confirmed that the majority of staff had received this training. Care Homes for Adults (18-65 years) Page 17 of 28 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 home provides the service users with an accessible complaints procedure and they are confident they will be listened to if they are not happy. Systems are in place to protect the residents from the possibility of abuse, neglect and self-harm. Evidence: The complaints procedure included in the service user guide was in pictorial format to promote the service users understanding. The five service users who completed surveys confirmed they knew how to make a complaint and that they knew who to speak to if they were not happy. The five staff, who completed surveys, also confirmed they knew what to do if a service user, their relative or representative had concerns about the home. No complaints had been received since the previous site visit and the CSCI (Commission for Social Care Inspection) or CQC (Care Quality Commission from April 1st 2009) had received no complaints on behalf of this home. Some of the many compliments received included, the staff make you feel like one of the family. I cannot fault anything, there is always a friendly welcome and visitors are well catered for and It was a lovely Mothers Day buffet and most enjoyable day. I do appreciate the efforts of the staff. The home had a copy of the local authority safeguarding adults policy and procedure to inform the staff of how to safeguard the residents from harm, and the staff training matrix confirmed they had received the protection of vulnerable adults training. The Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: home provided training in responding to challenging behaviour and the staff recruitment process safeguarded the service users by ensuring that recruitment checks including Criminal Record Bureau and the Protection of Vulnerable Adults list checks had been received, prior to the offer of employment. The AQAA recorded that, over the previous twelve months, one safeguarding referral had been made and records confirmed that the home had responded appropriately. Care Homes for Adults (18-65 years) Page 19 of 28 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. Service users live in a safe and well-maintained home, that is clean, comfortable, pleasant and hygienic. Evidence: The home was located along the main London Road close to the centre of Waterlooville town and within easy reach of shops and public services. Car parking facilities were available adjacent to the large, well-maintained house and the entrance was to the side of the building. The house was similar to other large residential homes located on the street. Inside the entrance hall was a display of photographs, covering one wall, and illustrating the diverse activities and projects engaged in by the service users. There was also a board showing photographs of the current staff team. The stairs leading to the first floor from the entrance hall had recently been re-carpeted, as had most of the communal areas, giving the home a fresh and clean ambiance. A partial tour of the premises was undertaken and the communal spaces and some of the service users bedrooms were viewed. Communal areas included the lounge, which was equipped with a large screen television, a library of videos and comfortable leather sofas and chairs. Scatter cushions, domestic lighting and a new carpet made this a pleasant room in which the residents could relax and socialise. A number of Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: service users owned their own large chairs, in the lounge area, which could potentially be problematic, but a staff member stated that, everyone get on well. The second lounge was a sun lounge or conservatory, which adjoined the dining room and provided a light, bright space for the residents to enjoy. It contained a music centre, a karaoke machine, appropriate furnishings and storage for activity materials. The garden was well maintained, mainly laid to lawn, and contained garden furniture and a bar-be-cue so that the service users could enjoy outdoor meals in the summer. A staff member stated that some of the service users had planted the bulbs in the garden and the plant pots located by the front door. The service user guide informed prospective service users that, their individual bedrooms will be decorated according to their choice to promote a personal feel, and bedrooms sampled confirmed this. One service user had chosen an electric bed so that they could be supported to the sitting position to watch their wide screen television. Bedrooms sampled had been suitably equipped with good quality and attractive furniture and supplied with washbasins for the convenience of the service users. The AQAA recorded that all the bedrooms had been redecorated within the previous twelve months. Communal washing facilities viewed included a wet room on the ground floor, a bathroom and a separate shower room on the first floor and one bedroom had recently been supplied with an en-suite bathroom. This situation is adequate as the number of service users at the present time is nine, with the prospect of one new service user accommodating the bedroom with the new ensuite. This service however continues to be registered for thirteen service users although the NMS (National Minimum Standards) recommended that by 1st April 2007 groups should be limited to ten service users sharing communal space. Although the washing and toilet facilities meet the standards and are recorded in the service user guide to inform prospective service users, having only one bath situated on the first floor, could be inconvenient for those service users whose bedrooms were located on the ground floor. The laundry room had been supplied with new industrial washing and drying machines and a basin for hand washing, liquid soap and paper towels were supplied to promote good hygiene practices. The staff training matrix confirmed that the majority of staff had undertaken infection control training and the cupboard in which the COSHH (Control of Substances Hazardous to Health) materials were stored, was secure to protect the service users. Care Homes for Adults (18-65 years) Page 21 of 28 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. Safe recruitment practices, appropriate induction and mandatory and specialist training prepare the staff for the supportive role and to meet the service users individual needs. Evidence: Since the previous site visit, the manager stated that the staffing had improved by the addition of floating staff (bank staff) working between the two homes he managed. There was a total of fourteen permanent staff, six of which, worked on a part-time basis. The manager confirmed that the rota was completed to ensure there were sufficient staff on duty to support the service users with their personal care needs. The AQAA confirmed that 50 of the staff team had achieved a National Vocational Training Qualification at Level 2 or above. The five staff, who completed surveys, thought there were always enough staff to meet the individual needs of the service users, and one carer commented, there are enough staff to cover the shifts thereby meeting the needs of the people using the service. Of the five service users, who completed surveys, four thought that the staff always treated them well and always listened to what they say, and one thought that they sometimes did. The recruitment procedure, described by the manager, included an initial visit to the Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: home before interview, to gain feedback from the staff team and to see how the service users responded to the prospective staff members. If the prospective candidates passed the first test, the manager and deputy manager carried out formal interviews at the home. Staff personnel files included application forms, interview notes and equal opportunities monitoring forms to confirm the process was carried out fairly. The records of two staff recruited since the previous site visit contained two written references, Protection of Vulnerable Adults First and Criminal Record Bureau checks to confirm safe recruitment, for the protection of the service users. The five staff, who completed surveys, confirmed that their employer had carried out checks such as CRB and references before they started work. The staff induction programme was based on the Skills for Care Common Induction Standards, which is an introduction to the caring role, which promotes the service users rights to be treated as an individual, and have their equality and diversity needs respected. Four of the five staff, who completed surveys, recorded that their induction covered everything they needed to know to do the job when they started, very well, and one that it mostly did. They all confirmed they were being given training which is relevant to their role, helps them to understand the service users needs with respect to equality and diversity and keeps them up to date with new ways of working. Training was incorporated into the work schedule for all the staff and the manager wrote in the AQAA, we have managed to source local training and in February 2009 we went onto e-learning on the computer with the new Information Technology system. The staff training matrix showed that staff had received up-to-date training in health and safety, fire safety, moving and handling, the Protection of Vulnerable Adults, food hygiene and first aid. Other courses completed by staff included infection control, care of medication, autism, Makaton, person centred care, health action planning, communication and supervision. Care Homes for Adults (18-65 years) Page 23 of 28 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. Service users benefit from living in a well managed home which is run in their best interests. Their health, safety and welfare is promoted and protected. Evidence: Since the previous site visit, the home manager had applied to be the registered manager for this home, and also of a home close by (Churchill), which is provided by the same company, and his application had been successful. The registered manager had completed a National Vocational Qualification (NVQ) at level 4 in health and social care and been awarded the Registered Managers Award. He had spent all his working life working in care settings and had four years of management experience. The manager stated that, since the previous site visit, the company which provided the home, had been taken over, and was now being run by a company known as Court Cavendish. He also confirmed that they were good providers and had instigated many improvements for the benefit of the service users. The manager was positive and enthusiastic about his work and stated that he promotes, an open and honest working environment and passes his experience and knowledge on to his staff giving them Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: support and confidence in their work. The quality assurance monitoring system for the home included the completion of questionnaires by the service users. The collated results provided an action plan for improvement with timescales, the delegation of responsibility and checks to monitor the progress to ensure the home was run in the best interests of the service users. We have support from the quality support team who will carry inspections and agree actions plans to address shortfalls in the service, the manager wrote in the AQAA, the quality support team operate a referral process so that if there are any concerns referrals can be made, and the service receives monthly visits, carried by other home managers or the regional Director and if there are any shortfalls, actions are agreed during the visit. The AQAA recorded that equipment had been serviced or tested as recommended by the manufacturer or other regulatory body and certificates for the electrical and gas appliances, sampled, confirmed they had been serviced within the previous year. The Control of Substances Hazardous to Health (COSHH) had been appropriately risk assessed to safeguard the residents and all the risk assessments had been signed by the staff to confirm they had read them. Policies and procedures and codes of practice in relation to Health and Safety were in the process of review to keep the staff up to date with current legislation and practice. The staff training matrix confirmed that training in moving and handling, food hygiene, first aid, fire training, infection control and health and safety had been regularly updated to inform the staff. There was a programme of maintenance and repair and maintenance support was supplied by the organisation. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 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 27 of 28 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 © (2010) 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. 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