Inspection on 10/02/09 for 43 Clayhill Road

This inspection was carried out on 10th February 2009.

CSCI 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

43 Clayhill Road 14/02/07

43 Clayhill Road 22/02/06

43 Clayhill Road 02/09/05

43 Clayhill Road 29/11/04

43 Clayhill Road 07/09/04

43 Clayhill Road 04/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 26/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 43 Clayhill Road Burghfield Common Nr. Reading Berkshire RG7 3HF     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: Denise Debieux     Date: 1 0 0 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.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: 43 Clayhill Road Burghfield Common Nr. Reading Berkshire RG7 3HF 01189835047 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): trina.williams-feast@new-support.org.uk Dimension (NSO) Ltd Name of registered manager (if applicable) Mrs Mandy Patrina Williams-Feast Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 6 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 43 Clayhill Road is a six bedroom detached house set in a residential area of Burghfield Common providing care and support for up to six people with learning disabilities. Accommodation is provided over two floors with three bedrooms on the ground floor and three on the first floor. The home has an assisted bathroom and shower room and can accommodate people who use wheelchairs. There are some local amenities close by and a bus service is available. The home has its own assisted transport that enables all the people they support to lead full and active social lives. Care Homes for Adults (18-65 years) Page 4 of 30 care home 6 Over 65 0 6 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This unannounced visit formed part of a key inspection and was carried out by Denise Debieux, Regulation Inspector. The Registered Manager for the home was present as the representative for the establishment. It was a thorough look at how well the service is doing. It took into account detailed information provided by the manager and any information that CSCI has received about the service since the last inspection on 14th February 2007. Service users at this home prefer to be referred to as the people supported. For clarity and consistency this term will be used throughout this report. Care Homes for Adults (18-65 years) Page 6 of 30 A tour of the premises took place. On the day of this visit the inspector spoke with each of the six people supported and four on duty staff. Prior to the inspection, survey forms were sent to the people supported, staff employed at the home, care managers, health professionals and GPs. Survey forms were returned by three of the people supported, five members of staff and three GPs. None were returned by other health professionals or care managers. These survey forms were correlated and the results were shared with the manager during the inspection. Comments made on the survey forms, both positive and negative, were included in the correlation. Care was taken to exclude any comments that could identify the writer. The manager demonstrated a very pro active attitude to the results of our survey and plans to explore any concerns raised further as part of the homes quality assurance process. Some of the comments made to the inspector and made on the survey forms are quoted in this report. Observations of the interactions between staff and the people supported were also used to form the judgements reached in this report. The manager had completed an annual quality assurance assessment (AQAA) and care plans of the people supported, staff recruitment and training records, menus, health and safety check lists, activity records, policies, procedures, medication records and storage were all sampled on the day of this visit. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. Fees at the home are between 870.58 and 1278.60 pounds per week. This information was provided on 10/02/09. The inspector would like to thank the people supported and staff for their time, assistance and hospitality during this visit and the people supported, staff and GPs who participated in the surveys. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 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 9 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The pre admission procedures at the home ensure that the needs and aspirations of the people supported are fully assessed prior to admission to make sure that their needs can be met. Evidence: There has been one, very recent admission to the home since the last inspection. The person had moved to the home, a few days prior to this inspection, from another home run by the same provider. The manager described how, since January, members of staff had been going and working with the person in her old home so that she could get to know them and so that the staff could learn exactly how she liked to be supported. Prior to her moving to the home an occupational therapist had visited 43 Clayhill Road and carried out a full assessment of the premises to ensure that the home could meet the persons physical needs. A transition plan was seen that sets out clearly how the move had been planned. The staff at the home are taking great care to ensure that the persons routine and weekly activities remain as unchanged as possible. The staff are also working to the care plan that was in place at the previous Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: home to make sure that there is as much consistency as possible, where necessary it was seen that this care plan had been amended to take into account the differences between the premises of the old home and 43 Clayhill Road. This care plan was sampled and contained very detailed information setting out exactly how the person supported preferred her care and support to be carried out. During the day of this inspection, observations of the way staff were working with and interacting with this person as they provided support, demonstrated that staff already have a sound knowledge of the persons likes, dislikes and preferences and are following guidelines set out in her care plan. The person herself looked settled and at home in her new surroundings and indicated that she was happy with the way things were going. In the AQAA, to demonstrate what the home does well, the manager stated that: Visits are arranged to view the house and those that live there, days and overnight stays. Personal assessments, health needs and those already living in the house are considered. This statement is supported by the findings on the day of this inspection. Data provided in the homes AQAA does not identify any people they support with specific religious, racial or cultural needs at this time. However, from the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Care Homes for Adults (18-65 years) Page 11 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The individual plans for the people supported are clear and comprehensive including details of needs and goals. They also incorporate known or indicated preferences. The people supported are supported to take risks as part of an independent lifestyle. Evidence: Care plans for two of the people supported were sampled and both were seen to be comprehensive, well set out and easy to follow. Care plans are person centred and are drawn up with the full involvement of the person supported, care plans are kept under review during key worker meetings, or more often, if needs change or a new concern arises. The staff document daily in a separate diary for each person supported to evidence that the persons individual goals and needs are being met. These diary notes evidenced that any new concerns identified are promptly acted upon and the care plan updated accordingly. Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: The care plans were all seen to be very individualised and included the personal preferences of the person supported and also risk assessments for all activities, with clear guidelines for staff to follow to minimise any associated risks. All people supported that returned survey forms stated that they could do what they wanted to do during the day, in the evening and at weekends. On the day of this visit, the people supported were seen to be choosing what they did and where they went within the home. Staff were seen to be helpful and offered assistance where needed or requested. It was also observed that staff had a good rapport with the people supported that were not able to fully communicate their wishes verbally, where they indicated that they wanted assistance, this was quickly understood by the staff and the assistance provided. It was also noted that the staff were skilled in recognising any non verbal signs that may indicate that the person supported was not entirely happy and were seen to be very quick to respond. In the AQAA, to demonstrate what the home does well, the manager stated that they: Give the people we support the opportunity to fulfil their desires and needs. Maintain dignity. Respect their rights. This statement is supported by the findings on the day of this inspection. Care Homes for Adults (18-65 years) Page 13 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people supported have opportunities to take part in appropriate activities within the home and in the local community. They are supported and enabled to maintain and develop appropriate personal and family relationships. Systems are in place to ensure that the rights of the people supported are respected. Meals are well-balanced and varied. Evidence: The daily routines at the home reflect the requirement to promote independence, individual choice and freedom of movement. The people supported spoken with during this inspection confirmed they could choose what to do, when they wanted. This was also confirmed by observations made by the inspector on the day of this visit. Each person supported has a weekly activity schedule that is based on his or her Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: known interests and hobbies. The activity schedules sampled were seen to be varied and included activities both within and outside the home in the local community. Local involvement includes local shops, library, church, theatre and music concerts. Four of the people supported attend local day centres and one person has a job. First thing in the morning is a very busy time with everyone getting up and getting ready to go to their various planned activities as was demonstrated when the inspector arrived on the day of this visit. Every year the people supported identify and draw up a yearly plan of things they would like to achieve or do during the year. The care plans demonstrated that the staff work closely with the people supported to enable them to work towards and achieve these goals. The home has its own transport that is available to facilitate activities and trips for the people supported. All people supported plan and take holidays or a number of short breaks during the year, with support from staff where needed. There are no restrictions to visiting times and staff support and encourage the people supported to maintain family links and friendships inside and outside the home. When asked Does the care service support individuals to live the life they choose? Two GPs answered always and one answered usually with one GP adding Personalised, supportive environment. When asked Does the care service respect individuals privacy and dignity? All three GPs answered always. On the day of this inspection staff always knocked and awaited permission prior to entering a persons personal bedroom, personal care was always carried out behind closed doors and all interactions observed between the staff and the people they support were polite, respectful and inclusive. The menu for the week of this visit was seen to be varied and well balanced, advice is sought from a local dietician, for individual people, as and when needed. The inspector was advised that the people supported plan and prepare their meals, with assistance and guidance from the staff where needed. The home use photograph and picture cards of different foods to enable the people supported to be fully involved in and make choices when planning meals. The lunchtime meal was taking place during this visit. The food was presented in an appetising manner and the people supported chose what they wanted for lunch and ate at the time that fitted in with what they had planned for the day. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: In the AQAA, to demonstrate what the home does well, the manager stated that they: Offer a varied choice of activities suitable for individuals. Choice of holidays, days out. Enable people to choose their own clothes. Choose their own decor for rooms and house. People we support help plan weekly menu. Promote independence in all aspects of daily routine and hygiene, but give assistance when required. This statement is supported by the findings on the day of this inspection. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal care and healthcare support and assistance was seen to be provided, where needed, in a respectful and sensitive manner. Sound policies and practices are in place for the administration and management of medications. Evidence: During this visit two care plans were sampled and it was seen that all health care needs were incorporated into the care plans. Diary notes evidenced that staff take prompt action to deal with any new health problem that may occur and care plans were specific with information for staff to follow when supporting people to manage any long term conditions. The care plans seen also contained a morning routine sheet and a nightly routine sheet that sets out exactly how the person supported likes to be supported with their personal care. Any equipment or aids needed to enable individual people to maintain maximum independence is provided, it was also seen that the staff have taken care to ensure that the home is furnished and laid out with attention being paid to the specific needs of the people living there, e.g. a number of people supported have mobility problems, the staff make sure that floor spaces are kept clear and that Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: furniture is not moved or rearranged without the full involvement of a person supported who has sight impairment. Medication is provided mostly in the blister pack system. The administration of some medications was observed and the medication administration records (MAR), medication storage, policies and procedures were all sampled and found to be in good order. At present no-one at the home is prescribed controlled drugs, however there was recently a change to the law relating to the storage of controlled drugs and the manager is aware that she needs to check the homes drugs cupboard to ensure that it complies with the new requirements. An excerpt from a CSCI guidance document: The safe management of controlled drugs in care homes was left with the manager. The full document can be downloaded from the CSCI website. In the AQAA, to demonstrate what the home does well, the manager stated that: All people we support have their support package. Regular appointments are made for: Dentist, G.P. Chiropody. Provide specialist aids where required, i.e. hoists, shower chairs, walking frames. Health action plan. Medication training, good record keeping, MAR sheets. This statement is supported by the findings on the day of this inspection. Prior to this visit, GPs were sent survey forms, three forms were returned, with two GPs stating that the home always meets individuals health care needs and one answering As far as I know. Additional comments made by the GPs included that the home: Works well with other health care providers e.g. GP services, Correct management of medical problems and I have been impressed by the efforts made by the staff to address key areas. When asked on the survey form if the staff treat them well, all three people supported who returned the form answered always. 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. All required policies and procedures are in place to ensure that people supported feel their views will be listened to. Policies and practices are in place to protect the people supported from abuse and neglect. Evidence: The home has a complaints procedure in place that is available to all people they support that has been individualised to the home and is available in an alternative format if required. No complainant has contacted the Commission with information regarding a complaint or allegation made to the service in the past twelve months. There is a whistle blowing policy in place and the home have a copy of the latest Berkshire Safeguarding Adults Policy and Procedure. All staff have received training or updates in the protection of vulnerable adults, this is clearly recorded in the homes training record. In the AQAA, to demonstrate what the home does well, the manager stated that: All people we support have a copy of the complaints procedure. Service user handbook, audio version available. Training for working with vulnerable adults. Staff are aware of being able to make a complaint against another staff member if there is any suspicion Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: of abuse in any form, i.e. neglect, financial, personal. This statement is supported by the findings on the day of this inspection. The people supported who returned survey forms all stated that they knew who to speak to if they were not happy and that they knew how to make a complaint. When asked on the survey forms if the home had responded appropriately if they or the person supported had raised concerns about their care, all three GPs answered always with one adding the comment: Very responsive. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The location and layout of the home is suitable for its stated purpose. It is accessible, safe and well maintained. The home was found to be clean and hygienic and to meet the individual and collective needs of the people supported in a comfortable and homely way. Evidence: 43 Clayhill Road is a six bedroom detached house set in a residential area of Burghfield Common providing care and support for up to six people with learning disabilities. Accommodation is provided over two floors with three bedrooms on the ground floor and three on the first floor. The home has an assisted bathroom and shower room and can accommodate people who use wheelchairs. People supported spoken with expressed their satisfaction with the accommodation provided at the home and three people explained how they had chosen the decor and furnishings in their own rooms. All of the people supported who returned survey forms said that the home was always fresh and clean. The home was toured during this visit. The furniture and furnishings were seen to be of a good quality and specialist equipment is provided if needed by the people Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: supported. Personal bedrooms were all seen to be highly personalised to the individual persons wishes. In the AQAA, to demonstrate what the home does well, the manager stated that they: Provide a clean homely environment. Safety is paramount, rails and ramps provided. People we support all have their own bedroom decorated to their choice. Wash basin in each room. Privacy is respected. Staff always knock before entering anyones room. Rooms are kept clean and tidy. Safety issues are adhered to. Equipment serviced regularly. Pleasant garden. This statement is supported by the findings on the day of this inspection. Laundry facilities are sited on the ground floor with washing machines suitable for the needs of the people supported at the home. On the day of this visit the home was found to be warm and bright with a homely atmosphere and a good standard of housekeeping apparent. 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. The home has a staff training and recruitment programme which is designed to ensure that the people supported have competent and qualified staff and that, as far as reasonably possible, they are protected from harm. Evidence: The staff rota evidenced that staff are provided in sufficient numbers to meet the needs of the people supported at the home. The manager calculates the number of staff needed on each shift based on the needs of the people supported and staffing levels are flexible depending on additional staff support needed for individual activities planned by the people supported. The morning (7.30am to 3pm) shift is covered by two or three care workers, two or three care workers cover the afternoon/evening shift (2pm to 9.30pm) and the night staff consists of one waking care worker and one sleeping on the premises and available if needed. Of the nine care staff, four hold a National Vocational Qualification (NVQ) level 2 or above in care, with a further two currently undertaking their NVQ level 2 training. At the last inspection the staff recruitment files were seen to be in line with the requirements for staff recruitment. Since then there has only been one member of Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: staff recruited who is currently working at the home. During this visit the file of this member of staff was sampled. The file was seen to contain all documents and checks required of the regulations. Another file had been sampled by the inspector, although it was later ascertained that, although this person had worked some shifts when first recruited, they had not worked at the home for a number of weeks due to other commitments. It was concerning that this file did not contain all the required information and had discrepancies that had not been explored. E.g. there was a gap in employment of over thirty years with no written explanation and no evidence that this gap had been identified or followed up, the dates the applicant had given for working at their previous place of employment did not tally with the dates given on the reference provided by that employer (two years difference) and reasons for leaving previous places of employment working with vulnerable adults or children had not been verified. The manager was unaware that employing a person to work at the home without all required checks and information in place would be an offence and was not aware of new regulations that came into force in July 2004 relating to staff recruitment and employment. The inspector was advised that the human resources department at the providers head office carry out many of the pre employment checks and recruitment administration and it is concerning that this persons recruitment file had been considered complete and signed off by both a member of staff from the human resources department and by the area manager for the home. The amended regulations relating to recruitment requirements for care homes were reviewed with the manager during the inspection and copies of the CSCI guidance documents: Criminal Records Bureau Checks and the associated annex 2, which set out the changes to regulations and explain the latest recruitment requirements, were left at the home for future reference. The manager confirmed that the missing information identified above would be obtained prior to the person working at the home again. As this was the only file that caused concern and as the member of staff identified is not working at the home at this time, no requirement has been made. However, whilst the registered manager and provider may delegate various aspects of the recruitment and vetting process (for example, to human resources), it must be noted that accountability still remains with the registered persons who must ensure that the requirements within regulations have been met before they allow a person to work at the home. Staff induction is in line with the new, mandatory Skills for Care common induction standards and the inspector was advised that staff are supervised until they have completed their induction. Staff are booked on additional training and updates as the Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: courses become available. In the AQAA, to demonstrate what the home does well, the manager stated: Staff have CRB and POVA checks before commencing work in the house and now all staff are regularly checked. People we support are involved in recruiting process. Training, NVQ. House inductions. Staff supervisions. Monthly staff meetings. This statement is supported by the findings on the day of this inspection. Of the three people supported who returned survey forms, all said that the staff always listened and acted on what they said. When asked if they received training which is relevant to their role and keeps them up to date with new ways of working, all five staff members that returned survey forms answered yes. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People supported benefit from the management approach at the home providing an open, positive and inclusive atmosphere. The home has a quality assurance and monitoring system in place that is based on seeking the views of the people supported. Policies and procedures are in place to ensure, so far as is reasonably practicable, the health, safety and welfare of the people supported and staff. Evidence: The manager holds an NVQ level 4 and has achieved her Registered Managers Award. She has worked in care for nineteen years and has worked at 43 Clayhill Road for the past fourteen years. The views of the people supported are sought on a regular basis and monthly visits by a representative of the responsible individual take place as required. The organisation carry out a yearly survey which seeks the views of the people supported plus their family and friends. There are house meetings every six to eight weeks where ideas Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: and opinions are sought from the people supported. Once a year the home identifies and draws up their house goals for the coming year with input from the people supported at the home and incorporating improvements identified as a result of the yearly survey. The people supported spoken with during this visit confirmed their involvement in staff recruitment and other aspects of the day to day running of the home e.g. choosing colour schemes when redecorating communal areas, choosing and planning menus and being involved when new people are moving to the home etc. All necessary health and safety checks are carried out by the staff at the home with documentary evidence inspected of routine fire practices and evacuations. Fire equipment checks, daily checks of fridge and freezer temperatures and a number of up to date maintenance certificates were seen. All records and documentation sampled during this inspection were well written, up to date and well maintained. In the AQAA, to demonstrate what the home does well, the manager stated: Good record keeping. Good safety procedures. House is managed well and runs efficiently. Emergency plans are in place. This statement is supported by the findings on the day of this inspection. When asked what the service does well, comments received from GPs included: prompt and appropriate action and follow up of medical problems. Excellent staff., Very caring with genuine interest in welfare of residents and Attentive to individual needs. Caring. All interactions observed between the staff and the people they support were inclusive, caring and respectful and evidenced that the home has a close, caring and stable staff team. The manager and staff spoken with demonstrated a strong commitment to enabling and supporting the people living at the home to meet their goals and, wherever possible, to live the life of their choice. Care Homes for Adults (18-65 years) Page 27 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 28 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 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 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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