Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 25/02/09 for 48 Burton Road

Also see our care home review for 48 Burton Road for more information

This inspection was carried out on 25th February 2009.

CSCI 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Observation of staff showed positive attitude and relationships with people who used the service. Staff continue to strive for high standards within the home and have supported people who use the service in a sensitive and supportive way. Each person using the service has a pictorial and person centred plan of care, which they have helped to develop. Some people living in the home need support to communicate with others. People are involved in a variety of leisure and work activities. Staff support people to identify what activities they want to be involved in on a daily basis. People are able to develop life skills, to complete domestic chores in the home, and take responsibility for shopping and cooking. Staff said they are committed to supporting people to achieve identified goals. People are supported to go out for meals, or to the pub, and food is prepared and cooked by individuals, with the support of staff members. Staff enable and support people to keep in touch with their family and friends, either by arranging visits, and or by phone or letter.

What has improved since the last inspection?

The Annual Quality Assurance Assessment (AQAA) document which is completed by the care manager told us: "Involving the service users in the plans and decisions for the home. Health Action Plans are in place for all individuals. Encouraging service users to be involved in the review process and supporting service users to build confidence in attending the meetings. We arrange these meetings in a way that makes individuals comfortable. Increased activities within the community. Increased the flexibility in the rota to enable service users to attend activities. Health Action Plans are in place in the service. All medication is audited on a monthly basis. The medication is stored in separate baskets for each individual which is labelled for each person and has their picture on it. There has been less incidents in the service for individuals. Staff continuously look at new ways to involve individuals. We have a computer programme which allows us to create documents in symbols. Staff have achieved more training.The manager has achieved her registered managers award, 4 staff have their NVQ level 3. Three members of staff have now enrolled on the NVQ level 3. There has been some improvement in time management, and the staffing levels on shift have increased. This means there are more staff around to ensure all individuals have the support they need."

What the care home could do better:

The Annual Quality Assurance Assessment (AQAA) document which was completed by the care manager told usInvolve service users in documenting in their daily diaries. Review service users personal centred plans, goals and aspirations. Encourage individuals to be more independent with any health needs. Explore more suitable in house activities. Encourage service users to participate more frequently in the preparation of their evening meals. Finding and accessing more educational opportunities for individuals. Training all staff in the procedure of ordering and returning medication. Involving individuals to give feedback about an incident. Involve service users where appropriate to be more involved in carrying out fire checks supported by the staff team to further gain skills. Increase the staffing percentage for NVQ status. Involve service users in the recruitment and selection process Time management. We strongly recommend that the care manager applies for Fit Person Registration with the Commission for Social Care Inspection. We recommend that consideration is given in regard to how the existing quality assurance system is implemented, and is fedback to staff and the people using the service.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 48 Burton Road 48 Burton Road Branston Burton on Trent Staffordshire DE14 3DN     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: Pam Grace     Date: 2 5 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 31 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 31 Information about the care home Name of care home: Address: 48 Burton Road 48 Burton Road Branston Burton on Trent Staffordshire DE14 3DN 01283545370 01283545370 48burtonroad@robinia.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Robinia Care Homes (2) Limited care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category of service only: Care Home Only (Code 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) 4 Date of last inspection Brief description of the care home The service is registered to provide 24-hour support and care for four younger adults with a learning disability and complex needs, and may have a diagnosis on the Autistic Spectrum Disorder. The home currently provides accommodation for three male individuals. The property is a period semi-detached house located in the residential area of Branston, on the outskirts of Burton-on-Trent. The home is conveniently situated close to a town, on a bus route and close to shops and amenities. The premises are set back from the main road and have tall metal gates leading to the gravel frontage and drive. The building is on three floors and comprises: four bedrooms, an office/sleep-in room, lounge, dining/activity room, bathroom and toilet facilities, laundry room and additional storage. One of the bedrooms has an en-suite Care Homes for Adults (18-65 years) Page 4 of 31 Brief description of the care home shower and toilet facility. Parking space is adequate and to the rear of the house is a large grassed area and patio. People who use the service have access to a variety of activities in the home and the community, supported by staff. Care Homes for Adults (18-65 years) Page 5 of 31 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 visit was an unannounced key inspection and therefore covered the core standards. The inspection took place over approximately six and a half hours by one inspector who used the National Minimum Standards for Younger Adults as the basis for the inspection. Prior to the inspection, the care manager completed an Annual Quality Assurance Audit (AQAA) for us. A tour of the home was undertaken. Care Homes for Adults (18-65 years) Page 6 of 31 On the day of the inspection the home was accommodating three people. Due to the complex needs of some people living in the home, we were unable to communicate effectively with all individuals present during the visit. We spoke with people who use the service, examined records, carried out indirect observation, and spoke with two staff on duty. Two care plans and two staff records were examined and observation of daily events took place. Medication procedures were inspected so that we could see how safe they were. There are satisfactory medication systems in place and the staff have a good knowledge of medication and of drug usage. A monthly audit of all medicines is carried out. We did not make any requirements, but made two recommendations as a result of this unannounced inspection. The fees charged for the service at 48 Burton Road, are from 1861.86. pounds to 2654.07 pounds per week. The fee information included in this report applied at the time of inspection, the reader may wish to obtain more up to date information from the care service. What the care home does well: What has improved since the last inspection? What they could do better: The Annual Quality Assurance Assessment (AQAA) document which was completed by the care manager told us Care Homes for Adults (18-65 years) Page 8 of 31 Involve service users in documenting in their daily diaries. Review service users personal centred plans, goals and aspirations. Encourage individuals to be more independent with any health needs. Explore more suitable in house activities. Encourage service users to participate more frequently in the preparation of their evening meals. Finding and accessing more educational opportunities for individuals. Training all staff in the procedure of ordering and returning medication. Involving individuals to give feedback about an incident. Involve service users where appropriate to be more involved in carrying out fire checks supported by the staff team to further gain skills. Increase the staffing percentage for NVQ status. Involve service users in the recruitment and selection process Time management. We strongly recommend that the care manager applies for Fit Person Registration with the Commission for Social Care Inspection. We recommend that consideration is given in regard to how the existing quality assurance system is implemented, and is fedback to staff and the people using the service. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information provided to people about the service ensures that they have the full facts about costs to enable them to make the decision about the suitability of the service and its ability to meet their needs. Evidence: The Annual Quality Assurance Assessment document (AQAA), which was completed by the care manager, confirmed that peoples health, personal and social care needs are fully assessed prior to admission to the service. This also told us: All service users have relevant guidelines in place to identify how various needs, need to be met. Health Care Needs: The service users attend health care appointments with support. Staff document the outcome on an appointment and keep a log of professional contacts. Family Contact: All service user have a family contact form to enable staff to document the frequency of contact with families via letter, phone etc. The staff support in making arrangements for individuals home visits. Weekly Timetables: All service users have a weekly timetable detailing their planned activities Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: for the week. We complete pre admission assessments to ensure that we can meet the needs of the individuals, as part of this we have visit to the home for the individual, where they come to the home during the day and for an over night stay. Statement of Purpose: The statement of purpose has been developed. The statement of purpose sets out the layout of the each room within the service. Each service user has a copy of the homes statement of purpose Statement of Purpose: The statement of purpose is based on the five competencies, first outlined by John O Brien 1987 and the Governments White Paper strategy. Individual service users are able to manage aspects of their lives with support or independently. This is evidenced in lifestyles, such as activities, community participation etc. The Statement of Purpose outlines what we promise to do as a service and the staff team work alongside the service users to ensure it happens. Equality and Diversity: All service users at Burton Road are able to participate in their community. This is with staff support. Service users have a range of activities this includes activities such as swimming, cinema, bowling, local car boot sales, discos. The pictorial Statement of Purpose and Service user Guide which is specific to this service and the resident group, was in the process of being reviewed. These documents had been explained to people who use the service with the use of pictorial support. The Guide included details of the terms and conditions of occupancy and fee level. Each person also had an agreement, which recorded how the service was to provide support for each person. The care manager and staff confirmed that pre admission assessments had originally been undertaken either by the home, by social services, and or the specialist community learning disabilities service. The people who use the service had been resident in the home for a number of years and there was one vacancy. One person spoken with, said that they were happy living at this home. Care Homes for Adults (18-65 years) Page 12 of 31 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. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. Evidence: The Annual Quality Assurance Assessment (AQAA) document, which was completed by the care manager, confirmed the following: Care Reviews: Service users are supported to review their needs. Family and friends are supported to attend. The times of an individual care review is arranged to enable families to attend. This may take place in an evening or weekend depending on the requirements. All service users have a Health Action Plan. Personal Care: All service users have support plans that identify how they want to be supported with personal care needs. Document all health visits on a professional contact form. Record all health visit outcomes on appointment summaries, and also include next visit where required. Support service users where needed to attend medical appointments. Ensure that any Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: medical attention needed is obtained swiftly. Ensure that service users are in agreement with medical professions as and when needed. Ensure that all issues are discussed in a private place, ensuring confidentiality. Record, store and administer medication in line with policy and procedures. Promote and encourage service users to self administer where possible, and complete the medication compliance sheet to monitor and record any discrepancies. Audit medication on a monthly basis. Ensure all staff are trained to administer medication prior to undertaking administration of medication. Protocols are in place for PRN medication. We looked at two care plans, both of which contained a client profile with person centred information. Evidence of health services input was also seen. Each plan was individualised, and recognised the personality and needs of the person. The plans were reviewed on a regular basis, and any changes to the skills achieved were recorded. Staff know the people using the service very well, and the care and support they need. They confirmed that individuals are consulted on a daily basis, and are encouraged to be involved with their care plan reviews. This consultation was also confirmed when we spoke to one person using the service who was being supported in making a choice for lunch. We saw that people were asked by staff if they wanted drinks, food and snacks, which were made available throughout the day, with a choice of options for hot or cold food and or drinks. Risk assessments seen identified in detail the risks for each individual. These were complete, and contingency plans were in place, ensuring the safety of each individual. However, some of these were out of date and needed reviewing. This was highlighted and discussed with the care manager and will be rectified. Care Homes for Adults (18-65 years) Page 14 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are involved in decisions about their lives, and play an active role in planning the care and support they receive. Evidence: The Annual Quality Assurance Assessment document (AQAA), completed by the care manager, confirmed the following: Service users are encouraged to follow a lifestyle they feel comfortable with. Service users spend quality time with friends, families as and when they wish to. Service users spend time alone if they want to. We encourage service users to maintain hobbies of their choice. We support all individuals to choose their own activities. We support service users to access local services for example hair dressers, and will challenge decisions which discriminate against any service user. We ensure that the service Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: users receive a holiday with their choice of destination on a once yearly basis. All service users have an individual activity plan, outlining what they want to do. We motivate and encourage service users to participate in a varied choice of activities. We encourage service users to maximise their day by choices in activities. We support service users where needed to become comfortable with new activities, and give one to one support. We ensure that activities are maintained and new ones developed. Service users are encouraged to access local pubs, shops etc if they choose. We encourage and support service users to have a healthy and balanced diet, with professional input if the need arises. Service users are encouraged to participate in preparing meals for themselves with support. We looked at two care plans. Information regarding triggers to any known behaviour, for example, what may upset a person, or known fears, were included within the care plan. Information was recorded in regard to how the person communicated. Assessments covered all aspects of daily living, for example traffic awareness, cooking skills, travelling in vehicles. Information relating to the persons culture and religious needs were included in the plan, and how these were to be met. Personal risk assessments recorded the identified risk, the level of risk and how to support the person. Thus ensuring the safety of individuals. People who use the service made the following comments in relation to lifestyle, I hoover the carpets and I do my washing, I am happy here. Due to the complex needs of some people living in the home, we were unable to communicate effectively with all individuals present during the visit. However, those individuals appeared happy and well cared for. People who use the service had limited verbal communication, and also communicated using their own gestures and facial expressions, or through complex behaviour. Staff had supported those individuals to participate in the development of their plans and information. From observation and discussion with staff it was evident that people who used the service were supported to make decisions about their daily routine. During the day, people were observed being able to choose how to spend their time in the home. Staffing levels had been reviewed since the previous inspection. An additional staff member had been recruited to enable individual activities to take place each day. Discussion took place with staff and people who use the service throughout the visit. This covered their daily programmes, activities, trips out, and visits to see their families and friends. Daily activities and life continued as normal during our visit. Staff Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: explained the inspection process to people using the service, during the inspection visit. Care Homes for Adults (18-65 years) Page 17 of 31 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. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: The Annual Quality Assurance Assessment (AQAA) document, completed by the care manager, confirmed the following: All service users have a Health Action Plan. Document all health visits on a professional contact form. Record all health visit outcomes on appointment summaries, and also include next visit where required. Support service users where needed to attend medical appointments. Ensure that any medical attention needed is obtained swiftly. Ensure that service users are in agreement with medical professions as and when needed. Record, store and administer medication in line with and policy and procedures. Complete the medication compliance sheet to monitor and record any discrepancies. Audit medication on a monthly basis. Ensure all staff are trained to administer medication prior to undertaking administration of medication. Protocols are in place for all PRN medication for each individual. Service users arrangements for Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: death forms are completed. We looked at two health care plans, these recorded health care needs and how people were to be supported. A record was also maintained of health visits and any outcomes. People who use the service also had access to support from an external Psychology agency. Assessments of risk recorded that two individuals need two to one support in the community and one person requires one to one support, all people require one to one support in the home. Additional staffing had been provided to ensure the right level of support. Each person was registered with a local General Practitioner (GP). There were good relationships fostered between the home, the learning disabilities service, the GP and the local pharmacist. Other specialists maintain further contact and support. For example, Speech and Language Therapist, and where necessary, District Nurses were approached for advice, information and any equipment necessary. People using the service attend surgery and or clinics as appropriate to their health needs. The evidence to support this was contained within daily records, and care plans seen. The home operated the Boots Monitored Dosage System (MDS). The staff stated that there were no controlled drugs in use. The home had reviewed the medication system and procedures to a good standard. Observation of administration practices was satisfactory and staff were aware of the usage of the medication administered. Medication records contained required entries, and were signed. Where people require as required(p.r.n.) medication, a protocol for usage is available. Discussion with staff revealed that they knew people well, and how to support each individual. Care Homes for Adults (18-65 years) Page 19 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure. People are protected from abuse, and have their rights protected. Evidence: The Annual Quality Assurance Assessment document, which was completed by the care manager, confirmed the following: There is a complaints procedure available for all service users, and easily accessible within the service. All service users have an individual complaint procedure. All complaints are dealt with within 28 days. All service users are encouraged to consider having an advocate, as a means of resolving any worries within the service. All service users have locks fitted to bedrooms, and staff have no rights to enter unless agreed with individual service users. All staff employed have a CRB in place and these are redone every three years. Anyone placed on the POVA is not permitted to work for the company. All staff receive training in Adult Protection. Any physical intervention used is recorded. Staff are trained in Team Teach techniques. All bank staff used in the service have an induction. All staff have read the whistle blowing policy and there is a copy of Vulnerable Adults document. Service users money are checked on a daily basis and audited once a month by the service manager. Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: The home has a complaints procedure that is clearly written and easy to understand using a helpful system of pictures. The complaints procedure was displayed around the home and staff reported that a copy is available to all people with a photograph of the responsible person. There had been no complaints and no Safeguarding referrals made since the previous inspection. The policies and procedures for safeguarding adults are available in the home and staff received training during their induction. Staff records demonstrated that people are able to keep updated with their knowledge, and attend regular training for Safeguarding adults and awareness of abuse. Staff recruitment records evidenced that staff are recruited following thorough procedures, which included Criminal Records Bureau (CRB)and Protection of Vulnerable Adults (POVA) checks prior to commencement of employment. Staff spoken with at the time of the inspection confirmed this. A spot check of peoples finances revealed that the home appropriately records and receipts all personal monies held for people who use the service. Care Homes for Adults (18-65 years) Page 21 of 31 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 physical design and layout of the home enables people who use the service to live in a safe, and comfortable environment, which encourages independence. Evidence: The Annual Quality Assurance Assessment (AQAA) document completed by the care manager commented on the following: Burton Road has been fully redecorated with input from the service users, to make it into a warm and inviting home. The service users are encouraged to have their bedrooms decorated in a way that they choose. The service is located on the main street, making it accessible for public transport, where appropriate for the individual. The service is similar to the rest of the houses on the road. The service is accessible to all service users. The service is clean and free from any odour, and there are handwashing facilities in the kitchen, laundry and bathroom.The staff carry out weekly water checks, health and safety checks and fire alarm checks. All maintenance work is carried out by the companies maintenance team, and the service received is of excellent standards. Encourage the service users to share the development of the rear garden on a regular basis. Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: A tour of the building confirmed that all areas internally had been well maintained. There is an ongoing programme of redecoration and refurbishment for the service. Throughout the home adequate standards of hygiene were observed. The kitchen is domestic in nature. The lounge is big enough to accommodate the people who use the service. The separate dining room is well used for mealtimes, and for some activities. There are modern and comfortable type furnishings in place, which people using the service had helped to choose. The outside rear has a level paved area, which enables people to safely use the garden. Bedrooms seen had been personalised, furnishings and fittings were of a good standard, and rooms had been decorated to their individual choice. One person who uses the service told us that they were happy with their bedroom, and with their lounge. Care Homes for Adults (18-65 years) Page 23 of 31 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. Staff are trained, skilled and provided in sufficient numbers to support the people who use the service and to ensure the smooth running of the service. Evidence: The Annual Quality Assurance Assessment document (AQAA), which is completed by the care manager, confirmed the following: The staff team ensure that the service users views are at the forefront of our service. 50 per cent of the staff team have an N.V.Q level 3. All staff have completed a four day induction training. All staff have undergone vulnerable adult training. Staff are encouraged through training, support and supervisions and staff meetings to advocate on behalf of service users. All newly recruited staff go through a thorough recruitment and selection process. All staff have a POVA and CRB check. All staff have received a contract. All staff have a job description. All staff have an individual personal development plan. All staff receive regular support and supervision. The staff team are committed to the service and the service users. We do the following to ensure that gender identity is promoted within the service. Staffing Ratio: The staff team is a mix of male and female staff. We have worked with all service users and implemented personal centred plans, to voice service users opinions on what individuals want to Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: achieve. The service users are all different at Burton Road, and the team will support the different lifestyles. All staff are able to voice opinions, concerns, either through staff meetings, or support and supervisions, which are carried out on a monthly basis. Service users are able to be included in staff meetings but on the whole choose not to. From our discussions with staff, the care manager, and the examination of staff recruitment and training records, we were assured that the recruitment and training provided, promoted an effective staff team. Staff have achieved more training.The manager has achieved her registered managers award, 4 staff have their NVQ level 3. Three members of staff have now enrolled on the NVQ level 3. There has been some improvement in time management re the staffing levels on shift, these have increased, which means there are more staff around to ensure all individuals have the support they need. Staff spoken with confirmed that staffing levels were flexible to meet the needs of the people who use the service, and their commitment to daily activities, for example; transport to an appointment, or a shopping trip. A member of the staff team and or the care manager would be available at the home during the day. The staff rota for week commencing 1st February 2009 confirmed that staffing levels had been maintained. Four staff members including the care manager were on duty during the day, three staff members during the afternoon and evening, with an additional member of staff supporting individual activities each day between 10.00a.m. and 8.00p.m. Staff records were examined, those records evidenced that appropriate Police and security checks had been made prior to their employment, ensuring the safety of the people using the service. The care manager confirmed that there had been two new staff recruited. Staff spoken with confirmed that they had received an induction on commencement of employment, and tasks undertaken during this time had been overseen by a senior member of staff, and signed off using a checklist system. We saw the services training matrix for 2009, which confirmed that staff are given update refresher and mandatory training according to their role and responsibilities. Staff spoken with confirmed this, and said that they received regular supervision via their line manager. Staff meetings are held wherever possible on a three monthly basis. Staff meeting minutes were available for us to view. Care Homes for Adults (18-65 years) Page 25 of 31 Care Homes for Adults (18-65 years) Page 26 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect. Further development of the quality assurance system already in place is needed. Evidence: The Annual Quality Assurance Assessment (AQAA) document which was completed by the care manager confirmed the following: The home manager is experienced in working with adults who have a learning disability. The manager is responsible for one other service situated next door. The management team operate an open door policy, and strive to promote fairness in all areas of the staff team. We value our staff team, and are aware that the service needs good staff to do well. Each service has Team leaders. We ensure that all service users are able to maximise their full potential, access the community, and lead a valued and varied life style. We ensure that all staff receive ongoing and regular training updates. We ensure that staff receive regular support and supervisions, and a yearly appraisal. We ensure that staff receive training to enable them to carry out their role, and obtain Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: good and sound knowledge. All staff have a personal development plan. We listen to staff concerns and deal with any issues as they arise. We ensure staff are represented through the Employee Council. The manager reported that she has completed the NVQ level 4, and the Registered Managers Award. We discussed the need for the care manager to be registered. The care manager is aware of the need to resubmit her application for Registration with the Commission for Social Care Inspection as soon as possible. We discussed the existing quality assurance system, and ways to improve this. This included feeding back the outcomes of surveys to staff and people using the service. It was evident from observation and discussion with staff, that the manager is extremely enthusiastic and committed to promoting peoples rights and providing a quality service. The manager understands the importance of person centred care and effective outcomes for people who use the service. Staff commented they feel valued and part of a supportive team and would have no hesitation in approaching the manager. People who use the service are well supported by the sensitivity, training, and experience of the staff employed by the organisation. Meetings for people who use the service, and for staff are held on a regular basis. People are encouraged and supported to speak out at meetings. There is evidence that the service has a thorough recruitment procedure in place. This evidence came from the staff we spoke with, and records we sampled. The ethos of the home was reflected in the policies and procedures, the records, attitude and competence of the staff in addition to comments received from the people who use the service. Peoples citizenship and their rights, are protected by the staff and the training that they undertake. The Annual Quality Assurance Assessment (AQAA) document, completed by the care manager, contained adequate information, and confirmed the improvements the service intends to make in the coming year. Care Homes for Adults (18-65 years) Page 28 of 31 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 29 of 31 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 1 37 The manager should submit an application to begin the Fit Person Registration process following satisfactory CRB clearance The manager should give consideration regarding how the service is quality assured, and the method of feeding back outcomes to the staff and people using the service. 2 39 Care Homes for Adults (18-65 years) Page 30 of 31 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. Care Homes for Adults (18-65 years) Page 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!