Inspection on 13/11/08 for ANA Treatment Centre

This inspection was carried out on 13th November 2008.

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.

Other inspections for this house

ANA Treatment Centre 14/11/07

Similar services:

Flint House

The Ley Community

Yeldall Manor

21 High Street

Vale House

Chestnut Walk

The Old Vicarage

Cherwood House Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: ANA Treatment Centre Waterworks Road Farlington Portsmouth Hampshire PO6 1NJ     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: Richard Slimm     Date: 1 3 1 1 2 0 0 8 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: ANA Treatment Centre Waterworks Road Farlington Portsmouth Hampshire PO6 1NJ 02392373433 02392373434 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): ANA Treatment Centres Ltd Name of registered manager (if applicable) Janette Coulson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present alcohol dependence past or present drug dependence mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 29. 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: Past or present drug problem - D Past or present alchool problem - A Mental disorder, excluding learning disability or dementia - MD Date of last inspection Brief description of the care home ANA Treatment Centre is a residential treatment centre for drug and alcohol addiction. It is registered as a Care Home providing support and accommodation for up to 29 service users. The service is located in a residential area of Farlington about two miles Care Homes for Adults (18-65 years) Page 4 of 30 care home 29 Over 65 0 0 0 29 29 29 Brief description of the care home to the northwest of Portsmouth city. The property is a large two storey detached building with accommodation arranged over two floors, all but two of the rooms being for single occupancy. Communal areas comprise a large main lounge a quiet lounge that can also be used for meetings, two small group rooms and a dining room. There are bath/shower rooms and toilets on both floors. Outside at the rear is a large enclosed garden laid to lawn with fruit trees. There is a patio area and seating available to those who use the service. Off road parking is available at the side of the building. The service provides a rehabilitation programme, which is highly structured and includes various restrictions on peoples? freedoms. The manager states that weekly fees range from #450 and #550. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This inspection was, a Key Inspection, which is part of the regulatory programme that measures services against core National Minimum Standards. The fieldwork visit to the site of the agency was conducted over seven hours, where in addition to any paperwork that required reviewing we (the Commission for Social Care Inspection) met service users, staff and management. The inspection process involved pre fieldwork activity, gathering information from a variety of sources, surveys, the Commissions database and the Annual Quality Care Homes for Adults (18-65 years) Page 6 of 30 Assurance Assessment information provided by the service provider/manager. The response to the Commissions surveys was good, with nine service users returning surveys, prior to the report being written. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service and/or their representatives have had the information needed to choose a service that meets their needs. Evidence: The manager has stated within the AQAA that: Very clear and detailed statement of purpose and client handbook. Detailed assessments are made prior to referral to ANA by Drug and Alcohol Team (DAT) Care Managers. These are forwarded to us prior to our assessment with the prospective client. We undertake our own assessment, cross referencing to the care managers assessment and consequently reducing the impact of multiple repetitive questions on clients who are, often very unwell upon referral and admission. Our assessment documentation is clear, unambiguous and linked to Hamphires approved Common Assessment Tool (CAT). There are no unplanned admissions at ANA - we are not an open access service. Clients visit for in person assessments accompanied by family members and or care managers - these occur frequently and prospective clients are enjouraged to tour the facilities and spend time with the current client group before making their decisions. Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: During the fieldwork visit the manager had to take time out to faciliate a meeting with a prospective client, who in the company of a respresentative came to the service to look around, ask questions and provide additional information to the manager. Pre-admission assessment information is very clear and informative and as identified by the manager, via the AQAA, is obtained using the services own assessment and also professional assessments and information. It is obvious from the comments of people using the service, nine surveys were returned to us (The Commission), that people were involved in making the decision about using ANA, all nine people ticking yes in response to the questions: were you asked if you wanted to move to this service and did you receive enough information about this home before you moved in so you could decide if it was the right place for you. People also provided additional comments: I had literature and a visit before coming here, I visited ANA with my Community Psyciatric Nurse (CPN) prior to being to come here. I was given a tour of the premise and also fully discussed with staff the treatment programme here, which was really helpful, I had other choices but felt that ANA was the right place for me, it felt right, I asked to come to ANA because I knew how things go on here, its a safe place, I was given ANAs details, so I could look them up on the Internet. The final comment also reveals the flexibilty of the service when undertaking assessments: my phone assessment was very clear about policy and I was given all the information to make my decision straight away. 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. Individuals rights to make independent decisions about their lives are rigidly controlled, although they play an active role in planning and agrreing the support they receive, as part of a structured programme. Evidence: ANA provides a specialist service to people involved with drugs and alcohol and therefore the support provided is very controlled and structured, as the primary reason for attending the centre is rehabilitation. The services support documentation is maintained on a database, which the manager, support staff and counselling staff have access to. The care plans are very clear and concise and differ little, initially, from each other, which given the primary aim of the centre is rehabilitation is no surprise. However, the plans do evolve as the person progresses through the programme and as the counsellors amend and/or update the daily logs/records. Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: A review of three peoples records took place during the visit and these were found to be comprehensive documents, which provided information relevant to each stage of the persons rehabilitation, including where sanctions have been used to reinforce the purpose of the programme and to encourage reflection, on the part of the individual, on how their behaviours impact upon not only themselves but other people too. The rehabilitation programme is a twelve step theraputic process, which aims to promote for each person an acceptance and realisations that their actions have an impact, as stated above, not only on themsleves but also other people within society and that for each action there are consequences, the consequences not always obvious to them or to other people but no the less real and tangible. Outside agencies are involved in reviewing and contributing towards the support offered to people residing at ANA and the care managers are provided with a monthly evaluation, which involves the client. As stated above all activite information is stored using a computerised system, which is accessible to support staff and theraputic staff. Access to this information is restricted via passwords, each staff member having a unique identifier, which authorises access to the system and allows records to be updated accordingly. Within the centre there are a number of offices, each office is lockable when not in use and an paper based records stored within locked cabinets within those rooms. The centre has plenty of rooms, which can be used for one-to-one meetings, which ensure privacy and confidentiality throughout the session and guidance or policies and procedures are in place to ensure information shared during such sessions remain confidential. 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 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 make choices about their life style, although restrictions are agreed on accepting a place on the programme. Supported to develop life skills and participate in social, educational, cultural and recreational activities are arranged. Evidence: The manager states via the AQAA: Formal education, community involvement and freedom of movement is limited in Primary Treatment due to focus on recovery from drug, alcohol and gambling addiction. The range of appropriate leisure activities has been considerably extended and now also includes celebrating client Birthdays, Auricular Acupuncture and music therapy sessions. Increased relapse prevention and twelve step lectures and work shops have been introduced. Family links and visits are maintained within specified boundaries throughout treatment. The menus have been Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: extended to include up to five daily choices of evening meal that reflect lifestyle, dietary, cultural and religious preferences. All requests for specific meals are accommodated. The manager also states via the AQAA that: Improved living environment, diversified meal choices, more visit options; bowling, Farlington Marshes, Clients attending AA/NA Conventions, External agency partnerships, providing on-site courses for clients: Art Therapy, Digital Photography, Introduction to word processing. Options for gardening: created a flower garden and vegetable patch that are maintained by clients. During the fieldwork visit time was spent speaking to a visiting lecturer from Highbury College. The gentleman stated that he was in the home setting up a teaching session on digital photography, which he felt really benefited the client group and encouraged bonding and support between the client group, as peoples differing levels of ability often lead to interactions between the clients and to people with greater awareness or knowledge helping those with less ability or confidence. In discussion with the manager it was explained that as the clients progress through the programme they begin to have more contact with external communities, immediate family or locally, etc, although this is based upon their wishes/desires It was clear on reading through some of the records on the support plans, that people coming towards the end of the twelve step programme, were having contact with families, including home visits and outings. The manager also discussed how a group of the residents have become involved with the local church, explaining that they are escorted up to the church and again on the return from the service attended. This particular community contact has lead, recently, to the church making a harvest festival delivery to the home, which should be recognised as progress being made in building and maintaining community links. The comments provided by the service users provide a good indication of how the programme operates and how this influences their social activities, etc: We have AA and NA meetings four evenings a week but the rest of the evening is free, after 9 weeks you are allowed out without staff for 3 hours, into Portsmouth unaccompanied by staff but in groups of 3, days are pre-planned, evenings usually a meeting (4 days) weekends just one group in morning. Outside of this I can do what I wish on the premise, I can go out on occasions, Its called recovery and not what we want to do, after week 9 we are allowed out for 3 hours on a Saturday and Sunday and during Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: the day its very structured and at night, however, I feel that you have choice whether you keep to your boundaries. Support staff work across the twenty-four hour period and are available to help the resident group with in arranging activities and social events within the parameters of the premise, the evening before the fieldwork visit occurring a support work had assisted in preparing a quiz. During our time at the centre two people Graduated from the programme, whilst we did not wish to intrude upon the ceremonies arranged for these people, we did observe people attending the service, including fellow clients, staff and members of the peoples families. A visit was made to the kitchen and dining room during our look around the home, the kitchen is a practical and well set out facility, which can be accessed by the service users, when making breakfast, snacks or drinks and is used by the cook/staff when preparing main and evening meals. The dining room is a large communal area, which can accomodate all of the service users at the sametime if required, however, the manager stated that often people stagger when they eat and so often there are only small groups in the dining room at any one time. As stated in the AQAA a choice of main meal options is provided and a variety of snack foods available, for consumption. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health care and support that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: The people entering the centre and/or commencing the therapeutic programme, often require little assistance from the support staff with the delivery of personal care. However, the manager did state that on occasions the individual being admitted may not, initially, possess many personal items, clothes or toiletries, etc and therefore a small stock of communal clothing and items used for personal care are provided by ANA, until the person can be supported to build up their own possessions, etc. Peoples health care needs are well managed by the centre, with a General Practitioner working closely with the centre to monitor and attend to the clients differing health care needs. Additional community resources, district nurses, community psychiatric nurses, DAT members and generic care managers are also involved with the resident group were Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: necessary, whilst internally the manager provides nursing advice and guidance and the counselling staff the opportunity to address emotional wellbeing. Since the last inspection visit improvements have been made to the way the service manages and stores the medication of the service users, with a new facility and better storage introduced. The AQAA makes clear that: Due to the risks involved in allowing addicts to administer their own medication, this is not allowed at ANA, therefore the staff are required to dispense and administer residents medicines. Whilst visiting the medication storage area/room it was noticed that medication dispensed that morning were still in the medication cupboard, in pots, although it was early afternoon. In discussion it was ascertained that medications are dispensed by staff but it is the responsibility of the residents to come and collect their medications, if they do not come to collect these medicines they are returned to the cabinet, in case the person comes back later or until they are destroyed. The problem with this practise, however, is that it encourages secondary dispensing, one person dispenses the medicine and a second person oversees the administration, which if a mistake occurs leads to issues/concerns over responsibility and accountability for two staff. The service should review this practise and should also consider only dispensing a medicine once a person comes to collect it. A system for reminding people that they have to collect their prescribed medications should also be considered, as the centre has an obligation, when taking over control of a persons medications, to ensure they receive regularly prescribed medicines. 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. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse, and have their rights protected. Evidence: The manager states via the AQAA that: Complaints procedure in place and easy to understand by both staff and clients. It is linked to the Client Handbook and Client Charter and contains very detailed timescales. ANA also has in place clearly explained policies and procedures, explicitly linked to QUADS standands and benchmarked against local agency procedures that protect clients from abuse, neglect and self harm. The dataset, which forms part of the AQAA documentation, establishes the existence of the homes complaints and concerns procedure and that this was last reviewed in the July of 2008. The dataset also contains information about the homes complaints activity over the last twelve months: No of complaints: 0. No of complaints upheld 0. Percentage of complaints responded to within 28 days: N/A. No of complaints pending an outcome: 0. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: Information taken from the service users surveys indicate that all nine people are aware of how to make complaints, comments added to the surveys including: I can speak to any member of staff if I am not happy about something, keyworker or any staff, there is always a counsellor, peer or project worker about so this is very helpful and your mind at ease. During the visit the manager provide us with sight of the centres/staffs training files, which indicates that staff have completed protection of vulnerable adults training and have access to relevant policies. The home also tells us, via the dataset, that policies on the protection of service users Safeguarding adults and the prevention of abuse and Disclosure of abuse and bad practice, were reviewed last in the July of 2008. The dataset also establishes that over the last twelve months no safeguarding referrals have been made to the Local Authority, a statement support by a review of our database, which established that no alert has been brought to the Commissions attention during this period. During the fieldwork visit the manager produced the minutes of a recent meeting with the Local Authority, which indicated that the protection concerns had now been resolved. 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 physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment. Evidence: We had a look around the premises in the company of the manager. The home was noted to be clean and tidy throughout and the general decorative state of the home good. The premise offers single occupancy accommodation only, large communal areas, single sex toilets, comunal bathrooms, a laundry and rooms used for theraputic sessions. The manager states via the AQAA: Maintenance of physical environment. Building fully repainted (internal) in last two months. Fixtures and fittings updated and replaced. Clients are responsible for undertaking their own laundry, as part of the life skills programme. All facilities are provided and maintained by Fleming House. Hygiene and health regulations are fully complied with. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: The AQAA is also used to identify that the centre has introduced: Accommodation for a wheelchair users, with self mobility. Feedback obtained from the surveys indicate that the service users find the accommodation to be satisfactory, clean and fresh, with people making comments such as: no complaints and it depends on which peer is doing the cleaning. Hallways and toilets always clean. In discussion with the manager it was ascertained that the service users undertake some domestic duties, cleaning their bedrooms, laundry, cleaning communal areas lounges, bathrooms, etc. Cleaning duties are also used as punishments when the service user breaches the boundaries of the programme, written notice of the offence, the punishment and timescale of the punishment are provided to the service users. 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. Staff in the home are trained, skilled and provided in sufficient numbers to support the people who use the service. Evidence: The manager states via the AQAA that: All ANA staff work well with our client group and put the well being and recovery of clients before anything else. Staff training has been extensive since registration and continues to be. All staff roles are clearly defined and laid out in job descriptions. ANA ensures that staff are qualified in their respective fields or are working towards such qualification. These include counselling certificates and diplomas, NVQs in Social Care and alternative treatments, such as Auricular Acupuncture, in addition to non accredited training in specific areas such as handling medicines, induction, lone worker training and understanding mental health. Whilst reviewing staff files records were seen that confirmed staff attendance on training and development courses and staff on duty discussed attendance of local colleges to completed both National Vocational Qualifications (NVQs) and also Counselling courses, one of the staff spoken with being a student counsellor working at the centre. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: The dataset also identifies that eighteen staff have completed medicine administrations training, three people have complete courses on nutrition and food hygiene and that all eighteen staff have completed an induction to skills for care standards. Information taken from the dataset indicates that there are eighteen staff working at the centre. Eleven of the eighteen staff have completed a National Vocational Qualification (NVQ) at level 2 or above and this gives the home a percentage of 61 of its staff possessing an NVQ at level 2 or above. Further information contained within the dataset establishes that a recruitment and selection strategy/procedure exists to support the management staff when employing new staff. It also indicates that all of the people who worked in the home over the last twelve months had undergone satisfactory pre-employment checks. On reviewing the files of two newly recruited staff all of the required checks were in place, Criminal Records Bureau (CRB) checks, Protection Of Vulnerable Adults (POVA) checks and two references. The files also contained completed application forms, health declarations, photographs of the employee, interview summaries, personal information and information used to support the CRB application process. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. Evidence: The AQAA states that: The Registered Manager has achieved her Registered Managers Award (RMA) and has a full job description to guide her in her role. The fieldwork visit established that the manager has introduced a number of management tools into the service to ensure the smooth operation of the centre, these tools including: Group or Community Meetings, supervision sessions for staff. The AQAA also indicates that the manager has been in post and overseen improvements to: care planning and external agency involvement, formalising links with other agencies that can enrich clients lives, improvement of therapeutic inputs, broadening of leisure activities, improvement of the living environment, further involvement of clients in recruitment activities, quality assurance review. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: The manager is supported in her role by one of the provider organisation Directors, who has an office on site, as does the provider organisations financial manager, who also ensures he is accessible to the service users. People spoken with during the day praised the manager for her performance, attitude and dedication to the role, one person describing the manager as the mother figure that keeps everything running. The AQAA states that: We actively seek feedback from clients on a weekly basis – this is necessary as all of our clients are short term, staying up to twelve weeks. This occurs in weekly community group, through non therapeutic 1-2-1 sessions that occur on a fortnightly basis and through staff supervision. Peoples records are updated on a daily basis by the therapeutic and support staff and a thorough handover takes place at each shift change, to ensure all on-coming staff are aware of any changes in a clients programme. Surveys and questionnaires are available to the manager and these are used as part of the centres quality auditing programme, the AQAA describing the Quality Assurance programme: The quality assurance system at ANA is based on the EFQM Model. It allows for results of staff supervision, client feedback, training and benchmarking to be fed into the quality cycle. The ANA development plan is built around this and is written down, with specific responsibilities to be allocated to the relevant staff / staff teams for execution. The service tells us, via the AQAA and dataset that health and safety policies and procedures are made available to the staff and that domestic appliances and personal equipment is regularly maintained and serviced. The AQAA is also used to inform us that: ‘Personal protective clothing is provided to staff and that COSHH materials are appropriately stored’, both comments were substantiated during the visit. Health and safety training is being made available to staff, with the staff files providing evidence of the training completed by staff: food safety, etc. The look around the premise identified no immediate health and safety issues and each communal facility was noted to contain paper towels, liquid soap and waste disposal bins. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: No concerns regarding the management of the home or issues of a Health and Safety nature were raised by the service users via the surveys. 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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