Inspection on 18/02/09 for Baytree House

This inspection was carried out on 18th 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.

Other inspections for this house

Baytree House 05/03/08

Baytree House 04/12/06

Baytree House 03/01/06

Baytree House 11/07/05

Baytree House 25/01/05

Baytree House 05/08/04

Baytree House 24/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Baytree House Torbay Council 22 Croft Road Torquay Devon TQ2 5UE 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: Michelle Finniear Date: 1 9 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. They reflect the things that people have said are important to them: 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (20092008) 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 29 Information about the care home Name of care home: Address: Baytree House Torbay Council 22 Croft Road Torquay Devon TQ2 5UE 01803211300 01803380164 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) : Torbay Care Trust care home 10 Number of places (if applicable): Under 65 Over 65 10 0 learning disability Additional conditions: Service Users aged 16 or 17 years may also be admitted. Service Users with Learning Disability who may have additional Physical Disability and/or Sensory Impairment. Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 29 A bit about the care home Baytree House offers short-term breaks, and a longer-term assessment service for adults and younger people aged between 16 and 18 years old with learning disabilities. Some people may also have additional physical or sensory impairments. There is a large dining room, lounge, activity room, bathrooms, showers and toilets. There are bathroom facilities adapted for disabled people, and there is wheelchair access throughout the house, with a passenger lift giving access to the first floor and to all but three bedrooms. A Home Based Breaks service is also based within Baytree House, which the manager oversees. This is a small additional outreach service, providing staff, who support clients for a short period of time within their own home setting. They do not provide personal care as a part of this service and so are not registered. Baytree House is situated near Torquay town centre within walking distance of the shops, amenities, beaches and attractions. There is also access to train and bus routes nearby. The current weekly fee at the home is 946.99 pounds per week . The management keeps the inspection report within the homes communal hallway where it is easily available to all. Care Homes for Adults (18-65 years) Page 5 of 29 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 Care Homes for Adults (18-65 years) Page 6 of 29 How we did our inspection: This is what the inspector did when they were at the care home We read information we were sent about the home and sent questionnaires to people who stay there and staff who work there. We visited the home twice, one time with an Expert by Experience who is a person with a disability who has experience of using services like this. They told us what they thought about Baytree House, which is in this report. We talked to people who were staying there and the people who worked there. We looked at the records they keep about people and how they run the home. What the care home does well People who stay at Baytree House have a say in the way the home is run. People can make choices about what they do and eat when they are there. The staff and manager value people with a learning disability and respect their rights. People said the staff listened to them. The expert by experience said The home has a relaxed feel and the staff are polite Care Homes for Adults (18-65 years) Page 7 of 29 and respectful. The staff have very good interaction with people staying there. I feel the staff are very person centred in everything they do. If I needed to have respite care I would choose this home. What has got better from the last inspection Since the last Inspection the home has: Made sure assessments are carried out before people move to the home. This is to make sure the home can meet their needs. A new medication cupboard has been ordered. This keeps peoples medication safe. Staff have been trained in what to do if they suspect people are being abused. Peoples money is being kept safely. Hot water is being checked to make sure people cannot be injured. Window openings are being restricted to ensure people cannot fall from them and be injured. There are enough staff to look after people. Staff records are being kept at the home. People know they need to tell us if anyone Care Homes for Adults (18-65 years) Page 8 of 29 is hurt or anything happens that puts people at risk. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Michelle Finniear 33 Greycoat Street London Care Homes for Adults (18-65 years) Page 9 of 29 SW1P 2QF 02079792000 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 10 of 29 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 11 of 29 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 is available to help people decide if the home is the right place for them. Full assessments are completed to make sure the home can meet peoples needs. Evidence: Baytree House provides a respite and assessment centre for people with a learning disability. Information about the home is provided in a guide which has symbols and pictures to help people understand what is provided and what people can do when they are at Baytree House. There is also an easy to understand contract which explains any rules about staying at Baytree House and what the home expects from people who stay there. Copies of this could be seen in peoples files. The staff said they try and make sure that people can have the same room every time they come to stay, which helps people to feel at home. The Expert by experience who came on this inspection said: I was shown a document called All about Baytree House (A service Users guide). I looked at the guide. It gave the service users an overview of the home. It is written in easy English with pictures. The staff go through it with each service user when they first arrive. I found it accessible and easy to understand. This shows they look at the needs of the Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: users not just the service. No one goes to the home for respite unless they have first visited the home to see if it is suitable for them. Most people come to stay at Baytree House for a short period of respite care or for assessment. This might be for a break from their families or so that they can be helped learn new skills. The home is developing a new small unit where people can follow a programme which helps people to learn how to be more independent. People are fully assessed before they come to the home. This means that staff look at what support people need when they come to the home and how they like to spend their time. They talk to people and their families (If people wish) about their healthcare needs and about any medication or special help they may need, for example with Epilepsy or their diet. This helps to keep people well. Assessments also help to make sure that the home can meet peoples needs, and that the home is the right place for them. If people need to come to the home in an emergency the homes staff make sure that a full assessment is carried out as soon as possible. The staff have been working on a new assessment which makes sure that all of the persons needs are assessed in one document. People (and their families if they wish) can go and visit the home to help them make a decision about whether they would like to have a break there. One of the times we visited there was someone who had come to have tea at the home and to have a look around. If people usually go to day centres during the day they can still do that while they are staying at Baytree House. Care Homes for Adults (18-65 years) Page 13 of 29 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. Peoples support needs are recorded and reviewed. Peoples rights are respected. Evidence: Each person who stays at Baytree House has a care plan. This tells staff about the support they need, and how they like to spend their time. Plans could contain a bit more information about what people can do well and on their social and personal histories. Some people have life story books which they are making with staff at Day centres and Baytree House. These are very good and show staff about what people do when they are not staying at Baytree House, and have pictures of people that are important to them. Some parts of the care plan are available in an accessible format, with pictures and symbols to help people understand what they say. People who work at the home have developed a new plan which is better for the people who stay at Baytree House. People are able to take some decisions about their lives and we talked with the manager about some of the times when people are not able to do what they want to do all the time. This might be because they are not well or have to follow a special diet that they do not enjoy but keeps them healthy. The staff at the home try hard to make Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: sure people can have as much of a say as possible. They understand about peoples rights. When we watched them talking to people staying at the home they helped people make choices for themselves. People who stay at Baytree House are invited to have a say about the home. They have a special evening when people can come and have their say about the way the home is run. This evening is run by people outside of the home and support is available to help people have their say about what they like and what the home could do better. The home has risk assessments which look at the risks people take and see if there is any way the risks can be reduced. Risk taking is important sometimes as it lets people have new experiences and learn new things. Risk assessments help that happen safely. Care Homes for Adults (18-65 years) Page 15 of 29 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 can continue with their lives and chosen routines while staying at Baytree House for a short while. Evidence: People who come and stay at Baytree House do not usually live there. Most people come and spend a short time there; some people visit for one night a week and others might only come for a weekend every couple of months. Some people however have been at the home in an emergency bed for several months wairting for a new placement to be identified, or undergoing a specialist assessment. It is not ideal for people to be in an environment where different people are staying there almost every night. The staff at the home understand this and try hard to make sure that the people that have lived there a long time have space to have some quiet time to themselves and access to staff time on their own. People who stay at Baytree House mainly attend day centres from their own home and still do when they stay at the home. When they are at the home there are lots of things for people to do. On the evening we were there people were watching Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: television, playing with a wii, playing games with staff or reading papers. Some people also chose to spend time in their rooms. The home tries to make sure that people have the same room every time they come so that helps them to feel at home. Baytree House has a mini bus so people can go out on trips as a group if they want to. We shared an evening meal with the people who were staying at the home. People have a choice of what they want to eat, and staff eat with people so they can support them discreetley if needed. We had a choice of Homity pie and salad or sausages, fried onions, beans and mashed potato with ice cream for dessert. The meal was very nice and was served in the dining room so that people could choose what they wanted when they saw everything available. People can have special diet if they need them and the home keeps records of what people can or like to eat. The Expert by Experience said The home has a very relaxed feel to it and the staff are friendly and respectful to everyone who comes to the home. People can get a hot or cold drink when they want to. There wasa good choice of food. The service users can choose what they want unless they have special dietary needs which are catered for. The food is served from a trolley not already plated up. People have a choice of soft drinks, tea or coffee. They have meetings with the cooks where they can choose the things they want to eat. There was a lot of lively and friendly banter between people and staff at the tables. The service users have a games room with things like a snooker table, air hockey table, various board games and jigsaw puzzles. I was told by the manager that the home puts on various events which help them raise funds which can be used to buy things for the home. There are regular meetings with the manager and staff to talk about things like any problems they have and things to do with the home. At the last meeting it was agreed to set up various night things like Arts and Crafts, Music and Pub nights. Care Homes for Adults (18-65 years) Page 17 of 29 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. Peoples healthcare needs are addressed. Evidence: The people who come and stay at Baytree House have a variety of needs for support. Some people have a milder learning disability and some people have more complex physical disabilities and health conditions which might include epilepsy or diabetes as well as more severe learning disabilities. The homes staff have told us that they try to make sure that the people in the home on any given day are able to mix well and get on with each other. The support plans contain information on peoples health needs and the manager is currently gathering more information from families on peoples past and current health so that they can make sure that they have all the information they need to care for people. Staff have had some training in specific healthcare needs and there are some nurses who work as a part of the staff team. However the home does rely quite a lot on agency staff. The home manager makes sure that the staff who support each person have the individual skills they need for example this might mean being trained to use emergency medication for epilepsy. This could be seen during the time we spent at the home. Peoples plans record any needs that they have for nursing care. As an example if a Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: person needs to have Insulin or specialist dressings carried out then a district nurse would be arranged to visit the home and provide this care. Some people have needs such as Oxygen or other non-invasive procedures, and the manager said that staff have received training in how to carry out the care needed and are confident to do so. One person who completed a questionnaire felt that staff needed more medical knowledge. Others felt care needs were being met. Protocols are in place for the use of specialist medication, which indicate exactly when this should be used. Staff carry this medication with them at all times when working with people who may need this in an emergency. Other aspects of medication administration seen were good, with staff being seen giving out medication sensitively and safely. New storage is on order for medication, as the current storage is not ideal. Baytree House has equipment available to support people while they are at the home. This includes some specialist beds and mattresses and hoists. Care Homes for Adults (18-65 years) Page 19 of 29 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 are protected by the homes policies on complaints management and prevention of abuse. Evidence: The home has a complaints procedure that is available in an accessible format. This helps people to understand what to do if they are not happy about something at the home and want to make a complaint. It tells them what will happen if they do, and gives the names of people to complain to. Since the last inspection the home has not had any formal complaints made. People spoken to said they knew what to do to make a complaint. Each member of staff is due to have training in adult protection and the Mental Capacity Act in March. This helps staff understand about what abuse is and what to do about it. It also helps ensure they understand peoples rights. There are policies and procedures for staff on what to do if they are worried about abuse. There is a whistle blowing policy which tells staff how to raise concerns outside of the organisation if they need to. Care Homes for Adults (18-65 years) Page 20 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment is safe but would benefit from some updating and improvements to decor. Evidence: When we visited the home we looked round all of the bedrooms, gardens and communal space. We also looked at the kitchens, bathrooms, laundry and other service areas. Baytree is an older building in a residential and holiday area of Torquay, close to the town and the sea front. There are gardens to the front of the home with seating areas and some parking in the grounds. There is one ground floor bedroom with others being on the mezzanine and first floor. The home has an annexe with two bedrooms that will be used for specialist assessment and reablement work. Some of the accommodation is looking tired and in need of refurbishment. This includes communal areas and bedrooms. Bathrooms and toilets are provided on each floor and there is a shower table for people who need more support. All areas of the home seen were clean, warm and comfortable. Every effort is made to make sure that people can have the room of their choice when they come to the home for respite care. One person at the home for a longer term assessment was using Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: accommodation in the annexe. This allowed them to get away from people and have some quiet space to themselves if they wished. The manager has plans to improve the accommodation and funding is allocated. This includes new furnishings. Comments received from people who completed questionnaires confirmed that the home was kept clean and tidy but that some work was needed to improve the decor and furnishings. The expert by experience who assisted the Inspection said: I was shown round the home by the manager. There were lots of pictures of service users doing various activities. All the service users have their own rooms. Each room has a sink with hot and cold water. They all have TVs in them. Some of the rooms look a bit bare because the service users only stay at the home a short time. The service users who stay longer do have personal items in their rooms. There are bathrooms with toilets on each floor. No service user has a bath or shower without a member of staff being there. There are also separate toilets at the home. The service users have a games room with things like a snooker table, air hockey table and various board games and jigsaw puzzles. The home also has a wii game which any of the service users can use. Some of the service users are tidying up the games room and a lots of the games and things are rather old. The home has had a recent infection control audit which helps to identify any areas where there could be a risk of cross infection. There are also risk assessments for the general environment, which covers areas such as hot water temperature monitoring and window restriction. Water temperatures are being recorded regularly which helps to ensure that the automatic regulators are working. This helps to protect people from the risk of scalding. Care Homes for Adults (18-65 years) Page 22 of 29 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. Staffing arrangements are satisfactory however some training is needed as a priority to ensure people can be supported in safety. Evidence: When we went to the home we looked at how the home recruits new staff and looked at some staff files. We also looked at the training they receive and on how the home supports them through a programme of supervision. We observed how the staff related to and supported the people who were staying there and we looked at the numbers of staff on duty. The expert by experience said The home is run like a family home with carers involved. This is a good thing to do as it makes it feel very homely not institutionalised. The home has a very relaxed feel about it and the staff are friendly and respectful to the service users and everyone who comes to the home. Staff are very person centred. Staffing levels at the home are dependant on the number and needs of the people accommodated. This varies from day to day. Some people need 1:1 staffing and on the day of the visit this meant that some agency staff were on duty, as two people staying needed 1:1 staffing. These staff although from an agency, knew the people at the home well and updated themselves as they came on duty by reading peoples case files. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: The staffing levels seen throughout both visits were set to take into account peoples needs and wishes. The manager confirmed there have been some staffing issues but the home is recruiting staff and is looking at consulting on more flexible ways of working. Staff files seen showed a full recruitment process is followed when staff are empoyed. This includes the taking up of references and criminal records bureau checks. These help to ensure that people are protected from being cared for by people who might be unsuitable to work with potentially vulnerable adults. Staff at the home are being supervised regularly. This helps to ensure they feel supported in their work, are working consistently and to their full potential to support people. Staff spoken to felt they were supported and received training to help them do their job. One person wrote Although I have had a 2 week Induction period I was consulted before being left alone to do my job. I also have the extra support from all of the staff team to ensure I am doing my work in the right way. Induction can last 3-6 months so I should have enough time to learn all I need to. People using the service felt that staff listened to them and treated them well. One person said the staff were Always happy to listen to me. Staff worked well as a team. People with disabilities on the staff team are supported and valued well. The home has adequate numbers of support staff such as cooks and cleaning staff on duty. Some staff training is needed to ensure that all staff have received current training in core areas such as first aid and moving and handling. These are essential for staff working directly with people who may be particularly vulnerable to injury. One person who completed a questionnaire felt that staff needed more medical knowledge and training in Autism. Care Homes for Adults (18-65 years) Page 24 of 29 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 home is being well managed. Evidence: The service manager of the home is newly appointed and has told us her position is not permanent at this moment in time. She has a lot of experience of managing services. The registered manager is not working at the home. The service manager, Julie Callaghan has been working hard to make sure that the systems for managing the home are working well to support people. While the registered manager has not been at the home the two assistant service managers have done a very good job keeping the unit running well and ensuring that people can still receive a good service from Baytree House. Management from the Torbay Care Trust have recommended the monthly provider visits for the home. These should be carried out every month as a minimum. They help to make sure that senior management know the home is running well and that staff feel supported. Baytree House has a system for making sure that the home is working well and that people who use the service can make changes to the way the home is run to make it better. This is called Mapping Excellence. People are invited to come to the home for a fun evening where independent advocates are there to help people fill out questionnaires about the home. This information is used to write a development plan Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: for the home which includes peoples comments on what is working well and what could be improved. Previously people have said for example they would like televisions in the bedrooms, they would like more activities, handrails in the bathrooms and some redecoration. These have all been done or are planned to be done soon. Peoples health and safety needs were being addressed. The home has regular audits to check that the home is safe for people to stay and work in. Equipment is serviced regularly to make sure it is safe for people to use, and the fire system is being tested. A new system has been installed and the home were waiting for the old one to be removed to reduce any confusion. Incident reports are audited and this led to a recent referral to the falls co-ordinator to make sure that people had the equipment they needed to reduce the risk of falls. Seniors at the home do weekly health and safety checks and a monthly review is completed by the manager. This helps to ensure the home is safe. Clinical waste is stored outside of the home and there is equipment available to help people manage any risks of cross infection. Risk assessments are being updated regularly. Safety information is written in a symbol format where necessary so that people living at the home can understand it. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes  No  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 27 of 29 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 Description 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 Description 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 6 Care plans would benefit from a greater emphasis being placed on peoples skills rather than the support they need. Also plans could contain more information on peoples personal and social histories. Staff should all receive core training as a priority. This is to ensure people can be supported in safety. The monthly provider visits need to be carried out consistently. This helps staff to feel supported and helps management to be aware of any issues at the homes. 2 3 35 41 Care Homes for Adults (18-65 years) Page 28 of 29 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). 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