Inspection on 17/11/08 for Bidna House

This inspection was carried out on 17th November 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bidna House 15/01/10

Bidna House 09/10/07

Bidna House 20/11/06

Bidna House 18/09/05

Bidna House 09/06/05

Bidna House 28/10/04

Bidna House 15/07/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Honeybourne House

Extracts from inspection reports are licensed from CQC, this page was updated on 20/07/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Bidna House Bidna Lane Appledore Bideford Devon EX39 1NU 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: Susan Taylor Date: 1 8 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. 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 34 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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 34 Information about the care home Name of care home: Address: Bidna House Bidna Lane Appledore Bideford Devon EX39 1NU 01237470714 01237425842 info@caringchoice.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Simon Haywood,Mr David Anthony Haywood,Mrs Barbara Haywood Name of registered manager (if applicable) Mr Simon Haywood Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 12 12 1 1 care home 12 learning disability mental disorder, excluding learning disability or dementia Additional conditions: One resident to be accommodated over the age of 65 Date of last inspection 0 9 1 0 2 0 0 7 Care Homes for Adults (18-65 years) Page 4 of 34 A bit about the care home Bidna House is an older style house in Appledore. It is registered for up to 12 people with learning disabilities who live in a single bedrooms. The home is reached down a long private road. Fees charged range from £350 and £1250. Additional charges are made for certain activities, hairdressing, magazines and newspapers. A guide gives all the details about the charges that are made.. A bus route runs near to the home to Bideford and Westward Ho! Bidna House has a minibus, which is used all the time by people living there. Charges are made for some journeys like outings and events. No charge is made when a person needs to go to the Doctor for example. Care Homes for Adults (18-65 years) Page 5 of 34 Everybody who lives at the home has their own bedroom. Nobody has to share a room. Care Homes for Adults (18-65 years) Page 6 of 34 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 7 of 34 How we did our inspection: We talked to all the people who live at the home. We looked at some of the policies and procedures in the office. Policies are rules about how to do things. Procedures tell people how to follow the rules. We sent surveys that people filled in. The comments people made are in the report. Care Homes for Adults (18-65 years) Page 8 of 34 What the care home does well The manager finds out about people before they move into the home. This is so that the staff know what the persons needs are and how best to support them. Each person has a plan of care that is agreed with them. It is reviewed regularly with the person. This is so that the team make sure that they are meeting that persons needs. Care Homes for Adults (18-65 years) Page 9 of 34 People tell us that they like living at Bidna House. People tell us that they enjoy going out to see shows, fairs and carnivals and have a good social life. There are good policies and procedures that ensure people are safe and well supported. Policies are rules about how to do things. Procedures tell people how to follow the rules. Care Homes for Adults (18-65 years) Page 10 of 34 The staff do a lot of training. This means that they learn how to look after people properly. The manager checks that people at the home are happy and well cared for. People are listened to and know who to contact if they are unhappy. The provider will not allow people to be abused by anyone What has got better from the last inspection The guide for the home now tells people exactly what extra charges they have to pay for. Care Homes for Adults (18-65 years) Page 11 of 34 Records show exactly what people have paid for. 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 Care Homes for Adults (18-65 years) Page 12 of 34 If you want to speak to the inspector please contact Susan Taylor CSCI 4th Floor Colston 33 33 Colston Avenue Bristol BS1 4UA Telephone number 0117 930 7110 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 13 of 34 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 14 of 34 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 . Potential new people benefit from a good admission and assessment process, which ensures that the home can meet their needs. Evidence: Three care files demonstrated that comprehensive assessment information had been obtained from placing authorities. These had been reviewed since. Staff told us that the information had enabled them to get to know people when they first moved into the home. We tracked the experiences of someone that had moved into the home earlier in the summer when their previous home closed. The manager told us that normally they encouraged people to visit several times, staying for lunch and overnight. However, it had not been possible to do this because short notice was given by the placing authority and the person moved in within a matter of days. This had been a frustrating experience for both the individual and the provider as the placement had been made as a result of a new brokerage service being run by Devon Social Services. Given the circumstances surrounding the persons move records demonstrated that initially the move to Bidna had been a very unsettling time for them and was reflected in the Care Homes for Adults (18-65 years) Page 15 of 34 Evidence: behaviour they displayed initially. However, when spoke to this person and they said Bidna is great and felt settled living there. Whilst the team had little control over the persons admission, it was clear that they had worked with the individual to help them settle and feel at home living at Bidna House. Care Homes for Adults (18-65 years) Page 16 of 34 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 . People who live at Bidna House benefit from having regularly reviewed plans of care, which reflect their individual needs and choices. Evidence: We looked at the care files for 3 people to establish whether they had a care plan that had been discussed and reviewed with them and or their advocate. Peoples needs included individuals with epilepsy, communication, behaviour and mental health issues. The provider sent information to the Commission (AQQA) about improvements that had been made to the care planning system since the last inspection to ensure people had full access to the information kept about them. All the care plans seen had been regularly reviewed. The plans were person centred and in a format that made them accessible to the individual, in symbol format with simple language. Additionally, individuals personal preferences, routines and social activities had been recorded. The plans also outline the abilities of individuals to manage their own finances, travel independently and manage personal hygiene and what actions need to be taken to Care Homes for Adults (18-65 years) Page 17 of 34 Evidence: maximise their independence in issues relating to these. An assessment about a person with communication difficulties highlighted that pictures should be used to enable them to communicate their needs. We observed that this was being done with the person whilst we were at the home. These improvements ensure that people are fully involved in planning their care and will be able to refer to this themselves at reviews. 100 percent of people responding in a survey verified that they make their own decisions about what they do during the day, during the evenings and at weekends. We observed this to be the case whilst we were at the home. We looked at duty rosters that showed that additionaly staff were rostered to work at times when people were going out to places like clubs or outings. This means that people get the support they need to learn new skills and specific staff have the time to completely focus on the needs and wishes of individuals. 3 peoples financial records were examined. The provider told us that fees are paid into a business account from which money is transferred into individual accounts. We were shown statements for this account. People had their own savings accounts and we were shown statements for these. Balance sheets had been completed and were audited and found to be in order. Two signatures were seen on balance sheets denoting withdrawals. Receipts for purchases tallied with entries seen in the records. The provider told us that a qualified accountant audits the accounts. Additionally, records demonstrated that transactions are regularly audited as part of the organisations quality assurance processes. Since the last inspection, the provider had ensured that additional costs charge to people for transport are properly accounted for. Additionally, the costs which individuals can expect to pay for is publicised in the statement of purpose that had been reviewed and updated following our last inspection. The provider told us that these additional costs are for non medical or activities and no charge is made for hospital or GP appointments for example. We saw receipts that tallied with the entries and in turn, corresponded with outings that people living in the home had gone out on. The home had policies and procedures about risk assessment and management. In practice comprehensive risk assessments had been completed and were detailed. Each file clearly set out ways to minimise identified risks and hazards, whilst at the same time encouraged the individual to be as independent as possible. We observed that staff followed the measures set out. People were kept safe; whilst at the same time had freedom to do what they wanted to do. For example, we looked at the file for a person that has epileptic seizures. We met the person and support workers on the first day of the inspection when we went out with a group of people to the Breakaway club. The staff had a clear understanding of the persons emergency treatment and rescue plan and explained that they often had to follow it because the person tended to have more seizures when out. Both of the staff were knowledgeable about the persons condition and verified that they had had first Care Homes for Adults (18-65 years) Page 18 of 34 Evidence: aid and specific training about the management of epilepsy. They had ensured that the person wore a protective helmet as described in the individuals risk assessment and care plan. We observed that staff discreetly monitored the person, whilst at the same time allowed them to have freedom to enjoy themselves at the disco. Care Homes for Adults (18-65 years) Page 19 of 34 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 live at Bidna House are able to take part in activities that suit their needs and wishes and are supported to access the local community and maintain family and friends contacts. Evidence: On the first day of the inspection, we joined a group of 7 people who went out to the Breakaway Club in the evening. They were accompanied by 2 support workers. There was a lively atmosphere at the club with a disco underway. And people seemed to enjoy meeting up with their friends and told us they were having a great time. The following day we looked at daily records for 3 individuals and it was clear that people enjoy an active lifestyle. The daily records showed that people went on regular walks with dogs to different places in North Devon, went shopping to buy clothes and food, attended social activities such as playing, watching skittles and went to local specialist clubs such as Breakaway and Gateway. The home charges a fee for transport Care Homes for Adults (18-65 years) Page 20 of 34 Evidence: to these activities and at the last key inspection we asked the provider to ensure that this is made explicit in their information they give to people (the Statement of Purpose and Services Users Guide) and this had been done. Information that the provider sent to us verified that in the last 12 months, people have had the opportunity to go on 2 holidays to Butlins and numerous trips out to fun fairs, carnivals and theatre trips. Additionally, people have access to computer courses, art classes, a cookery course and drama groups run by the local college and Devon County Council. In a survey, 100 percent of people verified that they can do what they want to during the day, evening and at weekends. In the files we looked at we saw that people are in the process of discussing a document with their key worker entitled My Goals. This will ensure that peoples views about how they wish to lead their life is taken account of and that support is given to help them achieve this. People told us that they keep in contact with relatives. One person said they liked to visit their relations regularly and records demonstrated that they were enabled to do so. People had keys to their rooms. The type of key varied from keypad to star locks dependent upon the system most appropriate for the person. We observed that staff were respectful towards people and addressed them according to the individuals preference that had been recorded in their care file. People told us that they have unrestricted access to all communal areas, except the main kitchen for safety reasons. A copy of the menu for the week was displayed in the dining room. Photographs had been used to depict the options available for lunch on the second day of the inspection. People invited us to join them for lunch. We observed that people were offered a choice and second helpings at the meal. It was clear that peoples likes and dislikes had been taken account of when we spoke to the group about the meals. People made comments like I like cooking and told us that they have done courses at the local college. Records demonstrate that meals provided are varied and ensure there is a good nutritional balance for people. Care Homes for Adults (18-65 years) Page 21 of 34 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 . People are treated with dignity and respect. Bidna House has good systems for capturing medical information, which means that healthcare is individualised and takes account of peoples needs. Evidence: Plans of care gave details of how individuals personal and health care needs were met. 100 percent of healthcare professionals responding in a survey verified that the staff always and have the right skills and experience to care for people. Additionally, their comments verified that the team usually seek advice and act on it. Correspondence in care files demonstrated that other social and healthcare professionals, for example the Consultant for the Community Learning Disability Team have a lot of input into the care of people living in the home. This has ensured that personal and healthcare needs are regularly assessed and well met for people living there. We observed that staff were respectful to people and always knocked before entering a persons bedroom. In a survey 100 percent of people verified that they were always treated well by the staff. We tracked the assessment process for a person that has epilepsy. Records Care Homes for Adults (18-65 years) Page 22 of 34 Evidence: demonstrated that the person needs to be monitored closely to ensure that their safety is maintained during a seizure. Additionally, the assessment was detailed and provided staff with a clear picture of how the person would present if they were having a seizure, how it would progress and what treatment would be needed. An emergency and rescue plan had been written and gave good guidance about when staff should use prescribed treatment and when to involve emergency services. Staff verified that the rescue treatment could only be given by authorised staff that had undergone training. Mar charts verified that only authorised staff had given this medication as needed. We were shown a box that is used when the person goes out, which contained the rescue medication and observed staff taking this with them when the person went to the Breakaway Club. Information sent to the Commission by the provider verified that none of the people who live at Bidna House administer their own medications. We discussed this with the registered manager who explained that this is an area that they could support some individuals to achieve as part of the My Goals plan. Medicines were stored securely and records relating to when these had been given as prescribed to individuals where well maintained. Similarly, the registered manager verified that they do not have anyone on any controlled medications, but they were aware that should this change they would need to ensure that this is stored appropriately, i.e. double locked in a container secured to a wall. Care Homes for Adults (18-65 years) Page 23 of 34 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 . Peoples views are listened to and acted upon. Improvements have ensured that individuals are fully protected from possible financial abuse. Evidence: In a survey, 100 percent of people verified that they knew who to speak to and how to make a complaint if they needed to. We saw the complaints procedure prominently displayed on the notice board of the home. This had been updated to show the correct contact details of the Commission for Social Care Inspection (CSCI) and is in a total communication format making it more accessible to people living in the home. Information sent to the Commission by the provider verified that no complaints have been received since the last inspection. We spoke to 3 staff, all of whom had a good understanding of what constituted abuse and what they should do to report any suspicions of abuse. Training records demonstrated that staff have received training in the protection of vulnerable adults and policies are in place to ensure that any allegations are followed up. At the last key inspection, we reported that staff files did not have evidence of people being checked to see if they were suitable to work with vulnerable people i.e. POVA check prior to employment. This has improved, although we found that a POVA and CRB check had been done after a newly appointed staff member had started work at the home. We discussed this with the registered manager who had been unclear of the regulatory requirements as to the sequencing of pre-employment checks such as this. Care Homes for Adults (18-65 years) Page 24 of 34 Evidence: We recommended that the manager familiarise himself with the Commissions guidance Safe and sound? Checking the Suitability of new care staff in regulated social care services [available at http:/www.csci.org.uk]. Additionally, at the last key inspection we reported that changes were required to ensure that people are protected from abuse with regard to the charges made at Bidna House. The provider had ensured that additional costs charge to people for transport are properly accounted for. Additionally, the costs which individuals can expect to pay for is publicised in the statement of purpose that had been reviewed and updated following our last inspection. The provider told us that these additional costs are for non medical or activities and no charge is made for hospital or GP appointments for example. We saw receipts that tallied with the entries and in turn, corresponded with outings that people living in the home had gone out on. Care Homes for Adults (18-65 years) Page 25 of 34 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 . People live in a comfortable, well-maintained home that is clean. Evidence: Bidna House is a large detached house down a secluded private lane in Appledore. We toured the premises. On the Ground floor there are two large lounges and separate dining room, which far exceed the national minimum standards in relation to size. Since the last key inspection, new furniture had been bought by the provider that had been chosen by the people living in the home. The kitchen is large and separate to the dining room for health and safety reasons. We observed some people using the tea and coffee making facilities with varying levels of support from staff. For example, one person made hot drinks for everyone. People showed us their bedrooms, which reflected their individual tastes. One person said that they liked music and their room reflected these interests. Another person showed us their ensuite toilet and the nearest bathroom to them that was close by. 100 percent of people responding in a survey verified that their home was kept clean and fresh, and we also observed this to be the case. People told us that they have support from staff so that they can clean their own bedroom. Additionally, they told us that they were choosing new furniture for the dining room and we saw a brochure that people were looking at to do this. The accommodation is comfortable for the people that live there. Care Homes for Adults (18-65 years) Page 26 of 34 Evidence: Information that the provider sent to us verified that an audit using Essential Steps guidance [Department of Health] had been carried out. Additionally, 100 percent of the staff had attended training covering infection control management. The laundry was clean. Staff verified that there was a plentiful supply of gloves and aprons for them to use when delivering personal care to people. Safe systems were observed being followed with regard to separation of bed linen and clothing to maintain good infection control, whilst at the same time did not detract from some people being supported to participate in the process of doing their washing. Care Homes for Adults (18-65 years) Page 27 of 34 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Recruitment practices at Bidna are not robust and therefore fail to protect people living there. However, training and staff development ensure that competent and knowledgeable staff care for people. Evidence: We examined duty rosters for October and November 2009, which accurately recorded the names of staff, and duties that had been worked. Staff in a survey commented that staff shortages have been a problem but this has been addressed. The manager told us that the number of staff on duty had increased since the last key inspection. We observed that staff did not appear rushed and were attentive to people living in the home. At the last key inspection, we reported that staff files did not have evidence of people being checked to see if they were suitable to work with vulnerable people i.e. POVA check prior to employment. We examined records for 3 staff and 1 volunteer. Preemployment checks had been carried out properly in 3 out of 4 [75 percent] of files. Recruitment practices have improved, however we found that a POVA and CRB check had been obtained after a newly appointed staff member had started work at the home on 5/10/08 (verified by duty rosters). We discussed this with the registered manager who was unclear about the regulatory requirements as to the sequencing of pre-employment checks such as this. We recommended that the manager familiarise Care Homes for Adults (18-65 years) Page 28 of 34 Evidence: himself with the Commissions guidance Safe and sound? Checking the Suitability of new care staff in regulated social care services [available at http:/www.csci.org.uk]. Therefore, the recruitment practice was not robust enough to protect the people living at Bidna House. Information sent to us by the provider/manager tells us that 80 percent of staff hold NVQ level 2 in care and a further 27 percent are in the process of doing the NVQ level 3. In the 3 staff files examined, we saw that induction records follow the Skills for Care standards. Additionally, all of the senior management team have completed the Registered Managers Award ensuring that high quality cover is available when the manager is on leave. Training records demonstrated that staff receive a high standard of training and are working towards accreditation with the National Autistic Society. We spoke to staff during the inspection and was told that they had regular 1:1 supervision sessions with the manager and team leader. We looked at 3 staff files; all recorded that a recent supervision session had taken place. This was also borne out when we spoke to staff that told us they felt well supported by the manager and provider. Bidna House has been awarded the Investors in People Award, which demonstrates that the provider is committed to staff development. Care Homes for Adults (18-65 years) Page 29 of 34 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 . Bidna House is a well run home in which the peoples views are listened to and acted upon. Evidence: The registered manager has been in post for some years and holds the Registered Managers Award and NVQ Level 4 in care. Additionally, in the AQAA he has verified that he is in the process of doing a Masters Degree in Autism. 100 percent of Healthcare professionals in a survey verified that the service is well run. Therefore, people live in a safe place where their views are listened to. The provider gave the Commission a reasonable picture of the current situation in the service, in a document entitled AQAA (Annual Quality Assurance Assessment), which we received on time. The information provided was clear and enabled us to know what to focus on during the inspection. Additionally, it was clear that the manager and provider fully embraces quality assurance and puts the people living in the home at the centre of everything they do. At the same time, they were open about what they could do better and able to demonstrate continous improvement in various areas throughout the course of the inspection. Our main concern at the inspection has been that the Care Homes for Adults (18-65 years) Page 30 of 34 Evidence: recruitment procedure was not as robust as it should be to protect people living at Bidna House. We are confident that this will be addressed and audited in the future to ensure that this does not happen again. The certificate of registration was displayed in the hallway, which is a legal requirement. We also saw the public liability certificate, which was valid. We were shown a file containing Quality Assurance questionnaires. This contained questionnaires relating to quality assurance surveys carried out in 2008, including one relating to the Investors in People Award. A variety of people, such as residents relatives, care managers, general practitioners and friends. The questionnaires sought information about what the respondents thought about the management of the home, the social activities provided, the staff team and the environment together with a question about what might be improved. A separate questionnaire had been compiled for people to complete. However, this was not in a suitable format for learning disabled people. A recommendation is made with regard to this to improve the ways in which people living in the home are enabled to give formal feedback about the service they receive. Comprehensive Health and Safety policies and procedures were seen, including a poster displayed near to the office stating who was responsible for implementing and reviewing these. Staff we spoke to told us that they had been regular training. We were shown the induction pack and saw that completion of this had been recorded in the files we looked at. We toured the building and observed that cleaning materials were stored securely. Records of accidents were kept and showed that appropriate action had been taken. For example, two of the people whose care we tracked had had minor accidents and received first aid from qualified staff. The fire log was examined and demonstrated that fire drills, had taken place regularly. Similarly, the fire alarm had also been regularly checked. People living in the home told us that the alarm was regularly sounded. The provider told us that one person reminds them to arrange for the alarm to be checked and this is done weekly with the person. Certificates verified that an engineer had installed the fire alarm. First aid equipment was clearly labelled. Maintenance certificates were seen for fire alarm and electrical systems. The provider had verified in information sent to the Commission that a local electrician had inspected both the electrical system and appliances. Care Homes for Adults (18-65 years) Page 31 of 34 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 1 34 19 The home must ensure that 30/11/2007 all staff have relevant checks completed prior to working in the home. Care Homes for Adults (18-65 years) Page 32 of 34 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 1 34 19 The registered provider must 22/05/2009 ensure that people living at the home are safeguarded by ensuring that thorough preemployment checks have been carried out on all new employees prior to their commencement of duties at the home. This will ensure that people are protected and cared for by the right people. 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 39 Surveys should be in a total communication format so that people can use them independently to give formal feedback about the service they receive. Care Homes for Adults (18-65 years) Page 33 of 34 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 34 of 34 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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