Inspection on 23/01/09 for Blossomwood

This inspection was carried out on 23rd January 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Blossomwood 08/03/07

Blossomwood 02/02/06

Blossomwood 14/10/05

Blossomwood 21/11/04

Blossomwood 22/06/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Blossomwood Colchester Road Elmstead Market Colchester Essex CO7 7AZ The quality rating for this care home is: three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ray Finney Date: 2 3 0 1 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 35 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 35 Information about the care home Name of care home: Address: Blossomwood Colchester Road Elmstead Market Colchester Essex CO7 7AZ 01206825510 01206825510 blossomwood@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Ramrup Bolaky,Mr Pelandapatirage Gemunu Susantha Dias Name of registered manager (if applicable) Mr Ramrup Bolaky Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 12 0 care home 12 learning disability Additional conditions: Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 12 persons) Date of last inspection 0 8 0 3 2 0 0 7 Care Homes for Adults (18-65 years) Page 4 of 35 A bit about the care home Blossomwood is near Colchester and Elmstead Market. You can walk to the shops in Elmstead Market. The home has rooms for 12 people to live there. The home has got cars that people can use. This means that the people who live there can get out and about easily. Care Homes for Adults (18-65 years) Page 5 of 35 There is one shared room. All the others are single rooms. There are large gardens that people can use. There is a Service Users Guide that the home can let you have. It costs between £727.00 and £1441.00 a week to live there. Care Homes for Adults (18-65 years) Page 6 of 35 An Expert by Experience joined us on the day of the inspection to talk to people. Experts by Experience are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use social care services. The term Expert by Experience is used to describe people whose knowledge about social care services comes directly from using them. What the Expert by Experiences thought can be read in the report. Care Homes for Adults (18-65 years) Page 7 of 35 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 8 of 35 How we did our inspection: This is what the inspector did when they were at the care home We looked at lots of different evidence for this report. We looked at paperwork like care plans, staff files and menus. The manager sent us information called an Annual Quality Assurance Assessment or AQAA. This gave us information about how they run the home. Care Homes for Adults (18-65 years) Page 9 of 35 We visited the home on 23rd January 2009. We looked around the home. We talked to people living in the home and staff. We looked to see if people were happy with what goes on in the home. Care Homes for Adults (18-65 years) Page 10 of 35 What the care home does well Listens to people and helps them to do the things they want to do. Staff are very good at helping people. Looks after peoples health and cares for them well. Helps people keep in touch with their families and friends. Care Homes for Adults (18-65 years) Page 11 of 35 Helps people get out and do lots of activities that they enjoy. People have comfortable bedrooms with their own things in them. What has got better from the last inspection Care Homes for Adults (18-65 years) Page 12 of 35 There has been some decorating. There has been some new furniture and carpets. What the care home could do better Care Homes for Adults (18-65 years) Page 13 of 35 Carry on making the paperwork better. Carry on making the decorating 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 Care Homes for Adults (18-65 years) Page 14 of 35 Ray Finney CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 15 of 35 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 16 of 35 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 . Through the comprehensive admission process people choosing to live at Blossomwood can be confident that their needs will be met. Evidence: The manager stated in the AQAA, Prospective service users, relatives and carers are offered on information Pack and they are given the opportunity to visit. Trial visits are arranged (daily, overnight and weekly) prior to admission. The information in the Service User Guide informs people clearly of the service they can expect from Blossomwood. Records examined show that people each have a copy of the Service User Guide in their personal files. There have been no new service users for a number of years but there is an assessment process in place. The assessment process is carried out by the management team, which consists of the manager and deputy manager. Through discussions the management team were able to demonstrate a solid knowledge of the importance of having a robust assessment process in place because of the complex needs of people using the service. Care Homes for Adults (18-65 years) Page 17 of 35 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 living in Blossomwood receive good quality care based on their assessed and identified needs. Evidence: The manager stated in the AQAA, Each service user has their own detailed and comprehensive Care Plan, within these there are priority and needs identified and Care plans and Risk Assessments are reviewed 6 monthly, we involve the Service user, their relatives and staff in this process. A sample of three care plans were examined on the day of the inspection. The care plans contained good detailed information setting out what staff need to do to ensure all aspects of peoples health, personal care and social needs are met. There are care plans in place covering communication needs, safety and risk, personal care, eating and drinking, mobility, recreation, expression of sexuality, wishes and worries, housekeeping, finance and physical needs. Relatives also play an important part in providing information that is used when Care Homes for Adults (18-65 years) Page 18 of 35 Evidence: developing the persons individual care plan. The sample of care plans examined had a family background that was written in good detail. The views of the individual are also recorded and include areas such as work, leisure, education, relationships and social skills. Records examined contained details of Care Plan reviews and minutes of review meetings, which ensures that peoples changing needs are reassessed and care plans are updated to take any changes into account. The manager stated in the AQAA, The home takes a person centred approach to all aspects of the care process. This enables and empowers service users to take as much control as possible. The care plans clearly state what the person wants and enjoys as well as what they do not want. One person had recorded, I dont want to go to the institute [local college] this year. Another person had said, I can communicate with other people. I enjoy being with numbers. In addition to recording what the person likes and does not like, how they communicate these likes and dislikes is also recorded, which ensures good understanding between staff and people in the home. Care plans also contain the views of the persons key worker. A member of staff who completed a survey stated, I am involved in updating the care plans. Staff spoken with on the day of the inspection were able to demonstrate a good awareness of peoples likes, dislikes, wishes and needs. A relative who completed a survey stated, Our [relative] is treated with dignity and respect and the staff go to great lengths to find out what [our relatives] views are and to give choices. There are a range of risk assessments in place covering individual identified risks. The assessments identify what the risk is, what are the implications for the person and the risk to others, what actions are taken to reduce the risk and a planned future strategy. There is ample evidence that people living in the home are encouraged and supported to be as independent as possible and that risks are minimised without limiting the individuals choice to be independent. One person has a risk assessment around running their bath independently. The person has stated that they do not want staff to check the temperature of the water as they feel this is taking away their independence and they are capable of checking the temperature themselves. Staff have ensured that the person understands that the thermometer in the bathroom is used to test the water before getting in the bath and knows what the maximum temperature should be. Observations during the day showed the interactions between staff and people living in the home were friendly and appropriate. A social care professional who completed a survey stated, From what I have observed I am confident staff are aware of equality, diversity and rights. Care Homes for Adults (18-65 years) Page 19 of 35 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living in Blossomwood can expect to enjoy a lifestyle that meets their wishes and needs. Evidence: The service has two vehicles so that people living there can get out frequently. The manager stated in the AQAA, Since we appointed a driver, it has made a big difference in allowing Service users to access a wider range of community based activities and education and service users have the opportunity to access a wide range of activities both in-house and in the community. A member of staff who completed a survey stated, A lot of activities are there for the service users. A social care professional who completed a survey told us, I feel Blossomwood provides a very person centred approach and excels at providing learning, employment and social opportunities for the service users in their care. Relatives who completed surveys also made positive comments about their relatives Care Homes for Adults (18-65 years) Page 20 of 35 Evidence: lifestyles. One said, They provide my relative with activities throughout the day giving them quite a good social life and another stated, They all have a summer holiday and a good Christmas party for staff, residents, relatives and friends. The Expert by Experience said, They showed me photos of the party they had at the home, where they invited all the friends and family of the residents. On the day of the inspection people were out and about to a variety of activities during the course of the day. There is a transport rota showing where people go including college, bowling, trampolining and college. People also attend Clubs and day centres including Jigsaw, Redhouse, Pathways, Gateway and Firs. A person living in the home who completed a survey stated, I like going to Red House. Records examined contained details of peoples individual daily routines and weekly activity programmes. There was evidence that people enjoy trips out to the pub and to social clubs. The manager stated in the AQAA that they have regular meetings and, everyone is given the opportunity to be involved in the running of the home. There is also evidence in peoples individual files that they are encouraged to get involved in the daily routines of the home such as changing their bed linen and cleaning their rooms where they have the capacity to do these day-to-day activities. The Expert by Experience said, One person told me that they cut the grass around the home and gets paid for it, I think that was brilliant. They also have a voluntary job that they go to during the week. The manager stated in the AQAA, We are working with Mencap in supporting a service user to have work experience gardening locally. Completed surveys and letters from relatives were complimentary about how their relatives are supported to maintain family links. The manager stated in the AQAA, Blossomwood promotes strong links with the families including visits, phone calls and letters. One relative said, I can phone the home or visit at any time and am always made welcome. Another said, we visit every 2 weeks and are kept informed by phone calls and We are always kept well informed on everything that relates to our relatives wellbeing. A person living in the home said, Sometimes I go to my parents. As previously reported, staff are very aware of peoples preferences around food. We saw on a tour of the premises that good home cooked food was being prepared for lunch and there was a range of fresh foods available. The Expert by Experience said, In the kitchen there was a list of what each resident didnt like so that the cook could give them something separate if needs be. Care Homes for Adults (18-65 years) Page 21 of 35 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 using the service can expect their personal and healthcare needs to be identified and provided with the support to ensure these needs are met as they would wish. Evidence: The manager stated in the AQAA, Peoples individual needs and how we support them are identified in the How we Care. Staff are to read, understand and follow these instructions. On the day of the inspection members of staff spoken with demonstrated a sound knowledge of peoples individual needs and wishes around personal care. A social care professional who completed a survey stated, I visit regularly and have never observed a breach in privacy or dignity and a relative who completed a survey said, The care at Blossomwood is second to none. Records examined confirm that peoples choices and preferences are taken into account when providing their personal care needs. The manager also stated in the AQAA, Individual care plans carefully consider race, gender, disability, age, religion and beliefs of each service user. Ethnic and cultural needs of individual service users are incorporated in the care planning process and Each service user has their own passport in their Care Plan, this is a summary of their life in pictorial form. Records Care Homes for Adults (18-65 years) Page 22 of 35 Evidence: examined confirm that care plans are individual and person centred. Each persons Individual Programme Plan identifies the need and the objective for the person and puts in a plan of action to achieve identified objectives. The manager stated in the AQAA, All service users have a section in their care plan to show they access the health services i.e. optician, GP, dentist, chiropodist and consultants. Documents examined confirm there are comprehensive records relating to peoples healthcare, which are completed to a good standard and are well maintained, including clinical notes and medical appointments. There was evidence that people are supported to access a range of healthcare professionals according to their individual needs, including doctors and consultant psychiatrist. On the day of the inspection a dentist came to the home provide treatment for one person and this treatment was provided appropriately and privately. There is a robust system in place for supporting people with their medication. The manager stated in the AQAA, All staff who administer medication have been re assessed and extra training given and personnel records confirm that staff have received training around medication. On the day of the inspection the storage of medication was examined and found to be appropriate. They have recently installed an additional Controlled Drugs cupboard that is strong and secure. Peoples records contained individual medication profiles that list what medication has been prescribed, how it is taken and any potential side effects to look out for. Medicines Administration Record (MAR) sheets were completed appropriately. The management team were able to demonstrate a good awareness of their responsibilities around supporting people appropriately with medication and were also able to show that they have worked hard over time to reduce the amount of medication that people need to take. A healthcare provider who completed a survey said what the service does well is, Provides up to date and accurate information at all times enabling us to dispense medication and provide medical care. Care Homes for Adults (18-65 years) Page 23 of 35 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 using the service can be confident that their concerns about how they are treated are listened to and acted upon as stated in the complaints and safeguarding procedures. Evidence: As at previous inspections, the service continues to have an appropriate complaints procedure in place. The manager stated in the AQAA, Staff and service users have been made aware we have updated the complaints procedure and it is available in easy read format with symbols. This is displayed on the notice board in each house. Records examined show there have been no complaints received or recorded by the home in the past twelve months. A relative who completed a survey stated, I have not had a need to raise concerns and another relative indicated that they knew how to make a complaint but never needed to. Minor concerns are dealt with as and when they arise. Discussions with the management team demonstrated that they take minor concerns seriously and act promptly on any issues raised. A relative who completed a survey stated, They take our views on board in all aspects of our relatives care and if we ever have any concerns we feel confident to discuss them with the staff, knowing that our relatives welfare will always be paramount. As reported elsewhere in this report, robust recruitment procedures are in place including police checks (known as Criminal Record Bureau or CRB enhanced Care Homes for Adults (18-65 years) Page 24 of 35 Evidence: disclosures) to ensure people working in the home are suitable to be working with vulnerable people. Members of staff who completed surveys confirmed that they have their CRB checks renewed. One person stated, 2 months ago I had a new CRB check after 3 years, another said, I have just had my CRB renewed and another I just had my CRB checked after 3 years. Additionally personnel records show that staff receive safeguarding training to ensure they are aware of how to recognise potential abuse or poor practice. Members of staff spoken with on the day of the inspection were able to demonstrate a good awareness of their responsibilities around recognising abuse or poor practice and reporting to the appropriate authorities. Care Homes for Adults (18-65 years) Page 25 of 35 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 can enjoy living in an environment that suits their lifestyle and which is well maintained and clean. Evidence: The manager stated in the AQAA that they have made a number of improvements to the environment in the past year including, New carpet throughout the Mainhouse. Bedrooms re-decorated. New bedroom furniture in both houses. All water thermostat controlled valves have been replaced. New radiator covers throughout and, In the report from Octobers inspection by the Essex Quality Monitoring team, we were praised for the standard of cleanliness, ongoing maintenance, decoration and the homely environment. They were happy with the new radiator covers and the water thermostat valves throughout. A tour of the premises showed a high standard of cleanliness throughout the home. Both laundry rooms were well maintained and contained equipment suitable for the size of the home and for the needs of the people living there. There were good quality furnishings both in the communal areas and in peoples individual rooms. The Expert by Experience said, Blossomwood was a very nice home, clean, tidy, colorful and spacious in the middle of the countryside. When they took us to look around the home, I was very impressed with all the signs. The rooms had pictures on the doors to show what was inside each room. There was a floor plan that showed who lived in each Care Homes for Adults (18-65 years) Page 26 of 35 Evidence: room. In the main living area there was a photo board of all the residents along with a photo of each staff member that was on duty at the time. I thought this was a good idea. Peoples bedrooms were well decorated and reflected their tastes and interests with ample evidence of personal possessions. The Expert by Experience said, The bedrooms were all very spacious and each room had its own sink. All had personal photos of their family. Someone living in the home who completed a survey stated, I like my room. The Expert by Experience said, I was concerned about one room that had two people living in there. I was concerned that they didnt have their own room, until I asked the manager and he explained that they have been together for 15 years and they choose to share a room and it upsets them to be apart. They did each have their own side on the room, one had their own trophies and the other their own artwork. Care Homes for Adults (18-65 years) Page 27 of 35 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living in the home can be confident they are cared for by a competent staff team who can meet their needs and who have been employed following thorough recruitment checks to ensure people are safeguarded. Evidence: At the last key inspection Blossomwood exceeded the key National Minimum Standards in much of the outcome group relating to staffing. Evidence examined at this inspection confirms that the service continues to improve in this area and both staff and management are to be commended for the high standard of care and support provided for people living in the home. The manager stated in the AQAA, We have a very low turnover of staff (none left in the last 12 months). There was a good response to surveys returned to us by members of staff and all contained positive comments about working at Blossomwood. Comments included, We have got well motivated staff, There is a very good team spirit, I am very happy working at Blossomwood, I am very happy working at Blossomwood and feel the staff team work well together with our mix of experience. On the day of the inspection a discussion with the management team demonstrated a commitment to valuing staff by supporting them to obtain National Vocational Qualifications (NVQ). All but one member of staff already has an NVQ award at either Care Homes for Adults (18-65 years) Page 28 of 35 Evidence: level 2 or level 3 and two people are working on level 4. A member of staff who completed a survey stated, I have just started my NVQ 4. A relative who completed a survey stated, I am confident that the care staff have all the skills required. Another member of staff who completed a survey stated, I keep up to date with new policies and guidelines regarding learning disabilities. Staffing levels in the home were seen to be good on the day of the inspection. Rotas show that there are five carers on per shift as well as the management team. There is also a cook and a driver employed on a full time basis. The management team explained that having a dedicated driver enabled the people living in the home to access a wide range of activities and enhance their lifestyles. Robust recruitment procedures are in place including police checks, also referred to as Criminal Record Bureau or CRB disclosures, to ensure staff working in the home are suitable to be working with vulnerable people. Personnel files examined were all maintained in good order and were well organised. All documents required by regulation were in place including proofs of identity, application forms with full employment history, two written references and CRB disclosures. The manager stated in the AQAA that improvements in the past year include an increase in the staff training budget and We purchased a laptop to aid staff with Training. There is a training and development programme in place that includes both in-house training and external courses. The training planner for 2008-09 was examined and shows that staff have received training that includes Care Planning, Epilepsy, Medication, Infection Control, the Mental Capacity Act and Assessing Mental Capacity. Personnel files also show that staff have had recent updates on Food Hygiene, Fire Safety, First Aid and Crisis Intervention. Additionally, as documented elsewhere in this report, staff receive safeguarding training (previously referred to as Protection of Vulnerable Adults or POVA) to ensure they are aware of the policies and procedures for safeguarding adults. A social care professional who completed a survey stated, I feel they are committed to improvement and development of staff. Completed staff surveys also contained positive comments about the training provided at Blossomwood. Comments included, Mandatory training and NVQ also available, Courses are provided in order to develop my skills and ability and There is good training for staff. Staff spoken with were well informed about peoples needs. On the day of the inspection staff were observed to interact well with people living in the home. Relatives who completed surveys were complimentary about how the staff team care for their relatives. One person said, Blossomwood staff are always helpful and we have always been most impressed with the staff. Another stated, Staff are professional, constantly training and seem to work well and get on together, which is an asset and adds to the smooth running of Blossomwood. Another relative said, It is a very happy home due to the dedication of staff and their constant efforts to keep up a high standard of care. Other comments from relatives include, The staff at Blossomwood are very caring and appear to have an innate understanding and concern for all the Care Homes for Adults (18-65 years) Page 29 of 35 Evidence: residents, The staff are very caring and supportive, When we visit the staff are always courteous and polite and answer any questions we have and The staff all appear to be knowledgeable and to know the needs of the residents very well. The Expert by Experience said, The staff seemed very friendly and the residents that we spoke to seemed very happy to live there. Personnel records examined confirm that staff have regular meetings, supervisions and appraisals so that their practice is monitored and training needs are identified, which ensures that people living in the home are supported by staff who have the skills and knowledge necessary to provide good quality care. Staff who completed surveys and staff spoken with on the day of the inspection made positive comments about how they are supported, including Six weekly supervision and yearly appraisal are carried out, There is regular supervision, We have regular house meetings and hand overs and We have regular meetings, house meetings, service user meetings and observation. Care Homes for Adults (18-65 years) Page 30 of 35 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is well managed in the best interests of people living there. Evidence: The manager, who is also one of the proprietors of the home, has been established in post for a number of years and holds a Learning Disability nursing qualification. He runs the home in close association with the deputy manager who has NVQ level 4 in care and has completed the Registered Managers Award. It was evident from our observations that they work together as a team whose skills complement one another. Both the manager and the deputy manager demonstrated a comprehensive knowledge of the needs of people living in the home. They also demonstrated that they have robust processes in place to manage the home. The manager stated in the AQAA, Our policies and procedures are updated yearly and records confirm this. Through discussions the management team demonstrated a commitment to developing and updating their skills and to keeping up with changes in legislation. The manager stated in the AQAA, Management team have attended MCA [Mental Capacity Act] courses provided by Essex County Council, now the MCA forms are being implemented for each person. Care Homes for Adults (18-65 years) Page 31 of 35 Evidence: The management team are committed to ensuring that the views of people living there and other interested parties are listened to and acted upon and there is a robust Quality Assurance programme in place to do this. The manager stated in the AQAA, Quality Assurance questionnaires are given to service users, families, professionals and staff. Quality Assurance questionnaire results were positive. Quality Assurance documents examined confirm that letters and questionnaires are sent to relatives, health and social care professionals and members of staff. The information from these surveys is analysed and collated into a report, which forms the basis of a development plan to make improvements to the service. A sample of records relating to health and safety were examined on the day of the inspection. The file is well organised with a checklist at the front recording when certificates were issued and the date they are due to be renewed. There was a Tendring District Council Environmental Premises Inspection certificate in place and a General Health and Safety Risk Assessment in place. We had a good response to surveys from people using the service, relatives, health and social care professionals and members of staff and all contained positive comments about the way the home is run. We also received a letter from a relative that was complimentary about the home. When asked what the service does well a relative responded, Everything as I see it and everything looks perfect. Another relative said, We feel Blossomwood feels like a family unit but also has the skills and experience to help in making our relatives day-to-day life normal. We cant praise them enough. A relative told us, I would like to take this opportunity of letting you know how highly we regard the provision at Blossomwood. Our relative has a really high quality of life there. Care Homes for Adults (18-65 years) Page 32 of 35 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 33 of 35 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 Care Homes for Adults (18-65 years) Page 34 of 35 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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